An Outbreak of Food Poisoning by Salmonella Typhimurium in a District of Lower Assam in North-East India

IntroductionFoodborne infection is a neglected health problem.Although large numbers of focal outbreaks are reported every year, implementation of strong food safety policies and guidelines is still awaited due to the paucity of data.Here, we report an outbreak of food poisoning from a district of Lower Assam where 65 people (attack rate 65%) reported sick in a span of a few hours in a particular locality. Materials and methodsAn outbreak investigation was conducted as part of a task force project of the Indian Council of Medical Research (ICMR) on foodborne pathogen surveillance in North-East India, in collaboration with the Integrated Disease Surveillance Programme (IDSP) team.A combined retrospective-prospective study was conducted.Data on patient demographics, time of onset of symptoms, presenting clinical features, and history of food items consumed were collected.Stool samples from cases were also collected for examination as per standard operating procedures (SOP). ResultsMost cases complained of abdominal cramps (n = 60, 92%), fever (n = 59, 90%), and diarrhoea (n = 55, 84%) about 48-72 hours after consumption of the food.'Prasad' (an offering comprising chickpea or bengal gram, moong or green gram, fruits, etc., and served raw) was thought to be the implicating food since it was consumed by 100% of cases.Salmonella Typhimurium was isolated from three of the seven stool samples collected, which showed resistance to cotrimoxazole, ampicillin, and ciprofloxacin. ConclusionThe outbreak was most probably associated with the consumption of raw 'Prasad' contaminated with S. Typhimurium identified in stool samples and showing multidrug resistance.Strengthening food hygiene practices and timely foodborne disease surveillance are essential to prevent similar outbreaks in the future.Recommendations were made for proper hygiene during preparation, handling, and storage of food.