Original Research

Salmonella food-poisoning outbreak linked to the National School Nutrition Programme, North West province, South Africa

Thejane W. Motladiile, John M. Tumbo, Adrien Malumba, Bolaji Adeoti, Nozizwe J. Masekwane, Oleteng M.R. Mokate, Otsile C. Sebekedi
Southern African Journal of Infectious Diseases | Vol 34, No 1 | a124 | DOI: https://doi.org/10.4102/sajid.v34i1.124 | © 2019 Thejane W. Motladiile, John M. Tumbo, Adrien Malumba, Bolaji Adeoti, Nozizwe J. Masekwane, Oleteng M.R. Mokate, Otsile C. Sebekedi | This work is licensed under CC Attribution 4.0
Submitted: 29 May 2019 | Published: 04 December 2019

About the author(s)

Thejane W. Motladiile, National Institute of Communicable Diseases (NICD), Johannesburg, South Africa; and Division of Public Health, Surveillance and Response, Provincial Department of Health, Mahikeng, South Africa
John M. Tumbo, North West Department of Health, Bojanala District Health Services, Rustenburg, South Africa; and Department of Family Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Adrien Malumba, North West Department of Health, Bojanala District Health Services, Rustenburg, South Africa
Bolaji Adeoti, North West Department of Health, Bojanala District Health Services, Rustenburg, South Africa
Nozizwe J. Masekwane, Bojanala District Municipal Health and Environmental Services, Rustenburg, South Africa
Oleteng M.R. Mokate, Division of Communicable Disease Control, North West Provincial Department of Health, Mahikeng, South Africa
Otsile C. Sebekedi, Division of Health Programmes, North West Provincial Department of Health, Mahikeng, South Africa

Abstract

Background: Salmonella enterica, with more than 2500 diverse typhoidal and non-typhoidal serotypes (NTS), are foodborne bacterial pathogens of global public health concern. NTS are the most commonly reported causes of foodborne acute gastroenteritis (AGE). Contaminated food products (meat, poultry, eggs and dairy) have been reported to be a source of more than 95% NTS infections. An outbreak of food poisoning occurred among schoolchildren exposed to food provided by the government-sponsored National School Nutrition Programme (NSNP) at a local public primary day school in North West province, South Africa. An epidemiological, environmental and microbiological investigation was conducted to establish the existence and extent of the outbreak, identify the source(s) and causative agent(s) and institute appropriate control and preventive measures.

Methods: An epidemiological investigation was conducted, including a review of the clinical records of the persons exposed, laboratory testing of the pathological specimens collected, environmental testing of the food samples and food preparation areas.

Results: A total of 164 children developed clinical symptoms of AGE following ingestion of processed maize meal, beans and vegetables. Salmonella enterica serovar Heidelberg (S. Heidelberg) was the causative agent for this AGE outbreak in 92.0% of the cases. The median duration of illness was 2 days with a case fatality rate (CFR) of 0.6%. The main food product that was contaminated was samp (processed maize meal) that had been poorly stored and prepared (53.4%).

Conclusion: A timeously-initiated epidemiological, environmental and microbiological an investigation led to the conclusion that the etiologic agent of this outbreak was S. Heidelberg, and the most probable food vehicle of transmission was cooked samp served to learners within the NSNP.


Keywords

Salmonella; food poisoning; samp; outbreak; response; public school.

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