Discussion: Analysis of the food preparation process

Discussion: Analysis of the food preparation process

Discussion: Analysis of the food preparation process

BACKGROUND: On August 8, employees at a Wisconsin county jail noted nausea, vomiting, abdominal cramps, and diarrhea among more than 100 inmates during the early morning inspection. As a result, the local health department was called to do an investigation about a suspected foodborne outbreak. A questionnaire filled out by inmates identified 200 cases of the gastrointestinal (GI) illness with the mean onset of illness approximately 8 hours after the August 7 evening meal (Figure a). Analysis of the food preparation process found that meals were made on-site in a central kitchen by inmates on a weekly rotating kitchen assignment. None of the food preparation supervisors reported being ill. Meals were pre-portioned and served to the inmates, to be consumed in their cells. Inmates were served a set menu and were not given a choice of food items. Figure a. (attached) Number of self-reported cases of illness among inmates housed at a county jail by hour of onset (N = 200) Graph of number of cases of illness among inmates housed at a county jail in august 7 and 8 shows that the number reaches the peak level at the end of august 7 and a waving increase and decrease is noted in august 8 and decreases completely by 10 hour. 1. Why was it important that none of the food preparation supervisors reported being ill? 2. Explain why epidemic curves like the figure shown are important in epidemiological analysis. What does the shape of this curve tell us about the epidemic? BACKGROUND for Question #3: For the August 8 evening meal, the casserole had been made by combining and reheating leftover food items from previous meals and food items that were near their expiration dates. Large batches of food were cooked and then cooled before final preparation for the next day’s meal. In some instances, the food was placed in a cooler and allowed to cool. However, the food remained for long periods at temperatures that promoted rapid growth of bacterial pathogens. A case-control study was used to determine the association of specific foods and beverages consumed by the inmates with the illness (Figure b). Figure b ( attached) Association between reported food exposures and cases of illness at a county jail 3. Use the table to calculate the odds ratio to determine which food was most strongly linked to the outbreak. 4. What recommendations would you make to prevent similar outbreaks in the future at this facility?


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