Outbreak of Staphylococcal Food Poisoning in a School - Tainan County

1987 Vol.3 NO.2

Correspondence Author:


On October 17, an outbreak of gastroenteritis occurred among students in an elementary school (enrollment 3.264) in Tainan County . Students became ill approximately 2-5 hours after eating lunch. About one third of students ate commercially prepared lunch boxes: the remainder ate lunch boxes brought from home. All cases of gastroenteritis occurred among students who ate lunch boxes supplied by one company, Company A. Of 283 students who ate Company A`s lunch boxes. 98 (34%) were ill. Symptoms included vomiting (74%), abdominal pain (60%). headache (48%). diarrhea (47%), and fever (24%). Lunch was served from noon to 1 00 pm. and onset of illness occurred from 2:00-6:30 pm with a median incubation period of 3.5 hours (Figure 1). Twenty stool and four vom-itus specimens from ill students were all negative for Salmonella, Singella. and Vibrio species. Vomitus specimens were discarded before confirmatory tests for Staphylococcus aureus could be carried Out. Fifteen stool specimens from ill and 15 from well students were also tested for Bacillus cereus; all were negative. Questionnaires were sent to all students who ate lunches boxes from Company A. To identify the suspect food vehicle in this outbreak, food exposure histories were compared for ill and well students who ate Company A lunch boxes. For this part of the investigation , a case of gastroenteritis was defined as any student who ate a Company A lunchbox on October 17 and developed two or more major symptoms (abdominal pain, diarrhea, or vomiting), or one major plus two minor symptoms (fever. headache. dizziness. or abdominal fullness).