An Outbreak Investigation of a Cluster of Gastroenteritis Following a Marriage Function in Wayanad District, Kerala, India

Foodborne diseases are a significant cause of morbidity and mortality, especially in low-resource settings. This paper describes the investigation conducted in response to a cluster of acute gastroenteritis outbreak in the Wayanad district of Kerala. House-to-house visits were undertaken to identify the case patients, along with laboratory and environmental investigations. The attack rate was 41.2% among those who consumed chicken biriyani compared to 6.9% among those who consumed vegetarian meals. The risk difference (95% CI) was 34.34 % (22.8-45.6), and the risk ratio (95% CI) was 6 (1.6-23) for chicken biriyani compared to vegetarian meals. The attributable fraction (95% CI) among those who ate chicken biriyani was 83.3% (35.6-95.6), and the population attributable fraction was 81.2%. We recommend strengthening of laboratory capacity for detecting foodborne pathogens and active surveillance of all food handlers and food preparation areas with the coordination of food safety, health and local self government departments.