Acute Gastroenteritis Outbreak Associated with a Sports Event in Bumthang, Bhutan, 2012

Abstract

On 6 Sep 2012, a medical officer from Bumthang Hospital notified the Royal Center for Disease Control, Ministry of Health in Thimphu, Bhutan, of an outbreak of gastroenteritis among students following an annual sports-event. We investigated this outbreak to verify the diagnosis, identify risk factors, and recommend control measures.  A case control study was used to assess risk factors and determine the cause of the outbreak.  We identified 202 cases among 587 participants, giving an overall attack rate of 34.4%. Cases were three times (odds ratio = 2.9, 95% CI = 1.89-4.31) more likely to have eaten beef curry and were also twice (odds ratio = 2.1, 95% CI = 1.39-3.14) as likely to have drunk pond water than controls. Four of 32 stool samples were positive for Campylobacter jejuni, and one was positive for Shigella sonnei. This was the first gastroenteritis outbreak related to a sport event in Bhutan possibly caused by Campylobacter jejuni that was associated with the consumption of beef curry.