Safe handling of uncooked, unpasteurized tempeh should be emphasized for preven- The number of pathogens required to cause an infection varies from as few as one (for Cryptosporidium) to as many as 10 8 (for Vibrio cholerae). During an investigation of an outbreak of gastroenteritis caused by Salmonella enterica serovar Paratyphi B variant L(+) tartrate(+), we identified unpasteurized tempeh as a novel food vehicle and Rhizopus spp. 88. GII noroviruses are a common cause of acute gastroenteritis (AGE) outbreaks in institutional settings globally. The time frame of the disease occurrence, environmental observations, anecdotal evidences, and the results of analytical study indicated the possibility of the acute gastroenteritis outbreak as a result of pipeline contamination. Guidelines for the public health management of gastroenteritis outbreaks due to norovirus. For example, by analyzing data from four different syndromic surveillance systems, health department staff in New York City noted a consistent increase in gastroenteritis in the days following a prolonged blackout in August 2003.

The results of the outbreak investigation indicated person-to-person and airborne transmission which is the most frequently recognized pattern in nosocomial viral gastroenteritis outbreaks 1, 5, 10. Rapid investigation of outbreaks of unknown etiology is critical for the identification of contaminated food vehicles or other possible sources of exposure, as well as the prevention of additional cases. On this basis an investigation was undertaken to identify the likely source of disease, in terms of both infectious agent and the vehicle of transmission. Outbreak investigations, an important and challenging component of epidemiology and public health, can help identify the source of ongoing outbreaks and prevent additional cases. 4 Gastroenteritis outbreak investigation An outbreak may be defined as the occurrence of a disease or health event in excess of the expected number of cases for a given time or place. cluster of cases was thought to represent a common source outbreak of gastroenteritis with a probable food-borne source of infection. starter culture as the source of the contamination. Published 1 April 2014 From: Public Health England. Investigation of a Rotavirus Gastroenteritis Outbreak among Immunosuppressed Patients in a Hospital Setting Ken Sugata 1 , 2 * , Jennifer Hull 1 , Houping Wang 1 , Kimberly Foytich 1 , Sung-Sil Moon 1 , Yoshiyuki Takahashi 3 , Seiji Kojima 3 , Tetsushi Yoshikawa 4 and Baoming Jiang 1

J Hosp Infect 2000 ; 44 ( 2 ): 113 – 118 .