What is this study about?

This study describes the investigation of a foodborne disease outbreak that occurred in a mental health institution. The bacteria that was identified in both food samples and patients’ samples was Salmonella Enteritidis, which is a non-typhoidal Salmonella (NTS). In this study, with the help of cutting-edge whole genome sequencing (WGS), we hypothesise how the outbreak started and how it evolved over time.

Why does this matter?

Foodborne disease outbreaks are a category 1 notifiable medical condition in South Africa, which means they must be reported to the National Department of Health within 24 hours.

Non-typhoidal Salmonella is a well-known cause of foodborne diseases globally, and according to the World Health Organization, unsafe food causes 600 million cases of foodborne diseases worldwide annually. Salmonella Enteritidis causes invasive and non-invasive disease and significantly impacts morbidity and mortality in low- and middle-income countries.

How did this study come about?

The team at the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD) was consulted by the respective provincial Department of Health, alerting us about a suspected outbreak, and sought our clinical advice and laboratory expertise in identifying the potential cause.

What was your role in the study?  

As the pathologist at the Centre for Enteric Diseases, I was responsible for interpreting laboratory results and correlating them with the clinical condition of patients. I also assisted in collating the various epidemiology reports from members of the investigating team and tying them up with the series of events that occurred. Lastly, I collated the WGS results of food, food handlers, and patients to draw a hypothesis on how the outbreak potentially started.

Why should people read this article?

This article will raise an individual’s awareness of foodborne disease outbreaks and equip them with key points as to how to prevent themselves from acquiring or spreading infection.

What impact do you hope the article will have on public health policy and healthcare access?

The management of varying institutions should have strict policies for providing proper training to professional food handlers, encourage them to be vigilant while preparing food, and enforce adherence to hygienic food preparation practices. Institutions and other healthcare personnel must continue to report foodborne disease outbreaks to increase the accuracy of the burden of disease in South Africa, thereby raising awareness of the problem and subsequently ensuring and encouraging food safety.

Dr Keeren Lutchminarain is a Senior Pathologist at the Centre for Enteric Diseases at the National Institute for Communicable Diseases.

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