A. Case Study Foodborne Illnesses

A Case Study of Massive Staphylococcal Food Poisoning Incident
In the summer of 2004, approximately 8,000 individuals gathered to celebrate a Catholic

priest`s ordination in Minas Genesis, Brazil. Within hours of food consumption, 4,000 patients
experienced acute gastroenteritis, and approximately 2,000 (50%) overwhelmed Emergency
Departments of 26 local hospitals of the triaged patients, 396 (approximately 20%) required
subsequent admission, and of these patients, 81 (approximately 20%) were admitted to intensive
case units.
A total of 16 (approximately 20% of those admitted to the ICU) patients progressed on to

develop of irreversible multi-system shock and expired while hospitalized. The trace-back
investigation implicated food prepares who were culture positive for enterotoxigenic-
Staphylococcus auseus as the source of contamination. This study provides information on the
magnitude and severity of oral exposure to Staphylococcal enterotoxin.
PESTICIDE FOOD POISONING FROM CONTAMINATED WATERMELONS IN
CALIFORNIA
Aldicarb, a carbonate pesticide, is the most potent pesticide in the market has a LD50 of
1mg/1kg. In the United States it is illegal to use aldicarb on certain crops, e.g; watermelons,
because it is incorporated into the flesh of the fruit.
Once an accidental or illegal use of such a potent pesticide occurs, there is no easy way
for the agricultural or public health system to protect the populace. This describes the impact of
one such event upon the health of individuals and the institutions of California on July 4, 2004,
California and other Western States experienced the largest known outbreak of food-borne
pesticide illness ever to occur in North America.
This was attributed to watermelons contaminated through the illegal accidental use of
aldicarb by a few farmers in one part of the state. Within California, a total of 1, 376 illnesses
resulting from consumption of watermelons was reported to the California Department of Health
Services (CDHS). Of the 1,376 ilnesses, 77% were classified as being probable or possible
carbonate illnesses. Many of the case reports involved multiple illnesses associated with the
same melon among unrelated individuals. Seventeen individuals required hospitalization. These
were 47 reports of illness involving pregnant women, two of whom reported having subsequent
still births. Thirty-five of the remaining pregnant women were followed-up 9 mo after the
epidemic no additional still births were found. To control the epidemic, it was necessary to
embargo on July 4 and to destroy all watermelons in the state on July 7 and to effect a field
certification program.
FOODBORNE DISEASE OUTBREAKS IN THE PHILIPPINES
An FBDO is defined by the US Center for Disease Control and Prevention (CPC) as an
occurrence in which atleast two persons experience a similar illness resulting from the ingestion
of a common food (CDC 2012). Foodborne illness is a global issue with the continuous increase
in food safety risks brought about by internationalization offood trade (Choi 2008). These
include outbreaks that are due to microbial pathogens, residue contaminations, biological toxins
from fishery products, and other chemical and physical contaminants (Spiric et al. 2015)
There is usually a high prevalence of FBDOs in developing countries due to poor

sanitation (O`Ryan et al. 2015). The World Health Organizarion (WHO), through the Foodborne
Disease Burden Epidemiology Reference Grong, identified the West Pacific Region-including
the Philippines to have intermediate burdens in the range of 140-360 disability-adjusted life
years per 100,000 population (WHO 2015). Although unhygiene food preparation occurs both in
developing and industrialized countries, it was reported that a safe food supply chain becomes
more difficult to obtain in developing countries because of poverty (Kaferstain 2003). Several
unhygienic food preparation conditions that were cited in developing countries included poor
personal hygiene of food handlers, restricted access to clean facilities, and lack of food storage
facilities at the appropriate temperatures (Kaperstain 2003). The main reason for FBDOs in
Malaysia was also attributed to unsanitary food handling procedures, which contributed to 50%
of the cases (MOH 2007). Analysis of surveillance data in South Vietnam (2009-2013) also
showed that most outbreaks were associated with canteens and the cases were linked to poor
personal hygiene and time-temperature abuse (Vol et al. 2014)
In the Philippines, a national food safety program was initiated in 2013. Collective efforts
of food regulatory agencies have increased awareness and significance of food safety in the
country with the signing of the Philippine Food Safety Act (2013) into law. This law aims to
promote the right to health of the people and strengthen the food regulatory system in the country
(Republic Act 10611). However, the Implementing rules and Regulations (IRR) of this law have
only been finalized in Feb2015 (DA and DOH 2015). The positive impact of the food safety act
of the country cannot still be fully appreciated in this study since the law enactment is only in its
infancy.
Systematic monitoring of foodborne disease outbreaks by country is required to allow

evaluation of outbreaks by country is required to allow evaluation of outbreak trends. Normally,
food regulatory agencies involved in the implementation of food safety control. The data
collection rests on the competence of health officers up to the municipality level, the
professionals involved in the food supply chain, and the facilities and laboratories for testing and
analyses (Collado et al. 2015). A previous study already presented trends of FBDOs in the
Philippines for the preceding period of 1995-2014 (Azanza 2006). Continuous monitoring and
analyses of information from outbreaks occurring in the country could help contribute to the
development of national food safety systems. The objective of this article was to present trends
in the foodborne disease outbreaks, in the Philippines for the period of 2005-Jun 2018.
Outbreaks with multiple implicated food vehicles were those involving cases that
implicated the consumption of several types of foods and no exact food vector was definitively
identified as the cause of the outbreak. Institutionally prepared implicated foods were classified
as those of the food service area preparation. Home-prepared foods reported in this study were
classified either as those prepared or consumed by a single household or prepared and consumed
by multiple households.
FOODBORNE ILLNESSES
(Project In Risk Management as Applied to

Safety Security and Sanitation)
Respectfully Submitted By:
Maria Angelica P. Valdez
Respectfully Submitted To:
Mrs. Remedios G. Galaites

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A Case Study of Massive Staphylococcal Food Poisoning Incident

In the summer of 2004, approximately 8,000 individuals gathered to celebrate a Catholic

A total of 16 (approximately 20% of those admitted to the ICU) patients progressed on to

There is usually a high prevalence of FBDOs in developing countries due to poor

Systematic monitoring of foodborne disease outbreaks by country is required to allow

(Project In Risk Management as Applied to

Respectfully Submitted By:

Maria Angelica P. Valdez

Respectfully Submitted To:

Mrs. Remedios G. Galaites

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