An Acute Gastroenteritis Outbreak from Rice, Bangladesh, January 2021

Abstract

On 7 Jan 2021, the health manager at Bheramara, Bangladesh, notified the Institute of Epidemiology, Disease Control, and Research that 18 people were hospitalized for acute gastrointestinal illness. We conducted a retrospective cohort study to describe the outbreak and identify its source and took actions to contain it. Cases ate lunch after a funeral service on 5 January in Bheramara and had three or more loose stools in 24 hours, and vomiting or abdominal cramps after 5 January. We interviewed attendees with a semi-structured questionnaire. A Food Safety Inspector examined the food preparation areas. Stool and water samples were tested for enteric pathogens. Food-specific-attack rates, risk ratios, and 95% confidence interval (CI) were calculated. Common symptoms were diarrhea (94%) and vomiting (42%). The median incubation period was 16 hours (range 7–23). The attack rate of lunch attendees was 62% (72/117) with one death. Attendees who ate the second serving of rice had significantly higher risk of having acute gastrointestinal illness than those who did not (risk ratio 2.59, 95% CI 1.06–6.34). No pathogenic organism was isolated from stool and water samples. We suspected inadequately stored cooked rice was the source of the outbreak. We recommend proper cooking and storage of rice in a clean environment to prevent future outbreaks.