E. Coli-caused Foodborne Outbreak in Bantul Regency, Indonesia, 2023: A Retrospective Cohort Study

Background On October 18, 2023, Bantul District Health Office received notification from the Pleret Public Health Center (PHC) that several employees were sick with diarrhea and abdominal pain. Objective An epidemiological investigation was carried out to confirm the outbreak, detect additional cases, identify risk factors and causes, and recommend preventive measures. Methods This study employed active case finding followed by a retrospective cohort study. Individuals who reported diarrhea, stomachache, or malaise after consuming chicken distributed on Monday, October 16, 2023, were considered. Data were obtained through an e-questionnaire and direct interviews with all employees, their families, and food handlers. Food samples were sent to the health laboratory for analysis. Chi-square and multiple binomial regression were used to analyze the data. Results There were 68 sick individuals among the 140 people interviewed. Most cases occurred in women (52.9%), the 41-50-year age group (26.5%), and PHC employees (64.7%). Diarrhea (95.6%), abdominal pain (70.6%), and malaise (19.1%) were the most prevalent symptoms. The outbreak was identified as a common source, with incubation periods ranging from 1 hour to 20 hours, with an average of 5 hours and 6 minutes. Fried chicken was linked to a higher chance of becoming afflicted in this outbreak (aRR=5.09; 95% CI=1.33-19.47). E. Coli and mold were detected in the laboratory results. Conclusion This study concludes that there was a foodborne outbreak among PHC employees due to E. coli . Therefore, improving the foodborne disease surveillance system and monitoring household food production is needed to prevent outbreaks.