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First Report of a Foodborne Providencia alcalifaciens Outbreak in Kenya
Mohammad Monir Shah1, Erick Odoyo2, Peter S Larson2
1Centre for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine Nagasaki University, Nagasaki, Japan; Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya; Department of Tumor and Diagnostic Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan shah@nagasaki-u.ac.jp ichinose@nagasaki-u.ac.jp.
Insights
A Providencia alcalifaciens outbreak caused gastroenteritis in Kenyan children. Poor hygiene and food handling were identified as key factors, highlighting the need for improved sanitation practices.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Providencia alcalifaciens is an emerging bacterial pathogen causing gastroenteritis in children and travelers.
- Acute gastroenteritis outbreaks pose a significant public health challenge, particularly in resource-limited settings.
Purpose of the Study:
- To investigate an outbreak of diarrhea caused by Providencia alcalifaciens in Kenya.
- To identify the source, transmission routes, and contributing factors of the outbreak.
Main Methods:
- Epidemiological investigation including case finding and interviews.
- Bacterial isolation and identification of Providencia alcalifaciens.
- Random Amplified Polymorphic DNA (RAPD) fingerprinting for isolate comparison.
Main Results:
- Providencia alcalifaciens was isolated from four children with diarrhea.
- Seven primary and four secondary cases were identified, suggesting person-to-person transmission.
- Clonal isolates indicated a common source, likely contaminated mashed potatoes due to poor hygiene and handwashing practices.
Conclusions:
- This is the first reported foodborne infection by Providencia alcalifaciens in Kenya.
- Inadequate hygiene, food storage, and handwashing practices were the likely causes of the outbreak.
- Enhanced public health surveillance and hygiene education are crucial to prevent future outbreaks.
Abstract:
Providencia alcalifaciens is an emerging bacterial pathogen known to cause acute gastroenteritis in children and travelers. In July 2013, P. alcalifaciens was isolated from four children appearing for diarrhea at Kiambu District Hospital (KDH) in Kenya. This study describes the outbreak investigation, which aimed to identify the source and mechanisms of infection. We identified seven primary and four secondary cases. Among primary cases were four mothers who had children and experienced mild diarrhea after eating mashed potatoes. The mothers reported feeding children after visiting the toilet and washing their hands without soap. P. alcalifaciens was detected from all secondary cases, and the isolates were found to be clonal by random amplified polymorphic DNA (RAPD) fingerprinting. Our study suggests that the outbreak was caused by P. alcalifaciens, although no fluid accumulation was observed in rabbit ileal loops. The vehicle of the outbreak was believed to be the mashed potato dish, but the source of P. alcalifaciens could not be confirmed. We found that lack of hygiene, inadequate food storage, and improper hand washing before food preparation was the likely cause of the current outbreak. This is the first report of a foodborne infection caused by P. alcalifaciens in Kenya.
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