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Restaurant-associated outbreak possibly linked to methomyl poisoning, Ohio, 2000

Beatty, Mark E., Cowen, Kathy, Hoffman, Elizabeth, Long, Teresa, Parrish, Mary, Genevie, Ron, Smith, Forrest, Henderson, Alden, Barr, John, Olsen, Sonja J.
Food protection trends 2004 v.24 no.11 pp. 821-826
case-control studies, confidence interval, etiology, gastrointestinal system, incubation period, methomyl, nausea, odds ratio, patients, poisoning, salads, vomiting, Ohio
Sixty-eight percent of food borne outbreaks reported to CDC each year have no etiology identified. A subset of these is comprised of outbreaks with rapid onset and short duration. Differences exist in the identification of the cause of these outbreaks from traditional foodborne outbreaks. This study examined a foodborne outbreak associated with the carbamate pesticide methomyl at a restaurant in Columbus, Ohio, during October 2000. We conducted a case-control study and targeted laboratory testing of clinical and food specimens. We identified 25 patients and 48 controls. The most common symptoms were nausea (84%) and vomiting (52%). The median incubation period was 30 minutes. The house salad was statistically implicated (Odds Ratio = 8.9; 95% Confidence Interval =1.1-198). Methomyl was detected in two salad samples and an ill patron's vomitus. Methomyl-containing fly bait was in use at the restaurant. In summary, a salad contaminated with methomyl likely caused an outbreak of gastrointestinal illness with rapid onset and short duration. Identifying the cause of foodborne chemical outbreaks depends on early suspicion, collection of appropriate specimens, and laboratory procedures that detect a range of likely agents.