Outbreak of Salmonella enteritidis among guest of wedding party - Ajara, Georgia, 2018

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Ajara Public Health Center received information from two clinics on hospitalization of three patients with diarrhea on June 18. All the patients attended wedding party on June 17. Investigation was conducted to confirm outbreak, identify risk-factors and prevent disease further spread.

Cohort study design was selected for the investigation. Demographic and consumed food data was collected during face-to-face interview, using standardized questionnaire. Additional patients were identified based on case definition: person, who attended the wedding party on June 17 in Batumi and developed diarrhea and fever, and one of following symptoms—nausea, vomiting, abdominal pain—, and confirmed with positive culture or linked to a laboratory confirmed case. Attack rates (AR) for consumed products were calculated to identify risk-factors. Fecal specimens were collected from patients to perform bacteriological testing.

Out of 85 persons, who attended the wedding party, 77 were interviewed. Overall 34 persons met case definition (AR 44%), out of them 10 (29%) were hospitalized, 11 (32%) were outpatients and 13 (38%) didn’t seek medical care. Age range of patients was 2-78, with median 25,5. Among patients 11 (32%) were male. The highest AR (80%) was observed in children under 10 years old, and the lowest AR (30%) in 40-49 age group. We calculated AR for all types of served foods. Two food items were associated with the illness: 31 persons out of 35, who ate wedding cake, developed disease (AR 89%), in unexposed group of 42 AR was 7%. Also 14 out of 19 were sick in the group who ate (AR 74%) and 20 out of 58 (AR 34%) who didn’t eat cupcakes. From 11 clinical specimens two positive cultures of Salmonella enteritidis were received.

Salmonellosis outbreak was related to the wedding cake. Leftovers were discarded and the National Food Agency was notified for further investigation.

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