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KMID : 1137920180430040258
Journal of Agricultral Medicine & Community Health
2018 Volume.43 No. 4 p.258 ~ p.269
Epidemiological investigation on the outbreak of foodborne and waterborne disease due to Norovirus with delayed notification
Ha Mi-Kyung

Kim Hyeong-Su
Kim Yong-Ho
Na Min-Sun
Yu Mi-Jung
Abstract
Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June 5th but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification.

Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June 2nd to June 12th. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus.

Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef)

Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.
KEYWORD
Epidemiological investigation, Outbreak, Waterborne and foodborne infectious disease, Norovirus
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