Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

An outbreak of food poisoning among school hostel students in Penang - Malaysia, 2013

Sunita AR*, Rafidah MN**, Saraswathy BR***, Fadzilah K****

*Penang Port Health Office, Penang State Health Department, **Seberang Perai Tengah Distarict Health Office, Penang, ***Penang State Health Department, Penang, ****Epidemic Intelligence Program, Ministry of Health Malaysia


Introduction:  Food poisoning in school is a common occurrence in Malaysia. In Penang State, 50%-80% of food poisoning occurs in schools hostel. On 22nd January 2013, district health authority received notification from hospital on fourteen students presenting with diarrhoea and vomiting. All were treated as outpatient. The response teams were immediately mobilised to verify the outbreak, identify the source and implement control measures

Methods: Case definition of diarrhoea, vomiting with/out headache was used in active case finding. Retrospective cohort study was conducted to identify risk factors. Students were interviewed using standard questionnaire. Stools and rectal swabs taken from cases and food caterers were sent to laboratory for identification of causative agent. Food caterers were checked for vaccination status. Food caterer’s house, food handlers’ hygiene, storage and preparation observed and inspected.  Swabs were taken from kitchen utensils. Data was analysed using statistical software to measure the risk of food consumption.

Results: Attack rate was 33.3% (33/99) and majority of cases was girls. Mean age of cases was 13 years old (SD 2.47). The main symptoms were diarrhoea (100%) and vomiting (82%). Stool sample of one food caterer was positive for Salmonella Typhi 33% (1/3). He was not immunised against typhoid. The food was prepared in food caterers’ house and hygiene was inappropriate.  Cooking utensil swab was negative. We found that consumption of fish curry served at lunch had higher risk of food poisoning (Relative risk 2.58; 95% CI: 1.00-6.68).

Conclusion: This food poisoning outbreak among school hostel students was associated with consumption of contaminated fish curry. Food handler was referred for treatment and the school authority ordered to have proper kitchen to ensure food safety and quality.

Keywords: Food poisoning in school, food handler, Penang, Malaysia