Salmonellosis Outbreak among Yadamah Residents, Najran Region, Saudi Arabia, October 2022

Background: Foodborne diseases are considered a significant public health problem as they are responsible for a substantial rise in disease rate and mortality. On October 7, 2022, the Field Epidemiology Program reported an unexpected number of patients with fever, diarrhea, and vomiting who had presented to Yadamah Hospital with a similar history of eating food from the same restaurant in Yadamah City. Objective: to determine the source of infection, to assess the severity and extent of the current situation, and apply control measures in managing the outbreak. Methods: A case-series study was conducted. All exposed were ill, and none of the controls representing the at-risk population had food. Demographic consumed food data and symptoms were collected using a standardized questionnaire. Additional patients were identified based on hospital records. Blood and rectal swab samples from cases, food handlers, and food samples were sent to the laboratory. We inspected the restaurant and examined food handlers to identify possible sources of contamination during food preparation. Results: A total of 100 cases were identified. 41% of cases were hospitalized, of which 58% were Males. The median age was 13 years (1 - 50 years). The main reported symptoms were fever (99%), abdominal cramps (98%), diarrhea (95%), and vomiting (80%). A total of 32 rectal swab samples were taken; eight were from the patients, and one of the food handlers involved in preparing the shawarma reported positive for Salmonella enterica. No organisms were detected from food items. The food preparation room, floor, containers and tables were cleaned during environmental inspection. A food handler who prepared chicken could not provide the correct steps of thawing and handwashing. Conclusion: The features of this outbreak confirmed that it was FBDO with Salmonella enterica. Health education among the food handlers and training on safe food preparation practices are needed to control and prevent future outbreaks.