Epidemiological investigation of a foodborne collective infection (FBCI) episode at the Institute for Renewable Energy and Energy Efficiency Trade (IFMEREE-Oujda)

¹ Faculty of Science, Mohammed First University, Oujda, Morocco. LAPABE (Laboratory for Improvement of Agricultural Production, Biotechnology and Environment)
² Higher Institute of Nursing Professions and Health Techniques of Oujda (ISPITSO)
³ FETP – Graduate/National School of Public Health Rabat (ENSP)
⁴ Public Health Service, Regional Directorate of Health and Social Protection, Eastern Region, Morocco

^* Corresponding author: i.mouloudi@gmail.com/mouloudi.ibrahim@ump.ac.ma

Abstract

Foodborne outbreaks (FBOs) are common and sometimes severe, posing a public health emergency, especially in closed communities (cafeterias, hostels, schools), requiring prompt investigation and mandatory reporting. This retrospective cohort study involving 80 students was conducted in February 2017 following an FBO episode at IFMEREE in Oujda. A clinical and epidemiological definition of cases was developed. A questionnaire was designed to collect information on the implicated foods. Descriptive, univariate, and multivariate analyses were performed to study the food-related factors associated with this epidemic. In total, 57 respondents, aged 17 to 29 years, with an average of 20 years and a mode of 18 years, participated. The male sex predominated, with a sex ratio (M/F) of 2.16. There were 30 cases, resulting in an attack rate of 52.6%, with a female predominance (72.2% female vs. 43.4% male), and no deaths were reported. Among the foods served during lunch, buttermilk (LBEN) was the only food significantly associated with FBO, with a relative risk (RR) of 2.45, a confidence interval (CI95%: [1.61-3.74], p 0.0012), and an adjusted odds ratio (OR) of 17.05 (CI95%: [2.0-145.1], p 0.0096). Following our investigation of the FBO, a new hygiene control and monitoring system involving a new subcontracting company was implemented. This system aims to ensure compliance with the cold chain and update the medical records of kitchen and service staff. It also ensures improved traceability of foods, especially implicated dairy products (LBEN), from production to consumption, encompassing the entire distribution chain, including the requirement for a control meal.