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Vibrio parahaemolyticus gastroenteritis in Malaysia

Puthucheary SD

Med J Malaysia, 1973 Sep;28(1):44-6.
PMID: 4273784
Matched MeSH terms: Foodborne Diseases/etiology
Outbreak of Human Brucellosis from Consumption of Raw Goats' Milk in Penang, Malaysia

Leong KN, Chow TS, Wong PS, Hamzah SH, Ahmad N, Ch'ng CC

Am J Trop Med Hyg, 2015 Sep;93(3):539-41.
PMID: 26055742 DOI: 10.4269/ajtmh.15-0246

We report the largest outbreak of brucellosis in Penang, Malaysia. Brucellosis is not endemic in this region. The index case was a 45-year-old goat farm owner presented with 3 weeks of fever, headache, severe lethargy, poor appetite, and excessive sweating. He claimed to have consumed unpasteurized goat's milk that he had also sold to the public. Tests were negative for tropical diseases (i.e., dengue fever, malaria, leptospirosis and scrub typhus) and blood culture showed no growth. Based on epidemiological clues, Brucella serology was ordered and returned positive. Over a period of 1 year, 79 patients who had consumed milk bought from the same farm were diagnosed with brucellosis. Two of these patients were workers on the farm. Four laboratory staff had also contracted the disease presumably through handling of the blood samples. The mean duration from onset of symptoms to diagnosis was 53 days with a maximum duration of 210 days. A combination treatment of rifampin and doxycycline for 6 weeks was the first line of treatment in 90.5% of patients. One-third of the patients had sequelae after recovering and 21% had a relapse. We highlight the importance of Brucellosis as a differential diagnosis when a patient has unexplained chronic fever.

Matched MeSH terms: Foodborne Diseases/etiology; Foodborne Diseases/microbiology; Foodborne Diseases/epidemiology*
Perak, Malaysia, mass poisoning. Tale of the Nine Emperor Gods and rat tail noodles

Cheng CT

Am J Forensic Med Pathol, 1992 Sep;13(3):261-3.
PMID: 1476136

In October 1988, a series of food poisoning cases occurred in the State of Perak in Malaysia. Most of the victims were children. Ultimately 13 children between the ages of 2.5 and 11 years died. Epidemiological investigations showed that the probable source of the poison was Loh See Fun, a noodles in the shape of a rat's tail. All the deceased ate the noodles from one supplier. Clinical and pathological findings were similar in each case. Postmortem examination was performed in 11 cases. Toxicological examination on organs in 10 cases showed a high concentration of aflatoxin in tissues of the deceased. High levels of boric acid were excreted from most of the victims. Histological examination of the liver in these cases showed necrotic changes found in aflatoxin poisoning. Combination of the epidemiological, clinical, toxicological, and pathological findings pointed to the fact that there was a common toxin or toxins responsible for the deaths. These were thought to be a combination of boric acid and aflatoxin.

Matched MeSH terms: Foodborne Diseases/etiology; Foodborne Diseases/mortality*; Foodborne Diseases/pathology
Food taboos among the Orang Asli in West Malaysia: a potential nutritional hazard

Bolton JM

Am J Clin Nutr, 1972 Aug;25(8):789-99.
PMID: 5046724
Matched MeSH terms: Foodborne Diseases
Fulltext Acute renal failure following jering ingestion

H'ng PK, Nayar SK, Lau WM, Segasothy M

Singapore Med J, 1991 Apr;32(2):148-9.
PMID: 2042077

We report two cases of acute renal failure that followed the ingestion of jering. Features of jering poisoning included clinical presentation of bilateral loin pain, fever, nausea, vomiting, oligo-anuria, haematuria and passage of sandy particles in the urine. Blood urea (40.8 mmol/l; 21.9 mmol/l) and serum creatinine (1249 mumols/l; 693 mumols/l) were markedly elevated. With conservative therapy which included rehydration with normal saline and alkalinisation of the urine with sodium bicarbonate, the acute renal failure resolved.

Matched MeSH terms: Foodborne Diseases/complications
Microbiological quality of food contact surfaces (spoons) at selected restaurants in Klang Valley, Malaysia

Naili Nahar, Nor Ainy Mahyudin

Sains Malaysiana, 2018;47:1541-1545.

Food borne diseases increase worldwide and contamination of food contact surfaces serves as one of the reasons for their occurrence. The aim of this study was to determine the microbiological quality of spoons at selected restaurants in Klang Valley, Malaysia. Five restaurants were selected therein for the study. They were respectively labelled A, B, C, D and E. A total of 150 cleaned spoons (30 spoons from each restaurants) that were ready to be used by customers at the restaurants were examined. Total plate counts (CFU/cm2) of the spoons were determined; the presumptive and confirmatory tests for the presence of Escherichia coli on the spoons were also conducted. The samples were collected by surface swabbing. The result showed that restaurant C and B had the highest and lowest total plate counts (TPC), respectively. Samples from 3 of the 5 selected restaurants (restaurants C, D and E) showed positive results for the presence of E. coli mainly due to poor dishware cleansing. On the contrary, negative results for the presence of E. coli at restaurant A and B were associated with the advance cleaning procedure, which used more hygienic method with dishwashers.

Matched MeSH terms: Foodborne Diseases
Fulltext Prevalence and antimicrobial resistance of Listeria, Salmonella, and Yersinia species isolates in ducks and geese

Jamali H, Radmehr B, Ismail S

Poult Sci, 2014 Apr;93(4):1023-30.
PMID: 24706981 DOI: 10.3382/ps.2013-03699

The aims of this study were to determine the prevalence and antimicrobial resistance of Listeria, Salmonella, and Yersinia spp. isolated from duck and goose intestinal contents. A total of 471 samples, including 291 duck and 180 goose intestinal contents, were purchased from wet markets between November 2008 and July 2010. Listeria, Salmonella, and Yersinia spp. were isolated from 58 (12.3%), 107 (22.7%), and 80 (17%) of the samples, respectively. It was concluded that Listeria ivanovii, Salmonella Thompson, and Yersinia enterocolitica were the predominant serovars among Listeria, Salmonella, and Yersinia spp., respectively. Moreover, resistance to tetracycline was common in Listeria (48.3%) and Salmonella spp. (63.6%), whereas 51.3% of the Yersinia spp. isolates were resistant to cephalothin. Therefore, continued surveillance of the prevalence of the pathogens and also of emerging antibiotic resistance is needed to render possible the recognition of foods that may represent risks and also ensure the effective treatment of listeriosis, salmonellosis, and yersiniosis.

Matched MeSH terms: Foodborne Diseases/microbiology; Foodborne Diseases/epidemiology
Fulltext Structural equation modelling of food safety knowledge, attitude and practices among consumers in Malaysia

Soon JM, Wahab IRA, Hamdan RH, Jamaludin MH

PLoS One, 2020;15(7):e0235870.
PMID: 32639978 DOI: 10.1371/journal.pone.0235870

Factors contributing to foodborne illnesses in Malaysia were identified as insanitary food handling procedures and lack of hygiene in food preparation area. Food safety at home is a critical point as consumers represent the final step in food preparation and prevention of foodborne diseases. This study aims to investigate the food safety knowledge, attitude and self-reported practices among consumers in Malaysia. An online survey was conducted, and data were analysed using descriptive statistics and exploratory factor analysis. A model linking food safety knowledge and attitude and their direct effects on practices were confirmed using structural equation modelling (SEM). The proposed model fulfilled the goodness of fit indices and is deemed acceptable. Respondents demonstrate good level of food safety knowledge and positive attitudes and self-reported practices. Food safety knowledge has a negative and insignificant relationship with food safety practices (β1 = -0.284, p>0.05) while attitude significantly affects food safety practices (β1 = 0.534, p<0.05). The findings clearly indicate that food safety knowledge does not directly affect food safety practices This is also the first study to provide new empirical findings on thermometer usage among consumers in Malaysia. This study establishes an important point of reference where consumers use visual appearances to determine if food is thoroughly cooked and practice washing raw chicken prior to cooking. Food safety practices at home play a critical role in protecting consumers in reducing risks of foodborne illnesses.

Matched MeSH terms: Foodborne Diseases
Fulltext Investigation of the impacts of climate change and rising temperature on food poisoning cases in Malaysia

Hassan NA, Hashim JH, Wan Puteh SE, Wan Mahiyuddin WR, Mohd MSF, Shaharudin SM, et al.

PLoS One, 2023;18(10):e0283133.
PMID: 37862373 DOI: 10.1371/journal.pone.0283133

This study is an attempt to investigate climate-induced increases in morbidity rates of food poisoning cases. Monthly food poisoning cases, average monthly meteorological data, and population data from 2004 to 2014 were obtained from the Malaysian Ministry of Health, Malaysian Meteorological Department, and Department of Statistics Malaysia, respectively. Poisson generalised linear models were developed to assess the association between climatic parameters and the number of reported food poisoning cases. The findings revealed that the food poisoning incidence in Malaysia during the 11 years study period was 561 cases per 100 000 population for the whole country. Among the cases, females and the ethnic Malays most frequently experienced food poisoning with incidence rates of 313 cases per 100,000 and 438 cases per 100,000 population over the period of 11 years, respectively. Most of the cases occurred within the active age of 13 to 35 years old. Temperature gave a significant impact on the incidence of food poisoning cases in Selangor (95% CI: 1.033-1.479; p = 0.020), Melaka (95% CI: 1.046-2.080; p = 0.027), Kelantan (95% CI: 1.129-1.958; p = 0.005), and Sabah (95% CI: 1.127-2.690; p = 0.012) while rainfall was a protective factor in Terengganu (95% CI: 0.996-0.999; p = 0.034) at lag 0 month. For a 1.0°C increase in temperature, the excess risk of food poisoning in each state can increase up to 74.1%, whereas for every 50 mm increase in rainfall, the risk of getting food poisoning decreased by almost 10%. The study concludes that climate does affect the distribution of food poisoning cases in Selangor, Melaka, Kelantan, Sabah, and Terengganu. Food poisoning cases in other states are not directly associated with temperature but related to monthly trends and seasonality.

Matched MeSH terms: Foodborne Diseases*
Fulltext One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia

Barkham T, Zadoks RN, Azmai MNA, Baker S, Bich VTN, Chalker V, et al.

PLoS Negl Trop Dis, 2019 06;13(6):e0007421.
PMID: 31246981 DOI: 10.1371/journal.pntd.0007421

BACKGROUND: In 2015, Singapore had the first and only reported foodborne outbreak of invasive disease caused by the group B Streptococcus (GBS; Streptococcus agalactiae). Disease, predominantly septic arthritis and meningitis, was associated with sequence type (ST)283, acquired from eating raw farmed freshwater fish. Although GBS sepsis is well-described in neonates and older adults with co-morbidities, this outbreak affected non-pregnant and younger adults with fewer co-morbidities, suggesting greater virulence. Before 2015 ST283 had only been reported from twenty humans in Hong Kong and two in France, and from one fish in Thailand. We hypothesised that ST283 was causing region-wide infection in Southeast Asia.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a literature review, whole genome sequencing on 145 GBS isolates collected from six Southeast Asian countries, and phylogenetic analysis on 7,468 GBS sequences including 227 variants of ST283 from humans and animals. Although almost absent outside Asia, ST283 was found in all invasive Asian collections analysed, from 1995 to 2017. It accounted for 29/38 (76%) human isolates in Lao PDR, 102/139 (73%) in Thailand, 4/13 (31%) in Vietnam, and 167/739 (23%) in Singapore. ST283 and its variants were found in 62/62 (100%) tilapia from 14 outbreak sites in Malaysia and Vietnam, in seven fish species in Singapore markets, and a diseased frog in China.
CONCLUSIONS: GBS ST283 is widespread in Southeast Asia, where it accounts for a large proportion of bacteraemic GBS, and causes disease and economic loss in aquaculture. If human ST283 is fishborne, as in the Singapore outbreak, then GBS sepsis in Thailand and Lao PDR is predominantly a foodborne disease. However, whether transmission is from aquaculture to humans, or vice versa, or involves an unidentified reservoir remains unknown. Creation of cross-border collaborations in human and animal health are needed to complete the epidemiological picture.

Matched MeSH terms: Foodborne Diseases/microbiology; Foodborne Diseases/epidemiology
Fulltext Food poisoning outbreak in UiTM, Dungun, Terengganu, 1999.

Faizan, G., Balkis, A.K., Kasemani, E., Che Mohd Shabri, A., Amirullah, M.A.

Malaysian Journal of Public Health Medicine, 2002;2(1):50-53.
MyJurnal

Food poisoning is still a major problem in the state of Terengganu. The study was conducted during an episode of food poisoning outbreak which occurred in October, 1999, at Universiti Tekonologi Mara (UiTJ1rO, Dungun to determine the etiology, mode of transmission, source and the risk factors of the outbreak and hence to take appropriate remedial actions and preventive measures. A retrospective cohort study was conducted amongst 925 students using a standard questionnaire as well as environmental investigation and bacterial subtyping. All the samples were Malay females, age ranging jrom /9 — 22 years. It was found that majority ofthe victims (72 %) presented with abdominal cramp, 68.5% headache, 60.0% diarrhea, 55.2% fever, 45.0% nausea, 39.0% muscle
ache and 3]. 7% vomiting. The epidemic curve suggested of a common source of infection and the most probable food that has been contaminated was taken during lunch hour on October 20'I'1999, Statistical analysis showed that spices jiied chicken and "nasi minyak" were significantly associated with the illness (p < 0. 05). The most likely causative organism was Salmonella spp as supported by the clinical presentation and incubation period of the disease, identdication of contaminated food, bacterial subtyping result and environmental findings. Following the outbreaks, several remedial actions were taken including immediate close—up ofthe canteen for I4 days, treatment for the cases and health examination and typhoid immunization for all food handlers.

Matched MeSH terms: Foodborne Diseases
Fulltext Prevalence of pathogenic microorganims in ready-to-eat foods prepared at selected ‘high risk' school hostel kitchens and canteens in Pahang

Jeyaletchumi, P., Ardi, A, Noraliza, M.A., Nurul Aini, I., Maizatul Akmar, H., Suraya, H., et al.

Malaysian Journal of Public Health Medicine, 2006;6(1):23-28.
MyJurnal

Two hundred and sixty four samples of ready -to-eat foods (RTE) were obtained over a period of six months (April to September 2005) from 33 school hostel kitchens and canteens previously implicated in food poisoning outbreaks from 2000 to 2004. Sampling was done by food technologists and assistant environmental health ofhcers from various districts in Pahang while microbiological analysis was carried out at the Mentakab Food Quality Control Laboratory. The objective of the study was to obtain a comprehensive picture on the microbiological status of the foods that may have accounted for food poisoning outbreaks at school hostels and canteens in Pahang. Each food sample was analyzed for Total Plate Count (TPC), Salmonella, Coliform, Escheria coli, Staphylococcus aerus and Bacillus cereus. lt was found that none of the ready-to-eat foods sampled contained Salmonella although hve samples contained Bacillus cereus , four samples contained Staphylococcus aerus. High Coliform Counts were found in 15 food samples while Escheria coli was detected in two samples. Overall, it was found that 10.2 % of the samples had unsatisfactory counts.

Matched MeSH terms: Foodborne Diseases
Fulltext Paper review of factors, surveillance and burden of food borne disease outbreak in Malaysia

Sharifa Ezat, W.P., Netty, D., Sangaran, G.

Malaysian Journal of Public Health Medicine, 2013;13(2):98-105.
MyJurnal

Food borne diseases like cholera, typhoid fever, hepatitis A, dysentery and food poisoning occur as the results of ingestion of foodstuffs contaminated with microorganisms or chemical. The true incidence of food borne disease in Malaysia is unknown, however the incidence is low ranging from 1.56 to 0.14 cases per 100,000 population and the food poisoning cases is on the rise as the evident by the incident rate of 62.47 cases per 100,000 population in 2008 and 36.17 in 2009. The rapid population growth and demographic shift toward ageing population, changing eating habit such as consumption of raw or lightly cooked food, long storage of such food, lack of education on basic rules of hygienic food preparation and food trading without appropriate microbiological safety procedure become contributing factors for food borne diseases. Food borne disease in Malaysia is in the rise and the direct and indirect cost management of FBD will become one of the most common issues to face by the government. The world is spending millions and millions in cost of treatment due to food borne diseases. The information on this paper was collected via findings of previous journals, data and statistics from the MOH of Malaysia and WHO websites. As a result, authors found that the prevention and management of the food borne disease outbreak needs to be addressed seriously.

Matched MeSH terms: Foodborne Diseases
Fulltext An outbreak of typhoid from a wedding party in Bachok district, Kelantan, 2003

Wan Mansor, W.H., Hamizah, M.S., Wan Sulaili, W.S., Jeriah, I., Che Nok @ Nawi, I., Noraini, I., et al.

Malaysian Journal of Public Health Medicine, 2003;3(2):53-57.
MyJurnal

On March 17, 2003 the Kelantan Health Department was notihed about a possible typhoid outbreak following a wedding party. An investigation was carried out to identiy the source and recommend control measures. Active case detection, yield investigation and case»control study were conducted. Cases were symptomatic attendees with a stool or blood culture positive for Salmonella
typhii. Each control had a negative culture and denied symptoms. Of the more than 1 OOO guests, 477 experienced fever; 152 met the case definition. The party hostess was found to be an Salmonelb typhii carrier. Syrup prepared with untreated well water was identified as the most likely source for this outbreak, with an odds ratio 14.0 (95% C1: 2.9, 104.1). This was a common source
outbreak of typhoid. We recommend that all food handlers at large parties be screened for typhoid and other foodborne diseases and samples of higherisk foods should be kept for few days after each event in case they are needed for testing.

Matched MeSH terms: Foodborne Diseases
Fulltext Interactive games to improve knowledge on food poisoning prevention among school children in Cheras

Mohd Safwan Ibrahim, Noriah Hajib, Mohd Fadhli Mohd Fauzi, Erma Nur Shadila Mahamad Najadi

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):98-98.
MyJurnal

Introduction: Food poisoning may occur as single sporadic cases or massive outbreak in any institution, including boarding schools. Early this year, Cheras District Health Office had implemented set of interactive games on food safety programme at two boarding schools in Cheras which had repeated incidences of food poisoning outbreak. This study aims to evaluate the effectiveness of interactive games on knowledge of food safety among school children in Cheras. Methods: This study is a retrospective study based on secondary data. Two boarding school with total of 135 students were. The students were divided into 4 groups and participates in all 4 modules of interactive games. There were 10 items pre and post questionnaire on food safety knowledge collected during the program with score ranged zero to ten. The data were analysed descriptively and analytically with paired t test. Results: The response rate of this study was 100 %. Majority of the respondents were Malays (68.1%) and male (66.7%). The mean score at pre and post were 6.78 and 7.72 respectively. Paired t test showed that there was a significant increase of 0.94 mean score of knowledge after the programme (p-value < 0.05, CI 95%= -1.212, -0.664). Conclusion: The knowledge scores on food safety of the students increased significantly after the interactive game. However, without control group, the improvement cannot be said solely due to the program itself.

Matched MeSH terms: Foodborne Diseases
Fulltext Spatial analysis of food poisoning cases and its environmental relations in Sabah, Malaysia

Syed Sharizman Syed Abdul Rahim

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):4-4.
MyJurnal

Introduction: Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Pa-par illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Con-clusion: Food poisoning usually occurs in clusters with possible associated environmental factors.

Matched MeSH terms: Foodborne Diseases
Fulltext Screening of pathogenic bacteria from sea cucumber Acaudina molpadioides in Pulau Langkawi, Kedah

Abigail Li Yen Lew, Nurzafirah Mazlan, Siti Marwanis Anua, Thung Tze Young

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):42-46.
MyJurnal

Introduction: The outbreaks of foodborne diseases have been linked to the consumption of contaminated seafood. This research aims to screen the bacteria from the sea cucumbers Acaudina molpadioides collected from Pulau Langkawi. Methods: A total of 22 sea cucumber samples were collected randomly from Pulau Langkawi, Kedah, Malaysia. The samples were isolated and identified for the presence of bacteria using the conventional culture-based method. Presumptive bacteria colonies were subjected to various biochemical and antimicrobial susceptibility tests. Results: There were no bacterial growth in Hektoen Enteric (HE) agar and Thiosulphate-Citrate-Bile Salt (TCBS) agar. Positive samples were isolated from MacConkey (MAC) agar with 6 samples were Staphylococcus spp. (27.27%), 14 samples were Proteus spp. (63.63%) and 2 samples were Bacillus spp. (9.01%). Among these isolates, highest resistance was found against Ampicillin (45%) followed by Tetracycline (40%). Conclusion: The results indicate that the sea cucumbers Acaudina molpadioides were contaminated with potential bacteria. There is a need for adequate consumer protection measures.

Matched MeSH terms: Foodborne Diseases
Spectrum of flood-related diseases encountered during flood disaster in Johore, Malaysia

Badrul Hisham, A.S., Nor Azian Shaharom, C.M.D., Marzukhi, M.I., Norli, R., Fatimah, O., Kee, KF, et al.

Malaysian Journal of Community Health, 2009;15(3):15-23.
MyJurnal

The state of Johore, Malaysia had been hit by the worst flood in the Malaysian modern history on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) affecting all the eight districts. A total number of 157,018 and 155,368 Johore population had been displaced by the first and the second wave event respectively. The Johore State Health Department activated the Flood Action Plan which include mobilising medical teams to conduct daily clinical examinations on the flood victims and health teams to inspect flood relief centres, food premises and homes at flood-hit areas with regard to prevent and control communicable diseases. The spreadsheet format was used to collect data on diseases, injury and death throughout the Johore flood disaster period starting from the 19th December 2006 until 19th February 2007. Analyses showed that 19,670 flood victims (36.3%) had communicable diseases and 34,530 (67.0%) had non-communicable diseases. As for the communicable diseases and symptoms/syndromes related to communicable disease, 41.3% were acute respiratory infections (ARI) followed by 25.9% skin infections, 19.1% fever, 10.1% acute gastroenteritis (AGE) and 3.0% acute conjunctivitis. Other infectious diseases include 61 notifiable diseases (46 food poisoning, 14 dengue fever and one tuberculosis), 20 leptospirosis (with two deaths), 20 chicken pox and two melioidosis cases. The Batu Pahat district had the highest incidence for the majority of the communicable diseases because of the prolonged flooding period. No cholera, typhoid, malaria, measles or hand-foot-mouth disease (HFMD) cases were detected among the Johore flood victims. Trends of disease incidence follow the number of evacuees placed in the relief centres corresponding to respective wave. A total of 507 flood victims had physical injuries related to flood mostly due to fall onto wet floor at the relief centres. Fifteen deaths due to drowning were mainly caused by accidental fall into the flood water. The incidence of communicable diseases encountered had been appropriately anticipated and managed attributed to enhanced public health control programmes augmented by syndromic and laboratory surveillance on potentialy fatal infectious diseases. Equal emphasis should be given to the surveillance and control of chronic diseases.

Matched MeSH terms: Foodborne Diseases
Fulltext Food safety issues in recent Flood 2006-2007 in Johore

Daud, A.R., Thayalan, R., Farhatun Najmi, M.G.

Malaysian Journal of Community Health, 2009;15(3):55-59.
MyJurnal

Background and Objective : Johor was affected by the worst flood in 100 years in December 2006 and again in January 2007. The concern that improper sanitary facilities and contaminated water supply at relief centres would result in contaminated food made monitoring of food hygiene vital. The objective of this paper is to describe food hygiene surveillance activities carried out in flood relief centres and flood affected areas and the challenges faced in carrying out these activities.
Methodology : The food hygiene surveillance activities were carried out by the Assistant Environmental Health Officers (AEHO) in the districts. Among the surveillance activities carried out are inspection of food preparation areas in relief centres, inspection of food premises in flood affected areas and food sampling. Premise inspections were carried out using a specific inspection format. Food samples taken were sent to Public Health Laboratory, Johor Bahru for microbiological analysis. Anti typhoid vaccination for food handlers were also carried out. Apart from that, observations made by the health teams were alsotaken into account.
Results : A total of 3,159 food preparation areas in relief centres were inspected. During the same period, a total of 2,317 food premises in flood affected areas were inspected as soon these premises started operating after the floods. Inspections showed that 69 food preparation areas in relief centres and 181 food premises in flood affected areas had unsatisfactory hygiene. A total of 1,566 holding samples were taken and 425 samples were sent to the laboratory for analysis. Forty-six of the samples analysed were found to be positive for pathogenic bacteria such as e. coli, staphylococcus aureus and salmonella.
Conclusion : The health personnel from the Johor Health Department in various districts carried out an excellent job in ensuring food safety during the floods. There were no outbreaks of food poisoning. However analysis of food samples taken during the floods did show the presence of pathogenic organisms but probably their numbers were not high enough to cause any food poisoning. The promotion and enforcement of food hygiene requirements should be carried out continuously to ensure that every individual understands the need for hygiene and food safety during disaster situation such as flood.

Matched MeSH terms: Foodborne Diseases
Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia

Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam

Malaysian Journal of Community Health, 2009;15(3):111-118.
MyJurnal

Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.

Matched MeSH terms: Foodborne Diseases

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