Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
An Outbreak of Diarrhoea Attributed to Consumption of Street-Foods- Bangladesh, March 2018
*Afreen N,1 Faruque AM,2 Jony MK,3 Flora MS4
Abstract
Background: Diarrhoea outbreaks are common in Bangladesh and usually reported through event-based surveillance. Increased admission of diarrhoea cases was noticed in Upazila-health-center in early March, 2018 and reported to IEDCR on 11 March. The event was investigated to confirm outbreak, identify possible exposures and provide control measures.
Methods: We investigated outbreak since 12-14 March; conducted informal interviews, reviewed clinical records, created area-maps of case-patients, tested stool and water samples. For case-control study, we defined case-patients as “Any resident of that sub-district having ≥3 loose stools in 24 hours since 25th February’18 to date of investigation” and recruited 16 recently admitted case-patients mainly (most previous case-patients lacked contact information) and 32 neighborhood unmatched controls. Calculation of odds ratio and logistic regression were done to identify possible exposures with 95% confidence interval.
Results: Outbreak started since 3rd March; median age of line-listed case-patients (n=251) was 35 years (IQR 25-50) with male predominance (67%). Most case-patients were from municipality (53%, n=207). For case-patients versus controls, median age was 35 years (IQR 23-45.5) (versus 30 years (IQR 24-45)); 75% male (versus 31%); 60% (9/15) had occupations exposing them frequently to municipality (versus 19%). Odds ratios of consuming street-foods between 25 February-12 March (aOR 14.19, 95% CI 1.11-181.35) and similar illness among family members (aOR 35.4, 95% CI 2.71-461.98) were higher adjusting for sex and occupation. Interviews revealed that many people consumed available street foods in a fair occurred at this municipality from 2-10 March (prior to outbreak notification).
Conclusion: Duration of fair and outbreak showed that consumption of street foods from the fair was most likely source of this outbreak. Similar illness among family members might be due to person-to-person transmission or sharing same street food among family members. We suggested safety monitoring of street food sold in large gatherings (e.g., fair) to prevent similar outbreaks in future.
[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):42-53]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.7
Keywords: Diarrhoea, Outbreak, Gatherings, Street food, Bangladesh
- * Dr. Nawroz Afreen, Assistant Professor, Department of Epidemiology, National Institute of Preventive and Social Medicine. nawroz.afreen@gmail.com.
- Dr. Abdullahel Maruf Faruque, Upazila Health and Family Planning Officer, Bahubal Upazila Health Complex.
- Dr. Manjur Hossain Khan Jony, Assistant Professor, Department of Virology, Institute of Epidemiology, Disease Control and Research.
- Dr. Meerjady Sabrina Flora, Former Additional Director General, Planning and Research, Directorate General of Health Services.
*For correspondence