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1 "Eun Suk Cho"
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Epidemiologic Investigation
Epidemiological investigation of a food-borne outbreak in a kindergarten, Jeju Province, Korea
Kyoung Mi Kim, Eun Suk Cho, Seong Bae Ahn, Eun Ok Kang, Jong-Myon Bae
Epidemiol Health. 2023;45:e2023047.   Published online April 17, 2023
DOI: https://doi.org/10.4178/epih.e2023047
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
On Monday, September 6, 2021, at a kindergarten in Jeju Province, a large number of children vomited and developed food poisoning symptoms, and this necessitated an epidemiological investigation.
METHODS
The team surveyed symptoms and food intake history of kindergarten children, teachers, and workers who ate lunch between September 2 (Thursday) and September 6 (Monday), excluding weekends. In addition to rectal swabs, environmental samples from preserved foods, cooking utensils, drinking water, and refrigerator handles were collected. Pulsed field gel electrophoresis (PFGE) for genetic fingerprint analysis was also performed.
RESULTS
There were 19 cases among 176 subjects, which indicated an attack rate of 10.8%. The epidemic curve showed a unimodal shape, and the average incubation period was 2.6 hours. While no food was statistically significant in food intake history, the analysis of 35 rectal smear samples detected Bacillus cereus in 7 children, 4 teachers, and 1 cooking staff. Enterotoxins were also detected in 12 samples. Out of 38 environmental samples, B. cereus and enterotoxins were detected in the morning snack cereal, lunch bean sprouts, and afternoon snack steamed potatoes on Monday, September 6th. The result of the PFGE test on 10 isolates of B. cereus showed that there was no genetic homology.
CONCLUSIONS
Our results indicated that this outbreak was simultaneously caused by various strains of B. cereus from the environment.
Summary
Korean summary
모 유치원에서 제공한 급식 취식아동에서 발열이 없고 구토형의 주증상인 식중독이 발생되었다. 평균 잠복기 2.6시간 (최소 0.8, 최대 4.5시간)이며, 인체 및 환경 검체에서 바실러스 세레우스 균이 분리되었다. 이에 해당 집단발생은 구토형 바실러스 세레우스 감염증에 의한 식중독을 결론지었다.
Key Message
A large number of children in a kindergarten vomited suddenly. The average incubation period was 2.6 hours (min 0.8, max 4.5 hours) with uni-modal shape in the epidemic curve. Bacillus cereus and entertoxin were detected in rectal smear and environmental samples.

Epidemiol Health : Epidemiology and Health