Download - FWBD KRM GP 001

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Page 1: FWBD KRM GP 001
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bakteria,

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Jika populasi terlalu ramai dan penyiasat tidak

mempunyai cukup anggota untuk melakukan temubual,

pilih sebahagian dari mereka yang ada gejala dan

sebahagian dari yang tidak mengalami sebarang gejala

secara rawak. Langkah ini membolehkan analisa statistik

dibuat mengikut kaedah case control.

Gabungkan hasil analisa dari kajian epidemiologi di atas

dengan penemuan dari ujian makmal dan siasatan

persekitaran untuk merumuskan punca berlakunya

keracunan.

b. Mengambil sampel-sampel klinikal, makanan yang

disyaki, bahan mentah dan sampel lain jika berkaitan

seperti:

spesimen najis

sample muntah

swab rektal

swab peralatan memasak

swab (hidung, tekak, anggota) pengendali makanan

Swab persekitaran (meja, peti ais, kepala paip, effluen

tangki septic dan lain-lain)

PENGAMBILAN SAMPEL KLINIKAL AMAT PENTING kerana

ia boleh memberi petunjuk mengenai jenis patogen penyebab.

Ini kerana, sampel makanan biasanya tidak dapat diperolehi

semasa penyiasatan.

c. Menjalankan pemeriksaan ke atas premis makanan di

mana berlaku kejadian keracunan makanan.

Menganalisa keselamatan makanan menggunakan kaedah

HACCP. Pegawai Teknologi Makanan boleh dipanggil

dalam membantu siasatan.

Menutup premis di bawah Sek 18(1)(d) Akta 342

[Pengawalan dan Pencegahan Penyakit Berjangkit 1988]

atau (seksyen 10 atau 11 Akta Makanan 1983)

Menyita makanan.

Kawalan vektor (LILATI)

d. Pendidikan Kesihatan

Prosedur penyiasatan dan kawalan adalah seperti mana yang

dijelaskan di dalam Garispanduan Umum FWBD/UMU/GP/001

(pindaan2006).

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Lampiran 2

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Eating unknow

n

va

rie

tie

s o

f

mu

sh

ro

om

s,

mistaking toxic

mu

sh

ro

om

s fo

r

ed

ib

le

va

rie

tie

s

Pu

rch

asin

g

antim

ony conta

ining

utensils, storing high

acid foods in gray

enam

elw

are

Sp

ecim

en

s to

Co

lle

ct

Vom

itus

Vo

mitu

s, sto

ols,

urine

Fo

od

u

su

ally

In

vo

lved

3

Ma

ny va

rie

tie

s

of vild

mu

sh

ro

om

s

High-acid food

and b

evera

ges

Sy

mp

to

ms

a

nd

Sig

ns

Nausea, vom

iting

retching, diarrhea,

ab

do

min

al cra

mp

s

Vo

mitin

g, a

bd

om

in

al

pa

in

, d

ia

rrh

oe

a

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

3 m

in to 2 hours

Few

m

in to

1 hours

Ae

tio

lo

gic

a

ge

nt

an

d so

urce

Po

ssib

ly re

sin

-like

substances in

so

me

m

ush

roo

ms

Antim

ony in gray

enam

elw

are

Dis

ea

se

UP

PE

R G

AS

TR

OIN

TE

ST

IN

AL

, T

RA

CT

S

YM

PT

OM

S A

ND

S

IG

NS

[N

AU

SE

A, V

OM

IT

IN

G] O

CC

UR

F

IR

ST

O

R P

RE

DO

MIN

AT

E

In

cu

ba

tio

n [L

ate

nc

y] P

erio

d U

su

ally

L

es

s th

an

1

h

ou

r

Fu

ng

al A

gen

ts

Gastroin-

testinal

irritating group

mu

sh

ro

om

po

iso

in

in

g

Ch

em

ic

al A

ge

nt

4

Antim

ony

TA

BL

E B

– IL

LN

ES

SE

S A

TT

RIB

UT

ED

T

O F

OO

DS

A C

ON

DE

NS

ED

C

LA

SS

IF

IC

AT

IO

N B

Y S

YM

PT

OM

S, IN

CU

BA

TIO

N P

ER

IO

D, A

ND

T

YP

ES

O

F A

GE

NT

S

1,2

Page 22: FWBD KRM GP 001

15

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Storing

insecticides in

sam

e areas as

fo

od

s, m

ista

kin

g

pesticides for

po

wd

ere

d fo

od

s

Pu

rcha

sin

g le

ad

containing

ve

sse

ls, sto

rin

g

high acid foods in

lead containing

ve

sse

ls, sto

rin

g

pesticides in sam

e

are

a a

s foo

d.

Using uncoated tin

containers for

storing high-acid

foods

Sp

ecim

en

s to

Co

llect

Vom

itus, gastric

washing

Vom

itus, gastric

wa

sh

in

gs, sto

ols,

blo

od

, u

rin

e

Vo

mitu

s, sto

ols

urin

e, b

lo

od

Fo

od

u

su

ally

In

vo

lved

3

Any accidentally

contam

inated

foods,

particularly dry

foods [such as

dry m

ilk, flo

ur, baking

pow

der,

cake m

ixes]

High acid foods

an

d b

evera

ge

s

sto

re

d in

le

ad

containing

vessels, any

accid

entally

contam

inated

food

High-acid foods

an

d b

evera

ge

s

Sy

mp

to

ms

a

nd

Sig

ns

Salty or soapy taste,

num

bness of m

outh,

vom

iting, diarrhea,

ab

do

min

al p

ain

,

pa

llo

r, cya

no

sis,

dila

te

d p

up

ils,

spasm

s, collapse,

shock

Metalic taste,

burning of m

outh,

ab

do

min

al p

ain

,

milky vom

itus,

bloo

dy or black

sto

ols, fo

ul b

re

ath

,

sh

ock, b

lu

e g

um

line

Blo

atin

g, n

au

se

a,

vom

iting,

abdom

inal, cra

mps,

dia

rrh

oe

a,

he

ad

ache

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Few

m

in to

2 hours

30

m

in o

r lo

ng

er

30 m

in to 2 h

ours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

So

diu

m flu

orid

e in

insecticides and

rod

enticide

s

Lead in

earthenw

are

vessels,

pesticides, pa

int,

plaster, putty,

soldered joints

Tin

in

tin

ne

d ca

ns

Dis

ea

se

Fluorid

e

poisoning

Le

ad

poisoning

Tin

poisoning

Page 23: FWBD KRM GP 001

16

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Pu

rch

asin

g

Cadm

ium

containing

utensils, storing

high acid foods in

cadm

ium

containing

containers,

in

gesting

cadm

ium

containing foods

Storing high-acid

fo

od

s in co

pp

er

utensils or using

co

pp

er p

ip

es fo

r

disp

en

sin

g h

ig

h-

acid beverages,

faulty ba

ckflow

prevented valves

in vending

machines

Sp

ecim

en

s to

Co

llect

Vo

mitu

s, sto

ols,

urine, blood

Vom

itus, gastric

washings, urine,

bloo

d

Fo

od

u

su

ally

In

vo

lved

3

High-acid foods

an

d b

evera

ge

s

[m

etal colored

cake decorations]

High-acid foods

an

d b

evera

ge

s

Sy

mp

to

ms

a

nd

Sig

ns

Nause, vom

iting

ab

do

min

al cra

mp

s,

diarrhea, shock

Metalic taste,

nausea, vom

iting

[green vom

itus],

ab

do

mina

l p

ain

diarrh

oea

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

15 to 30 m

in

Few

m

in to

fe

w h

ou

rs

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Ca

dm

ium

in

plated utensils

Co

pp

er in p

ip

es

and utensils

Dis

ea

se

Cadm

ium

po

isoning

Co

oper p

oiso

ning

Page 24: FWBD KRM GP 001

17

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Storing high-acid

fo

od

s in

ga

lva

nize

d ca

ns

Storing cooked foods at room

te

mp

era

tu

re

, storin

g co

oke

d

foods in large containers in

re

frig

era

tors, prep

arin

g fo

od

s

several hours before serving

Stored cooked food at room

te

mp

era

tu

re

, storin

g co

oke

d

food in large containers in

re

frig

ara

tors, to

uch

in

g co

oke

d

foods, preparing foods several

ho

urs b

efore

servin

g, p

erso

n

with infections containing pus,

holiding foods at w

arm

tem

peratures, ferm

entation of

abnorm

ally low

-acids foods

Sp

ecim

en

s to

Co

llect

Vom

itus, gastric

washings, urine,

blood, stools

Vo

mitu

s, sto

ol

Vo

mitu

s, sto

ols,

re

cta

l sw

ab

.

Carriers: nasal

sw

ab, sw

ab of

le

sio

ns, a

na

l sw

ab

Fo

od

u

su

ally

In

vo

lv

ed

3

High-acid foods

an

d b

evera

ge

s

Bo

ile

d o

r frie

d

Rice

Ham

, m

eat and

poultry pro

ducts,

cre

am

-fille

d

pastries, w

hipped

bu

tte

r, ch

ee

se

, d

ry

milk, fo

od m

ixture,

high protein leftover

fo

od

s.

Sy

mp

to

ms

a

nd

S

ig

ns

Pain in m

outh and

ab

do

me

n, n

au

se

a,

vom

iting, dizzines

Nausea, vom

iting,

occasion

ally

Dia

rrh

oe

a

Nausea, vom

iting,

re

tch

in

g, a

bd

om

in

al

pa

in

, d

ia

rrh

oe

al,

prostrations

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Fe

w m

in

to

fe

w h

ou

rs

½ to

5

h

ou

rs

1 to 8 hours. M

ean

2 to 4 hours.

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Zinc in galvanized

containers

Exo-enterotoxin of

B.

ce

reu

s.

Organism

in so

il

Exo-enterotoxins A

,

B, C

, D

, E

o

r F

o

f

Staphylococci

aureus. O

rg

anism

from

naoses, skin

and lesions of

in

fe

cte

d h

um

an

s

an

d a

nim

als a

nd

fro

m u

dd

ers o

f co

ws

Dis

ea

se

Zin

c p

oiso

nin

g

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

Ran

ge

of

1 to

6 h

ou

rs

Ba

cte

ria

l A

ge

nts

Ba

cillu

s

ce

re

us

gastroenteritis

Staphylococcal

in

to

xica

tio

n

Page 25: FWBD KRM GP 001

18

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Using excessive

am

ou

nts o

f n

itrite

s

or nitrates in fo

ods

fo

r cu

rin

g o

r fo

r

covering up

sp

oilag

e,

mistaking nitrites

for com

mon salt

an

d other

co

nd

im

ents,

im

proper

refrigeration of

fresh produce.

Excessive

nitrification of

fertilized fields

Ha

rve

stin

g

sh

ellfish

fro

m

waters w

ith high

concentration of

Din

op

hyse

s

Sp

ecim

en

s to

Co

llect

Blood

Gastric w

ashings

Fo

od

u

su

ally

In

vo

lved

3

Cured m

eats, any

accidentally

contam

inated

food, spinach

exposed to

exce

ssive

nitrification

Mussels, clam

s,

scallops

Sy

mp

to

ms

a

nd

Sig

ns

Nause, vom

iting

cya

no

sis, h

ea

da

ch

e,

dizziness,

weakness, loss of

co

nscio

usn

ess,

choco

late brow

n

co

lo

ure

d blo

od

Nausea, vom

iting

ab

do

min

al cra

mp

s,

chills

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

1 to 2 hours

½ to

1

2 h

ou

rs

usu

ally 4 ho

urs

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Nitrites or nitrates

use

d a

s m

eat

curing com

pounds

or ground w

ate

r

from

shallow

we

lls, fe

rtilize

r

Okad

aic acid a

nd

oth

er to

xin

s

pro

du

ce

d b

y

dinoflage

llates

Dinophyses

acu

minate a

nd

D

.

forti

Dis

ea

se

Ch

em

ic

al A

ge

nts

Nitrite

poiso

ning

Diarrhetic

shellfish

poiso

ning

Page 26: FWBD KRM GP 001

19

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Eating certain

sp

ecie

s o

f

Am

anita,

Ga

le

rin

e, a

nd

Tyro

mitra

mu

sh

ro

om

s,

eating u

nkn

ow

n

va

rie

tie

s o

f

mushroom

s,

mistaking toxic

mu

sh

ro

om

s fo

r

ed

ib

le

va

rie

tie

s

Sp

ecim

en

s to

Co

llect

Urine

, b

lo

od,

vom

itus

Fo

od

u

su

ally

In

vo

lv

ed

3

Am

anita

ph

allo

id

es, A

,

verna, G

alerina

autum

nalis,

Gyrom

itra

esculenta [false

morels] and

sim

ilar sp

ecies o

f

mu

sh

ro

om

s

Sy

mp

to

ms

a

nd

Sig

ns

Ab

do

min

al p

ain

,

fe

elin

g o

f fu

lln

ess,

vom

iting, protracted

diarrhoea, loss of

stre

ng

th

, th

irst,

muscle cram

ps,

co

lla

pse

, ja

un

dice

,

dro

wsin

ess, d

ila

te

d

pupils, com

a death

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

6 to 24 hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Cyclo

pe

ptid

es a

nd

gyro

mitrin

in

so

me

mu

sh

ro

om

s

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

Ran

ge

of

7 to

12

ho

urs

Fu

ng

al A

ge

nt

Cyclo

pe

ptid

e

and gyrom

itrin

gro

up

s of

mu

sh

ro

om

poisoning

Page 27: FWBD KRM GP 001

20

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

In

ad

eq

ua

te

rinsing of b

ottles

cle

an

ed

w

ith

ca

ustic sod

a,

in

ad

eq

uate

b

akin

g

of p

re

tze

ls

Pe

rso

ns tou

ch

in

g co

oke

d

fo

od

s, p

erso

ns w

ith

infections containing

pus, room

tem

perature

storage, storing cooked

foo

d in large containers

in refrigerators,

inadequate co

oking or

reheating preparing

foods several hours

before serving.

Sp

ecim

en

s to

Co

llect

Vom

itus

Th

ro

at sw

ab

s,

vom

itus

Fo

od

u

su

ally

In

vo

lv

ed

3

Bo

ttle

d

beverag

es,

pretzels

Ra

w m

ilk, fo

od

s

containing eggs

Sy

mp

to

ms

a

nd

Sig

ns

Burning of lips,

mouth and throat,

vom

iting,

ab

do

min

al p

ain

,

diarrh

oea

So

re

th

ro

at, fe

ve

r,

nausea, vom

iting,

rhinorrhoea,

som

etim

es a rash

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Few

m

in

1 to 3 days

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Sod

ium

hydroxid

e

in

b

ottle

w

ash

in

g

co

mp

ou

nd

s,

detergents, drain

cle

an

ers, o

r h

air

straighteners

Streptococcus

pyo

ge

ne

s fro

m

throat and lesions

of infected

hum

ans

Dis

ea

se

SO

RE

T

HR

OA

T A

ND

R

ES

PIR

AT

OR

Y S

YM

PT

OM

S A

ND

S

IG

NS

O

CC

UR

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

Les

s th

an 1

ho

urs

Ch

em

ic

al A

ge

nts

Sod

ium

hydroxid

e

poisoning

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

Ran

ge

of

13 t

o 7

2 h

ou

rs

Ba

cte

ria

l A

ge

nts

Be

ta

h

em

olytic

streptococcal

in

fe

ctio

ns

Page 28: FWBD KRM GP 001

21

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Sto

rin

g co

oke

d fo

od

s

at room

tem

perature,

sto

rin

g co

oke

d fo

od

s

in large containers in

refrigerators, holding

fo

od

s a

t w

arm

[bacterial incubating]

tem

peratures,

pre

pa

rin

g fo

od

s

several hours before

se

rvin

g, in

ad

eq

ua

te

reheating of leftovers

Sto

rin

g co

oke

d fo

od

s

at room

tem

perature,

sto

rin

g co

oke

d fo

od

s

in large containers in

ho

ld

in

g fo

od

s a

t

warm

[bacterial

incubating] tem

perature,

pre

pa

rin

g fo

od

s

se

rvin

g, in

ad

eq

ua

te

reheating of leftovers.

Sp

ecim

en

s to

Co

llect

Sto

ols

Sto

ols

Fo

od

u

su

ally

In

vo

lv

ed

3

Cereal prod

ucts

so

up

s, cu

sta

rd

s

and sauces,

meatloaf,

sa

usa

ge

, co

oke

d

vegetables,

re

co

nstitu

te

d

dried potato

es,

refried beans

Cooked m

eat,

poultry, gravy,

sa

uce

s, so

up

s,

refried beans

Sy

mp

to

ms

a

nd

Sig

ns

Nausea, abdom

inal

pa

in

, w

ate

ry

diarrh

oea

Ab

do

min

al p

ain

,

diarrh

oea

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

8 to 16 hours

[m

ea

n 1

2 h

ou

rs]

8 to 22 hours

[m

ea

n 1

0 h

ou

rs]

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

En

te

ro

to

xin

o

f B

.

ce

reu

s.

Org

an

ism

in soil

Endo-enterotoxin

fo

rm

ed

d

urin

g

sporulation of C

.

perfringens in

in

te

stin

es.

Organism

in

fa

ece

s o

f

hum

ans, oth

er

anim

als, and in

so

il

Disease

LO

WE

R G

AS

TR

OIN

TE

ST

IN

AL

T

RA

CT

S

YM

PT

OM

S A

ND

S

IG

NS

[A

BD

OM

IN

AL

C

RA

MP

S, D

IA

RR

HE

A] O

CC

UR

F

IR

ST

O

R P

RE

DO

MIN

AT

E

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

“Ran

ge

of

7 to

12

ho

urs

Ba

cte

ria

l A

ge

nts

Ba

cillu

s cere

us

enteritis

Clo

stridiu

m

perfringens

enteritis

Page 29: FWBD KRM GP 001

22

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Drinking raw

m

ilk,

eating raw

m

eat,

in

ad

eq

uate

coo

king or

pasteurizatio

n

Obtaining fish and shell

fish from

sew

age

contam

inated w

aters in

endem

ic areas, poor

perso

na

l hygiene,

in

fe

cte

d p

erso

ns

touching foods,

inadequate co

oking

using co

ntam

inated

water to w

ash or freshen

fo

od

s, im

pro

pe

r sew

ag

e

disp

osa

l, usin

g nig

ht so

il

as fertilizer

Sp

ecim

en

s to

Co

llect

Stools, rectal

sw

ab, blood

Stools

Fo

od

u

su

ally

In

vo

lved

3

Ra

w m

ilk, p

ou

ltry,

beef liver, ra

w

clam

s, w

ater

Raw

fish, raw

sh

ellfish

,

crustacea, foods

washed or

pre

pa

re

d w

ith

contam

inated

water, w

ater

Sy

mp

to

ms

a

nd

Sig

ns

Diarrhoea, [often

bloody]

severe ab

do

mina

l

pain, fever,

an

ore

xia

, m

ala

ise

,

headache,

vom

iting

Profuse w

atery

dia

rrh

oe

a [rice

water stools],

vom

iting,

ab

do

min

al p

ain

,

dehydration,

thirst, collapse,

red

uced skin

turgor, w

rinkled

fin

ge

rs, su

nke

n

eyes

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

2 to 7 days,

[m

ean 3 to

5 days]

1 to 3 days

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

C.

jeju

ni

Enterotoxin of

Vib

rio

ch

ole

rae

01

classical an

d E

l

To

r b

io

typ

es, fro

m

faeces of infected

hum

ans

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

“Ran

ge

of

13 t

o 7

2 h

ou

rs”

Bacterial A

gen

ts

Ca

mp

ylo

ba

cte

r

enterocolitis

Cholera

Page 30: FWBD KRM GP 001

23

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Storing co

oked foods

at room

tem

perature,

sto

rin

g co

oke

d fo

od

s

in large containers in

refrigerators, holding

fo

od

s a

t w

arm

[bacterial incubating]

tem

peratures, inadequate

coo

king an

d re

he

ating

pre

pa

ring

fo

od

s seve

ra

l

ho

urs b

efo

re

se

rvin

g,

cross contam

ination,

im

proper cleaning of

eq

uipm

ent, o

btaining

foods from

co

ntam

inated

sources

In

fe

cte

d p

erso

ns

touching foods,

Im

pro

per

refrigeration,

in

ad

eq

uate co

oking

an

d re

he

ating

Sp

ecim

en

s to

Co

llect

Stools, rectal

sw

abs

Stools, rectal

sw

abs

Fo

od

u

su

ally

In

vo

lved

3

Po

ultry a

nd

m

ea

t

and th

eir p

roducts.

Egg products raw

milk and dairy

pro

du

cts, oth

er

fo

od

s co

nta

min

ate

d

by salm

onella

Any contam

in

ated

fo

od

, fre

qu

en

tly

salads, w

ater

Sy

mp

to

ms

a

nd

Sig

ns

Ab

do

min

al p

ain

,

diarrh

oea, chills,

fever, nausea,

vom

iting, m

alaise

Ab

do

min

al p

ain

,

dia

rrh

oe

a, b

lo

od

y

and m

ucoid

stools, fever

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

6 to 72 hours

me

an

1

8 to

3

6

hours

24 to 72 hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Va

rio

us se

ro

typ

es

of S

alm

on

ella from

faeces of anim

als

Sh

ige

lla

fle

xn

eri

, S

.

dysente

riae,

S.

so

nn

el a

nd S

.

boydii f

ro

m fa

ece

s

of infected

hum

ans

Dis

ea

se

Sa

lm

on

ello

sis

Sh

ig

ello

sis

Page 31: FWBD KRM GP 001

24

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Obtaining fish and

sh

ellfish fro

m sew

ag

e

contam

inated w

aters,

inadequate co

oking, cross

contam

in

atio

n

In

fe

cte

d p

erso

ns

touching foods,

Im

pro

per

refrigeration,

in

ad

eq

uate

cooking, im

proper

cle

an

in

g a

nd

disinfecting of

equipm

ent, eating

raw

or rare m

eats

[hem

orrhagic

syndrom

e]

Sp

ecim

en

s to

Co

llect

Stools

Stools, rectal

sw

abs

Fo

od

u

su

ally

In

vo

lved

3

Sh

ellfish

, F

ish

So

ft ch

ee

se

, ra

re

ham

burger, w

ater

Sy

mp

to

ms

a

nd

Sig

ns

Watery diarrhoea

[varies from

loose

stools to cholera-

lim

e dise

ase]

Se

ve

re

a

bd

om

in

al

pa

in

, d

ia

rrh

oe

a

[som

etim

es

blo

od

y] n

au

se

a,

vom

iting fever,

ch

ills, h

ead

ach

e,

mu

scu

la

r p

ain

.

[bloody urine-

hem

orrhagic

strains]

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

2 to 3 days

5 to 48 hours

me

an

1

0 to

2

4

hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Non 01 vibrios:

Vib

rio

ch

ole

rae

,

Vib

rio m

imic

us,

Vib

rio f

luvia

lis,

Vib

rio h

olli

sa

e

Entero-

pathoge

nic,

enterotoxigenic,

enteroinvasive

hem

orrhagic

strains [e.g. 0157]

of E

. co

li fro

m

faeces of infected

hum

ans a

nd other

an

im

al

Dis

ea

se

Vibrio

cho

lera-like

gastroenteritis

Pa

th

og

en

ic

Escherichia

coli diarrhea

Page 32: FWBD KRM GP 001

25

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Inadequate

cooking, im

proper

refrigeration,

cross contam

i-

nation, im

proper

cle

an

in

g o

f

eq

uipm

ent, using

sea w

ater in food

pre

pa

ra

tio

n o

r to

cool cooked fo

ods

Ina

de

qu

ate co

oking

contam

ination after

pasteurization, contam

ination

of foods by w

ater, rodents,

oth

er a

nim

als

Sp

ecim

en

s to

Co

llect

Stools, rectal

sw

abs

Stools, blood

Fo

od

u

su

ally

In

vo

lved

3

Marine fish,

sh

ellfish

,

crustacea [raw

or

contam

inated]

Milk, to

fu

, w

ate

r

Sy

mp

to

ms

a

nd

Sig

ns

Ab

do

min

al p

ain

,

diarrhoea,

nausea, vom

iting,

fever, chills,

he

ad

ache

Se

ve

re

a

bd

om

in

al

pain, fever

headache,

malaise, sore

th

ro

at. M

ay

stim

ulate

ap

pe

nd

icitis

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

2 to 48 hours

me

an

1

2 h

ou

rs

24 to 36 hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Vib

ro

para

haem

oly

ticus

from

se

afood and

seaw

ater

Ye

rsin

ia

ente

rocolit

ica.

Y.

pseudotu

ber-

culo

sis

Dis

ea

se

Vibro para

ha

em

olyticus

gastroenteritis

Ye

rsin

io

sis

Page 33: FWBD KRM GP 001

26

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

Ou

tb

re

ak

s

Sew

age pollution

of shellfish

grow

ing w

aters,

poor personal

hyg

ie

ne

, in

fe

cte

d

persons touching

foods

Po

or p

erso

na

l

hyg

ie

ne

, in

fe

cte

d

persons touching

fo

od

s, in

ade

qu

ate

cooking and

reheating

Sp

ecim

en

s to

Co

llect

Stools

Stools

Fo

od

u

su

ally

In

vo

lved

3

Cla

ms, o

yste

rs,

cockles, green

sa

la

ds, p

astry,

fostings

Unknow

n

Sy

mp

to

ms

a

nd

Sig

ns

Nausea, vom

iting,

Ab

do

min

al p

ain

,

dia

rrh

oe

a, lo

w

grade fever, chills,

malaise, anorexia

headache;

Duration approxi-

mately 36 h

Diarrhoea, fever,

vom

iting,

ab

do

min

al p

ain

,

som

etim

es

respiratory

sym

ptom

s

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

16

- 4

8 h

ours

3 to 5 days

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

No

rw

alk a

ge

nt

virus

Enteric viruses

[E

HC

O viruses,

Coxsackie

viruses,

reoviruses,

adenoviruses

rotaviruses,

polioviruses]

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

Gre

ater

th

an 7

2 h

ou

rs

Viral A

gen

ts

No

rw

alk a

ge

nt

gastroenteritis

Non specific

viral

gastroenteritis

Page 34: FWBD KRM GP 001

27

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Po

or p

erso

na

l

hyg

ie

ne

, in

fe

cte

d

pe

rso

ns to

uch

in

g

fo

od

s, in

ad

eq

ua

te

cooking

Po

or p

erso

na

l h

yg

ie

ne

,

in

fe

cte

d p

erso

n to

uch

in

g

fo

od

s, in

ad

eq

ua

te

co

okin

g, im

pro

pe

r

sew

age disposal, w

ater

contam

inated by

anim

als.

Sp

ecim

en

s to

Co

llect

Sto

ols

Sto

ols

Fo

od

u

su

ally

In

vo

lv

ed

3

Ra

w ve

getab

le

s

an

d fru

its [

Salm

on, w

ater

raw

vegetables

an

d fru

its [

Sy

mp

to

ms

a

nd

Sig

ns

Ab

do

min

al p

ain

,

constipation or

diarrhoea [faeces

containing blood

an

d m

uco

us]

Ab

do

min

al p

ain

,

mucoid diarrho

ea

fa

tty sto

ols

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

5 d

ays to several

mon, m

ean 3 to 4

we

eks

1 to 4 w

eeks

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

En

tam

oe

ba

his

toly

tica fro

m

feces of infected

hum

ans

Gia

rdia

la

mb

lia

fro

m fa

ece

s o

f

in

fe

cte

d h

um

an

s

or anim

als

Dis

ea

se

Parasitic A

gen

ts

Am

oe

bic

dysentery

[A

moebiasis]

Giardiasis

Page 35: FWBD KRM GP 001

28

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Ingestion of raw

fish, inadequate

cooking

Lack of m

eat

in

sp

ectio

n,

in

ad

eq

uate

cooking

in

ad

eq

uate

sew

age disposal,

sew

age

contam

inated

pastures

Inadequate

cooking, im

proper

sew

age disposal,

sew

age

contam

inated

lakes

Lack of m

eat

in

sp

ectio

n,

in

ad

eq

uate

cooking im

proper

sew

age disposal,

contam

inated

pastures

Sp

ecim

en

s to

Co

llect

Stools

Stools

Stools

Stools

Fo

od

u

su

ally

In

vo

lved

3

Rock fish, herring,

cod, squid

Raw

or insufficiently

co

oke

d b

ee

f

Raw

or

Insufficiently

cooked freshw

ater

fish [perch, pike,

turbot, salm

on]

Raw

or

insufficiently

co

oke

d p

ork

Sy

mp

to

ms

a

nd

Sig

ns

Stom

ach pa

in,

nausea, vom

iting

ab

do

min

al p

ain

,

dia

rrh

oe

a, fe

ve

r

Va

gu

e d

isco

mfo

rt,

hunger pain, lo

ss

of w

eig

ht,

abdo

minal p

ain

Va

gu

e g

astro

intestinal

disco

mfo

rt,

anaem

ia m

ay

occur

Va

gu

e d

isco

mfo

rt,

hunger pains, loss

of w

eight

convulsions

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

4 to 6 hours

8 to 14 w

eeks

5 to 6 w

eeks

8 to 14 w

eeks

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Anis

akis

Ph

oca

ne

ma

Porr

ocaecum

Taenia

sagin

ata

form

flesh of

infested cattle

Dip

hyllob

oth

riu

m

latu

m fro

m fle

sh

o

f

infested fish

Taenia

solium

from

flesh of

in

fe

cte

d sw

in

e

Dis

ea

se

Anisakiasis

Be

ef ta

pe

wo

rm

infection

[T

aeniasis]

Fish

ta

pe

wa

rm

infection

[D

ip

hyllo

-

bothriasis]

Pork tapew

orm

infection

[T

aeniasis]

Page 36: FWBD KRM GP 001

29

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Inappropriate

application for

me

lo

ns, storin

g

nse

cticid

es in

sam

e area as

fo

od

s, m

ista

kin

g

pesticides for

po

wd

ere

d fo

od

s

Spraying foods

just before

harvesting,

storing

insecticides in

sam

e area as

fo

od

s, m

ista

kin

g

pesticides for

dried foods.

Sp

ecim

en

s to

Co

llect

Blood, urine

Blo

od

, u

rin

e, fa

t

biopsy

Fo

od

u

su

ally

In

vo

lved

3

Waterm

elons, any

accidentally

contam

inated food

Any accidentally

contam

inated food

Sy

mp

to

ms

a

nd

Sig

ns

Ep

ig

astric p

ain

,

vom

iting,

ab

norm

al

salivation,

sw

ea

tin

g,

contraction of

pupils, m

uscular

incoordination

Nausea, vom

iting

ab

dom

inal

cram

ps,

dia

rrh

oe

a,

he

ad

ache

nervousness,

blurred vision,

chest pain,

cya

no

sis,

confusion

tw

itching,

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

½ hours

Fe

w m

in

to

fe

w

hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Ca

rb

arly [se

vin

]

Tem

ik [aldicarb]

Orga

no

ph

osph

oro

us

in

se

cticid

es [su

ch

as parathion,

TE

PP

, d

ia

zin

on

malathion]

Dis

ea

se

NE

UR

OL

OG

IC

AL

S

YM

TO

MS

A

ND

S

IG

N [V

IS

UA

L D

IS

TU

RB

AN

CE

S, T

IN

GL

IN

G, A

ND

/O

R P

AR

AL

YS

IS

] O

CC

UR

4

Incubation [

Late

ncy]

Period U

sually L

ess T

han 1

hours

Ch

em

ic

al A

ge

nts

Carbam

ate

poisoning

Organophos

phorous

poisoning

Page 37: FWBD KRM GP 001

30

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Ha

rve

stin

g

sh

ellfish

fro

m

waters w

ith high

concentration of

Proto

gon

alulax o

r

Gym

no

din

iu

m

sp

ecie

s [R

ed

tid

es]

Eating puffe

r-type

fish

, fa

ilu

re

to

effectively rem

ove

intestines and

go

na

ds fro

m

pu

ffe

r-typ

e fish

if

they are to be

eaten

Sp

ecim

en

s to

Co

llect

Ga

stric

washin

gs

Fo

od

u

su

ally

In

vo

lv

ed

3

Mussels and

calm

s

Pu

ffe

r-typ

e fish

Sy

mp

to

ms

a

nd

Sig

ns

Ting

ling, burning,

num

bness aro

un

d

lip

s, a

nd

fin

ge

r

tip

s, g

id

din

ess,

incoherent

sp

ee

ch

, d

ifficu

lty

to stand

respiratory

paralysis

Ting

ling se

nsatio

n

of fingers and

toes, d

izziness,

pa

llo

r, n

um

bn

ess

of m

outh a

nd

extrem

ities,

gastrointestinal

sym

ptom

s,

haem

orrhage,

desq

uam

ation of

skin

, e

ye

s, fixe

d,

tw

itch

in

g,

paralysis,

cya

no

sis, fa

ta

litie

s

occur

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Few

m

in to 30 m

in

10 m

in to 3 h

ours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Saxitoxin and

sim

ila

r to

xin

s fro

m

dinoflage

llates

Pro

to

go

na

ula

x

and G

ym

nodinium

species, w

hich are

co

nsu

me

d

Tetro

dotoxin from

intestines and

go

na

ds of

pu

ffe

rtyp

e fish

Disease

To

xic

A

nim

als

Paralytic

ne

uro

lo

gic

shellfish

po

isoning

Tetraodon

[F

ugu/P

uffer]

po

isoning

Page 38: FWBD KRM GP 001

31

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Eating A

.

muscaria and

related species of

mu

sh

ro

om

s,

eating u

nkn

ow

n

varieties of

mu

sh

ro

om

s,

mistaking toxic

mu

sh

ro

om

s fo

r

ed

ib

le

va

rie

tie

s

,

Eating m

uscarine

group of

mu

sh

ro

om

s,

eatin

g u

nkn

ow

n

varieties of

mu

sh

ro

om

s,

mistaking toxic

mushroom

for

ed

ib

le

m

ushro

om

s

Sp

ecim

en

s to

Co

llect

Vom

itus

Fo

od

u

su

ally

In

vo

lved

3

Am

anita

mu

sca

ria

, A

.

pa

nth

erin

a a

nd

related species of

mu

sh

ro

om

s

Clitocybe

dealbata, C

.

rivu

losa

a

nd m

an

y

species of In

ocybe

an

d B

oletus

mu

sh

ro

om

s

Sy

mp

to

ms

a

nd

Sig

ns

Dro

wsin

ess a

nd

state of

intoxication,

confusion

muscular spasm

s,

de

liriu

m, visu

al

disturbances

Excessive

salivation,

perspiration,

tearing, reduced

bloo

d pressure,

irregular pulse,

pupils constricted,

blurred vision,

asthm

atic

bre

ath

in

g

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

30 to 60 m

in

15 m

in to 2 h

ours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Ibotenic acid and

mu

scin

ol in

so

me

mu

sh

ro

om

s

Muscarine in

so

me

m

ush

roo

ms

Dis

ea

se

Pla

nt T

ox

ic

an

ts

Ibotenic acid

group of

mu

sh

ro

om

po

isoning

Muscarine

group of

mu

sh

ro

om

po

isoning

Page 39: FWBD KRM GP 001

32

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Eating any pa

rt of

Jim

son w

eed o

r

ea

tin

g to

ma

to

es

from

tom

ato plant

grafted to jim

son

weed stock

Eating w

ater

hem

lock;

mestaking w

ater

hem

lock root for

wild parsnip,

sw

ee

t p

ota

to

, o

r

carrot

Sp

ecim

en

s to

Co

llect

Urine

Urine

Fo

od

u

su

ally

In

vo

lved

3

An

y p

art o

f p

la

nt,

tom

atoes grafted

to

jim

so

n w

ee

d

stock

Ro

ot o

f w

ate

r

hem

lock C

icuta

viro

sa

. C

.

mascula

te,

an

d C

.

dougla

ril

Sy

mp

to

ms

a

nd

Sig

ns

Abnorm

al thirst,

ph

oto

ph

obia,

distorted sight,

difficulty in

sp

ea

kin

g,

flushing, d

elirium

,

co

ma

, rap

id h

eart

beat

Excessive

salivation,

nausea, vom

iting,

stom

ach pain,

frothing at m

outh,

irregular bre

ating,

co

nvu

lsio

ns,

respiratory

paralysis

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Less than 1 hours

15 to 60 m

in

utes

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Tro

pa

ne

a

lkalo

id

s

Resin and

cicutoxin in

hem

lock root

Dis

ea

se

Jim

son w

eed

Water h

em

lock

poisoning

Page 40: FWBD KRM GP 001

33

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Storing

insecticides in

sam

e area as

fo

od

, m

ista

king

pesticides for

dried foods

Eating liver,

in

te

stin

es, ro

e,

gonads, or flesh of

tropicfal reef

fishes; usually

large reef fish are

mo

re

co

mm

on

ly

toxic

Sp

ecim

en

s to

Co

llect

Blood, urine,

sto

ols, g

astric

washings

Fo

od

u

su

ally

In

vo

lv

ed

3

An

y a

ccid

en

ta

lly

contam

inated food

Num

erous

va

rie

tie

s o

f

tropical fish, e.g.

ba

rra

cu

da

,

gro

up

er, re

d

sna

ppe

r, a

mb

er

ja

ck, g

oa

t fish

,

skip jack, parrot

fish

Sy

mp

to

ms

a

nd

Sig

ns

Nausea, vom

iting

paraesthesia,

dizziness,

muscular

weakness,

an

ore

xia

, w

eig

ht

loss, confusion

Ga

stro

in

estin

al

sym

ptom

s,

tingling and

num

bness aro

un

d

mouth and

lim

bs, m

uscu

la

r

and joint pain,

dizzin

ess, cold

-

hot sensations,

rash, w

eakness,

slo

wn

ess o

f h

ea

rt

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

30 m

in to 6 h

ours

3 to 5 hours

som

etim

es

lo

ng

er

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Chlorinated

hydrocarb

on

insecticides

Cig

uato

xin

in

in

te

stin

es, ra

w

gonads, and flesh

of trop

ical m

arine

fish

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

Ran

ge

of

1 to

6 h

ou

rs

Ch

em

ic

al A

ge

nts

Chlorinated

hydrocarb

on

poisoning

To

xic

A

nim

als

Cig

ua

te

ra

poisoning

Page 41: FWBD KRM GP 001

34

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Ina

de

qu

ate he

at

processing of

can

ned fo

ods an

d

sm

oke

d fish

, p

ost-

processing

contam

inatio

n,

uncontrolle

d

ferm

entations,

im

proper curing of

Sp

ecim

en

s to

Co

llect

Blood, stool,

gastric w

ashings

Fo

od

u

su

ally

In

vo

lved

3

Ca

nn

ed

lo

w-a

cid

foods [usually

hom

e canned];

sm

oked fish;

co

oke

d p

ota

to

es;

fro

ze

n p

ot p

ie

s,

me

at lo

af, ste

w

left in ovens

with

out he

at

Sy

mp

to

ms

a

nd

Sig

ns

be

at, p

ro

stra

tio

n,

paralysis.

gastroenteritis

disappears in a

few

days

ne

uro

lo

gica

l

pro

ble

ms m

ay la

st

se

ve

ra

l d

ays.

deaths occur

Ga

stro

in

estin

al

sym

ptom

s m

ay

precede

ne

uro

lo

gica

l

sym

ptom

s.

ve

rtigo

, d

oub

le

or

blurred vision,

dryn

ess of m

outh,

difficulty in

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

2 hours to 8 days

[m

ean

18 to 36 ho

urs]

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Neurotoxins

A,B

,E

, a

nd

F

o

f

Clo

str

idiu

m

botu

linum

. S

po

re

s

found in soil, fresh

wa

te

r m

ud

a

nd

an

im

al

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

in t

he

Ran

ge

of

12 t

o 7

2 h

ou

rs

Bacterial A

gen

ts

Botulism

Page 42: FWBD KRM GP 001

35

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

ham

s a

nd fish,

tim

e tem

perature

abuse of potatoes,

po

t p

ie

s, ste

ws,

ho

ld

in

g fo

od

s a

t

room

a

nd w

arm

tem

peratures

Stream

s polluted w

ith

mercury com

pounds,

feeding anim

als

grains treated w

ith

mercury fu

ngicides,

eating m

ercury

treate

d grains or

meats from

a

nim

als

feed such grains.

Sp

ecim

en

s to

Co

llect

Urin

e, b

lo

od

, h

air

Fo

od

u

su

ally

In

vo

lved

3

overnight;

fe

rm

en

te

d fish

egg, fish, m

arine

mam

mals,

mu

skra

t ta

ils

Gra

in

s tre

ate

d

with m

ercury

containing

fu

ng

icid

e; p

ork,

fish and shellfish

exposed to

mercury

co

mp

ou

nd

s

Sy

mp

to

ms

a

nd

Sig

ns

sw

allo

win

g,

sp

ea

kin

g a

nd

bre

ath

in

g

descending

muscular

weakness,

co

nstip

atio

n,

pu

pils d

ila

te

d o

r

fixe

d, respiratory

paralysis.

Fa

ta

litie

s o

ccu

r

Num

bness,

weakness of legs,

sp

astic p

ara

lysis,

im

pa

irm

en

t o

f

vision, blindness,

com

a

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

1 w

eek or longer

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Methyl and ethyl

mercury

co

mp

ou

nd

s fro

m

industrial w

aste

and orga

nic

me

rcu

ry in

fungicides

Disease

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

Gre

ater

Th

an 7

2 h

ou

rs

Ch

em

ic

al A

ge

nts

Mercury

po

iso

nin

g

Page 43: FWBD KRM GP 001

36

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Using com

pound

as food extract or

as cooking or

salad oil.

Failure to

pasteurize m

ilk,

livestock infected

with

b

ru

ce

lla

c

Sp

ecim

en

s to

Co

llect

Bio

psy o

f

gastrocnem

ius

muscle

Blo

od

Fo

od

u

su

ally

In

vo

lv

ed

3

Co

okin

g o

ils,

extracts and other

fo

od

s co

nta

-

min

ate

d w

ith

trio

rth

ocre

sy

phosphate

Ra

w m

ilk, g

oa

t

cheese

Sy

mp

to

ms

a

nd

Sig

ns

Gastrointestinal

sym

pto

ms, [e

g.

pa

in

, u

ng

ain

ly

high stee

ping gait,

fo

od

a

nd

w

rist d

ro

p

Fe

ve

r, ch

ills,

sw

ea

tin

g,

weakness,

malaise,

he

ad

ache, m

uscle

and joint pain,

lo

ss o

f w

eig

ht

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

5 to

2

1 d

ays

[m

ea

n 1

0 d

ays]

7 to

2

1 d

ays

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Trio

rth

ocre

syl

phosphate used

as e

xtra

cts o

r a

s

oil substitute

Bru

ce

lla

ab

ort

us,

B.

melit

enis

is a

nd

B.

suis

fro

m

tissu

es a

nd

m

ilk o

f

in

fe

cte

d a

nim

als

Dis

ea

se

Trio

rth

o-

cresyl

phosphate

poisoning

GE

NE

RA

LIZ

ED

IN

FE

CT

IO

N S

YM

PT

OM

S A

ND

S

IG

N [F

EV

ER

, C

HIL

LS

, M

AL

AIS

E, A

ND

/O

R A

CH

ES

] O

CC

UR

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

Gre

ater

Th

an 7

2 h

ou

rs

Ba

cte

ria

l A

ge

nts

Brucellosis

Page 44: FWBD KRM GP 001

37

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

In

ad

eq

ua

te

co

okin

g, fa

ilu

re

to

pro

pe

rly

pasteurize m

ilk,

pro

lo

ng

ed

refrigeration

Ingestion of

contam

inated raw

milk, fa

ilu

re

to

pasteurize m

ilk

[1

45

F/6

3C

, 3

0

min

ute

s, 1

61

F/

72

C 1

5 seco

nd

s]

In

fe

cte

d p

erso

ns

touching foods, po

or

personal hygie

ne,

in

ad

eq

ua

te

co

okin

g,

im

proper refrigeration,

im

prop

er sew

age

disposal, obtaining

fo

od

s fro

m u

nsa

fe

sources, harvesting

sh

ellfish fro

m sew

ag

e

contam

inated w

aters

Sp

ecim

en

s to

Co

llect

Blood,

urine

Blo

od

Stools, rectal

sw

ab

s, b

lo

od

Fo

od

u

su

ally

In

vo

lv

ed

3

Co

le

sla

w, m

ilk,

ch

ee

se

, a

nim

al

pro

du

cts

Raw

m

ilk [rare]

Sh

ellfish, a

ny foo

d

contam

inated by

pe

rso

ns w

ho

touch foods, ra

w

milk, p

ost process

contam

inated

me

at, ch

ee

se

,

watercress w

ater

Sy

mp

to

ms

a

nd

Sig

ns

Fever, headache,

nausea, vom

iting,

stillbirths,

me

nin

gitis,

en

ce

ph

alitis,

se

psis

Chills, headache,

weakness,

Malaise

perspiration, fe

ver

co

ug

h, ch

est p

ain

Malaise,

headache, fever,

cough, nausea,

vom

iting,

co

nstip

atio

n,

ab

do

min

al p

ain

,

ch

ills, ro

se

sp

ots,

blo

od

y sto

ols

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

4 – 21 days

14 to 26 days,

me

an

2

0 d

ays

7 to

2

8 d

ays,

me

an

1

4 d

ays

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Lis

teria

mo

no

cyto

ge

ne

s

Co

xie

lla

bu

rne

tii

from

tissue and

milk of infected

anim

als

Sa

lmo

ne

lla t

yp

hi

[typh

oid] from

faeces of infected

hu

ma

ns. O

th

er

se

ro

typ

es o

f

Sa

lmo

ne

lla fro

m

faeces of infected

hum

ans or other

anim

als

Dis

ea

se

Listeriosis

Q fe

ve

r

Typh

oid or

Pa

ra

typ

ho

id

fevers

Page 45: FWBD KRM GP 001

38

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

In

fe

cte

d p

erso

ns

touching foods, po

or

persona

l hygiene,

inadequate co

oking,

harvesting shellfish

fro

m se

wa

ge

contam

inated

wa

te

rs, im

pro

pe

r

sew

age disposal

Ingesting raw

fo

od

s, in

ade

qu

ate

cooking

Sp

ecim

en

s to

Co

llect

Urine blood

Blo

od

Fo

od

u

su

ally

In

vo

lved

3

Raw

shellfish

sa

la

ds, co

ld

cu

ts,

any food

contam

inated by

hepatitis viruses,

water

Raw

crabs, slugs,

pra

wn

s, sh

rim

p,

snails

Sy

mp

to

ms

a

nd

Sig

ns

Fe

ve

r, m

ala

ise

,

lassitude,

anorexia, nausea,

ab

do

min

al p

ain

,

jaundice

Ga

stro

en

te

ritis,

headache, stiff

neck and back,

low

grade fever

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

10 to to days

me

an

2

5 d

ays

14 to 16 da

ys

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Hepatitis A

virus

from

faeces,

urin

e, b

lo

od

o

f

in

fe

cte

d h

um

an

s

and other

prim

ates

An

gio

str

on

gylu

s

canto

nensis

[ra

t

lung w

orm

] from

rodent faeces and

soil

Dis

ea

se

Viral A

gen

ts

Hepatitis A

[Infectious

hepatitis]

Parasitic A

gen

ts

Angio

strongyliasis

[E

osin

op

hilic

me

nin

go

en

ce

ph

alitis]

Page 46: FWBD KRM GP 001

39

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

reaks

Eating raw

or

in

ad

eq

ua

te

ly co

oke

d

pork or bear m

eat

in

ad

eq

uate co

oking

or heat processing,

feeding uncooked ro

in

ad

eq

ua

te

ly

heatprocessed

ga

rb

ag

e to

sw

in

e

In

ad

eq

ua

te

cooling, im

proper

refrigeration of

fish, im

proper

curing of cheese

Sp

ecim

en

s to

Co

llect

Blood, m

uscle

bio

psy skin

te

st

Vom

itus

Fo

od

u

su

ally

In

vo

lved

3

Po

rk, b

ea

r m

ea

t,

walrus flesh,

cross

contam

inated

gro

un

d b

eef a

nd

lam

b

Tuna m

ackerel,

Pa

cific d

olp

hin

[m

ahi m

ahi],

bluefish, cheese

Sy

mp

to

ms

a

nd

Sig

ns

Ga

stro

en

te

ritis,

fe

ve

r, o

ede

ma

aro

un

d e

ye

s,

muscular pain,

chills, prostration,

la

boure

d

bre

ath

in

g

He

adache,

dizziness, nausea,

vo

mitin

g, p

ep

pery

taste, b

urning

throat, facial

sw

ellin

g a

nd

flushing, stom

ach

pa

in

, d

ia

rrh

oe

a,

itching of skin

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

4 to 28 days

[m

ean 9 days]

Few

m

in to

1 hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Trichin

ella

spir

alis

[roundw

orm

] from

flesh or infested

sw

ine, be

ar,

walrus

Hista

mine-like

substance

pro

du

ce

d by

Pro

teus s

pp.

or

other bacteria

Dis

ea

se

Trichinosis

AL

LE

RG

IC

T

YP

E S

YM

PT

OM

S A

ND

S

IG

NS

[F

AC

IA

L F

LU

SH

IN

G A

ND

/O

R IT

CH

IN

G] O

CC

UR

Incu

bat

ion

[L

aten

cy]

Per

iod

Usu

ally

Les

s T

han

1 h

ou

r

Ba

cte

ria

l [a

nd

A

nim

al] A

ge

nts

Histam

ine

poisoning

[S

com

broid

po

iso

nin

g]

Page 47: FWBD KRM GP 001

40

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

ou

tb

re

ak

s

Usin

g e

xce

ssive

am

ou

nts o

f M

SG

a

s

flavour intensifier

Using

sod

iu

m

nicotinate as colour

preservative,

im

proper m

ixing

Sp

ecim

en

s to

Co

llect

Fo

od

u

su

ally

In

vo

lv

ed

3

Foods seasoned

with

M

SG

Meat or other food

in w

hich sodium

nicotinate has

been add

ed,

including baby

fo

od

Sy

mp

to

ms

a

nd

Sig

ns

Burning sensation

in

b

ack o

f n

eck,

fo

re

arm

s, ch

est,

feeling of tightness,

headache, nausea

Flushing,

se

nsa

tio

n o

f

wa

rm

th

, itch

in

g,

ab

do

min

al p

ain

,

puffing of face and

knees

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

Few

m

in to 1 hour

Few

m

in to 1 hour

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Mo

no

so

diu

m

glutam

ate [M

SG

]

Vitam

in, sod

iu

m

nicotinate used

as

colour

preservative

Dis

ea

se

Ch

em

ic

al A

ge

nts

Mo

no

so

diu

m

glutam

ate

poisonin

g

[C

hin

ese

resta

urant

syndrom

e]

Nico

tin

ic a

cid

[n

ia

cin

]

poisonin

g

Page 48: FWBD KRM GP 001

41

Fa

cto

rs

th

at

Co

ntrib

ute

d to

Fo

od

bo

rn

e

Ou

tb

re

ak

s

Eating liver and

kid

ne

y o

f a

nim

als

fro

m co

ld

re

gio

n

Sp

ecim

en

s to

Co

llect

Blo

od

Fo

od

u

su

ally

In

vo

lv

ed

3

Live

r a

nd

kid

ne

y

of artic m

am

mals

Sy

mp

to

ms

a

nd

Sig

ns

He

adache,

gastrointestinal

sym

ptom

s,

dizzin

ess, co

lla

pse

,

insom

nia,

desq

uam

ation of

skin

In

cu

ba

tio

n o

r

Laten

cy p

erio

d

1 to 6 hours

Ae

tio

lo

gic

a

ge

nt

An

d s

ou

rc

e

Vitam

in A

Dis

ea

se

Incu

bat

ion

[L

aten

cy]

Per

iod

in t

he

Ran

ge

of

1 to

6 h

ou

rs

To

xic

A

nim

als

Hyp

er

vita

min

osis A

1.

Sym

ptom

s and incubation periods w

ill vary w

ith the individua

l and group exposed because of resistence, age, and nutritional statu

s o

f in

divid

ua

ls,

num

ber of organism

s or concentration of poison in ingested foods, am

ount of food ingested, and pa

thogenicity and virulence of strain of

microorganism

s or toxicity of chem

ical involved. S

everal of the illnesses are m

anifested by additional sym

ptom

s and have incubation periods that are

shorter or longer than stated.

2.

A m

or d

etailed review

ca

n be found in : B

ryan, F

.L. 198

2 D

iseases T

ra

nsm

itted by F

ood [A

classifications and sum

mary], 2

nd

ed., C

enters for D

isease

Control, A

tlanta.

3.

Sam

ples of any of the listed foods that have

b

ee

n in

ge

ste

d d

urin

g the incubation period of the disease should be collected.

4.

Carbon m

onoxide poisoning m

ay sim

ulate so

me of the diseases listed in this cate

gory. P

atients w

ho have been in closed cars w

ith m

otors ru

nning or

have been in room

s w

ith im

properly ve

nted heaters are subject to exposure to carbon m

onoxide.

Page 49: FWBD KRM GP 001

42

Page 50: FWBD KRM GP 001

43

Page 51: FWBD KRM GP 001

44

Page 52: FWBD KRM GP 001

45

Page 53: FWBD KRM GP 001

46

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47

Page 55: FWBD KRM GP 001

1

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

- - - No.

Daftar

Episod

BAHAGIAN KAWALAN PENYAKIT

KEMENTERIAN KESIHATAN MALAYSIA

BORANG SIASATAN/LAPORAN WABAK KERACUNAN MAKANAN

(FWBD/KRM/BG/001 (Pindaan 2006))

A: NOTIFIKASI

Institusi

Institusi

Tarikh

Tarikh

Masa

Masa

Nama

Nama

Pe

la

por

Jawatan

Pe

ne

rim

a

Jawatan

Cara

Notifikasi

Telefon Faks E-mail Borang Lain-lain

B1: ANALISA DESKRIPTIF – TEMPAT (PLACE)

1. Alamat tempat/

premis kejadian

Mukim Daerah

Negeri

Koodinat:- Longitud Latitud

Sekolah/asrama sekolah Kolej/universiti

Hospital/klinik kesihatan

Pejabat kerajaan/swasta

Penjara/pusat jagaan khusus

Perkhemahan/kenduri/keramaian

2. Jenis

tempat/premis

kejadian

Rumah persendirian

B2: ANALISA DESKRIPTIF – ORANG (PERSON)

Kes dinotifikasi

Bilangan orang terdedah

Kes baru dikesan

Kadar Serangan

%

1. Bilangan

Kes

Jumlah Kes

Pesakit luar

Bilangan kes mati

Dimasukkan ke wad

Kadar Kematian Kes

%

2. Bilangan

kes

menerima

rawatan

Jumlah dirawat

Kes

Kontrol

3. Bilangan subjek

dimasukkan dalam

penyiasatan

epidemiologi

Jumlah

Lampiran 5

Page 56: FWBD KRM GP 001

2

B2: ANALISA DESKRIPTIF – ORANG (PERSON) – Sambungan.

4

Kes mengikut kumpulan umur

5 Bilangan kes mengikut

gejala

Bilangan

Kumpulan

umur

Lelaki Perempuan Jumlah

Kadar

serangan

mengikut

kumpulan

umur

Gejala Bil. %

Bawah 1 th.

1 - < 5 th.

5 - < 13 th.

13 - < 19 th.

19 - < 25 th.

25 - < 55 th.

55 - < 65 th.

65 th, ke atas

Jumlah

B3: ANALISA DESKRIPTIF - MASA

Onset terawal

Onset terakhir

Onset

Median

Tarikh

Tarikh

Tarikh

Masa

Masa

Masa

Tarikh

Jam

Jangkaan masa pendedahan kepada

agen:

Masa

Jangkaan

tempoh

inkubasi:

minit

B4: KELUK EPIDEMIK

Bilan

gan

K

es

Onset

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

Page 57: FWBD KRM GP 001

3

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

C: KAJIAN ANALITIK

Dibuat

Tidak dibuat (Nyatakan sebab)

Tarikh mula:

/ /

Bilangan kes/kontrol terlalu sedikit

Tarikh tamat:

/ /

Kejadian adalah terpencil (isolated)

Jenis Kajian: Case-Control

Analisa/kajian deskriptif kes sudah memadai

Kohort

Agen atau cara penularan telah diketahui

Definisi Kes:

Jadual Analisis Makanan/Hidangan

Makan Tidak Makan

Beza

Kadar

Serangan

(D-H)

RR

atau

OR

2

Nilai

p

Confid.

Interval

(CI)

A B C D E F G H

Bil.

Jenis Makanan/

Jenis Hidangan

1

Sakit

Tidak S

akit

Jum

lah A

+B

Ka

da

r: A

/C

x 1

00

Sakit

Tidak S

akit

Jum

lah E

+F

Ka

da

r: E

/G

x 1

00

Nota:

1

Pengiraan makanan berisiko (food attack rate) atau hidangan berisiko (meal attack rate) boleh dikira bergantung

kepada keadaan.

2

OR (Odd Ratio) digunakan untuk kajian kes control manakala RR (Relative Risk) digunakan untuk kajian kohort.

Jika kajian kes kontrol dibuat, kolum D, H dan perbezaan kadar serangan (D-H) tidak perlu diisi.

OR dan RR boleh dikira dengan menggunakan perisian seperti Epi Info dan SPSS.

Page 58: FWBD KRM GP 001

4

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

D: SIASATAN DI PREMIS MAKANAN YANG TERLIBAT

Perkara Tempat Makanan Disediakan Tempat Makanan Dijual/Hidang

1. Nama premis:

Alamat:

Gred kebersihan (jika

ada):

Berlesen Berlesen

Tidak berlesen Tidak berlesen

2. Status pelesenan

Restoran/kedai makan Restoran/kedai makan

Gerai/warong Gerai/warong

Kafeteria/kantin Kafeteria/kantin

Dapur/Dewan asrama Dapur/Dewan asrama

Dapur persendirian Dapur persendirian

Kenduri/perhimpunan Kenduri/perhimpunan

Penjaja bergerak Penjaja bergerak

Lain-lain

Lain-lain

3. Jenis premis

Terawat sepenuhnya Terawat sepenuhnya

Air bekalan JBA Air bekalan JBA

Air mineral/proses/tapis Air mineral/proses/tapis

Terkawal, tidak terawat Terkawal, tidak terawat

Telaga terbuka Telaga terbuka

Telaga tiub Telaga tiub

Gravity Feed System (GFS) Gravity Feed System (GFS)

Tadahan air hujan

Tadahan air hujan

Tidak terkawal Tidak terkawal

Sungai/parit/terusan Sungai/parit/terusan

Lain-lain Lain-lain

4. Sumber bekalan air

(boleh lebih daripada

satu pilihan)

Tandas pam Tandas pam

Tandas curah Tandas curah

Tandas lubang/timbus Tandas lubang/timbus

Tandas awam/berkongsi Tandas awam/berkongsi

Dalam sungai/semak Dalam sungai/semak

Lain-lain Lain-lain

5. Jenis tandas yang kerap

digunakan

Memuaskan Memuaskan

Kotor Kotor

6. Keadaan kebersihan

tandas

Page 59: FWBD KRM GP 001

5

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

D: SIASATAN DI PREMIS MAKANAN YANG TERLIBAT (Sambungan)

Perkara Tempat Makanan Disediakan Tempat Makanan Dijual/Hidang

Terkawal Terkawal

Tidak terkawal Tidak terkawal

7. Pelupusan air limbah

Terkawal Terkawal

Tidak terkawal Tidak terkawal

8. Pelupusan sampah/

sisa pepejal

Ada Ada

Tiada Tiada

9. Pembiakan LILATI

Tetap Orang Tetap Orang

Sementara Orang Sementara Orang

Tempatan Orang Tempatan Orang

Wargasing Orang Wargasing Orang

10. Bilangan pengendali

makanan mengikut

status dan

kewarganegaraan

Ada sijil kursus Orang Ada sijil kursus Orang

Ada kad kesihatan Orang Ada kad kesihatan Orang

Ada pelalian anti-Tifoid Orang Ada pelalian anti-Tifoid Orang

Kesihatan memuaskan Orang Kesihatan memuaskan Orang

11. Bilangan pengendali

makanan mengikut

tahap kesihatan dan

kebersihan

Penilaian terakhir (sebelum

kejadian)

Penilaian terakhir (sebelum

kejadian)

Tarikh: / / Tarikh: / /

Rating: % Rating: %

Penilaian semasa Penilaian semasa

Tarikh: / / Tarikh: / /

Rating: % Rating: %

12. Tahap kebersihan

keseluruhan premis

(Mengikut gred/rating

menggunakan format

KMM):

∀ KMM 3P1

∀ KMM 3P2

∀ KMM 3P3

Kontaminasi agen/penyebab Kontaminasi agen/penyebab

Ada Ada

Tiada Tiada

Pembiakan mikroorganisma Pembiakan mikroorganisma

Ada Ada

Tiada Tiada

Ketahanan survival mikrooganisma Ketahanan survival mikrooganisma

Ada Ada

Tiada Tiada

13. Hasil analisa HACCP

(spt. cara

penyimpanan bahan

mentah, semasa

penyediaan makanan,

proses memasak,

proses menghidang

dsbnya) bagi

memastikan

kewujudan faktor-faktor

berkaitan yang

mendorong kejadian

yang dilaporkan (Jika

ada, nyatakan)

Page 60: FWBD KRM GP 001

6

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

E: PENYIASATAN MAKMAL

Spesimen Klinikal Pesakit

Keputusan

Nama pesakit

Jenis

spesimen

Tarikh

ambil

Tarikh

hantar

Jenis

analisis

Pos. Neg

No. Rujukan/

Catatan

Spesimen Dari Pengendali Makanan

Keputusan

Nama pengendali

makanan

Jenis

spesimen

Tarikh

ambil

Tarikh

hantar

Jenis

analisis

Pos. Neg

No. Rujukan/

Catatan

Spesimen Makanan

Keputusan

Jenis

makanan

Tempat/premis

persampelan

Tarikh

ambil

Tarikh

hantar

Jenis

analisis

Pos. Neg

No. Rujukan/

Catatan

Spesimen Persekitaran

Keputusan

Jenis

sampel

Tempat/premis

persampelan

Tarikh

ambil

Tarikh

hantar

Jenis

analisis

Pos. Neg

No. Rujukan/

Catatan

Page 61: FWBD KRM GP 001

7

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

F: RUMUSAN AKHIR/ULASAN PEGAWAI PENYIASAT

1. Makanan/minuman disyakki/disahkan tercemar 2. Jenis agen pencemaran (jelaskan)

a. Jenis

Bakteria

b. Cara ditentukan

Virus

Analisa epidemiologi (Deskriptif, OR, RR)

Parasit

Ujian makmal

Kulat

Berdasarkan maklumat saintifik lain

Kimia/Logam berat

Berdasarkan gejala dan tempoh inkubasi

Lain-lain

Berdasarkan pengalaman lalu

Tiada bukti/sokongan khusus

3. Sumber makanan tersebut diperolehi

4. Jenis epidemik/wabak

Dapur perseorangan

Common source

Dapur institusi/asrama

Single exposure

Premis makanan tetap

Multiple/intermittent exposure

Pasar/supermarket/kedai runcit

Propagated

Penjaja bergerak

Bercampur (mixed)

Kenduri/perkhemahan/keramaian

Vending machine/kiosk

Lain-lain

5. Episod lain/terdahulu yang berkaitan (jika ada) 6. Tindakan kawalan khas dilaksanakan

Tempat Tarikh

Penutupan premis makanan

Akta CDC: Bilangan

buah

Akta Makanan: Bilangan

buah

Rampasan makanan

Ceramah/pamiran kesihatan berkumpulan

Kawalan pencemaran setempat

Lain-lain

7. Ulasan umum

Tandatangan & cop

Tarikh

Page 62: FWBD KRM GP 001

8

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

G: ULASAN PEGAWAI PENYELIA

i. Ulasan PPKP U32/36 Daerah

Tandatangan & cop

Tarikh

ii. Ulasan Pegawai Kesihatan/Pengerusi JW Teknikal Penyakit Berjangkit

Tandatangan & cop

Tarikh kes dibincangkan

di dalam Mesy JW

Teknikal

iii. Ulasan Pegawai Epidemiologi (CDC) Negeri

Tandatangan & cop

Tarikh

Nota Akhir

1. Borang Siasatan yang lengkap mesti disimpan di dalam Fail Siasatan Keracunan Makanan di Pejabat

Kesihatan Daerah/ Bahagian/ Kawasan yang terlibat.

2. Satu salinan perlu dihantar ke Unit Epidemiologi, Jabatan Kesihatan Negeri . JKN akan menghantar laporan

yang lengkap ke Unit Kawalan Penyakit Bawaan Makanan dan Air, Bahagian Kawalan Penyakit, KKM dan satu

salinan untuk makluman ke PKD /Bahagian/ Kawasan dalam masa sebulan dari tarikh selesai siasatan dan

kawalan

3. Dalam keadaan tertentu, laporan bertulis yang lebih lengkap perlu disediakan dan dihantar ke JKN dan

Kementerian juga dalam masa sebulan dari tarikh selesai siasatan dan kawalan

4. Kemaskini data dalam Modul Siasatan CDCIS perlu dilengkapkan sebaik sahaja selesai siasatan dan kawalan

(Tamat Kejadian)

Page 63: FWBD KRM GP 001

9

Cawangan Penyakit Bawaan Makanan dan Air

Kementerian Kesihatan Malaysia, 2006.

H: LAMPIRAN 1 - LINE LISTING KES DAN KONTROL

Nota:

1. Jadual ini hanya sebagai panduan. Pegawai penyiasat boleh menambah variabel yang ingin dikaji mengikut definisi kes

yang digunakan

2. Senaraikan jenis makanan yang diambil sekurang-kurangnya 72 jam sebelum onset.

3. Asingkan kolum bagi makanan yang sama tetapi diambil pada waktu yang berbeza. Umpamanya mengikut sarapan

pagi, makan tengahari, minum petang atau makan malam,

4. Gunakan helaian tambahan jika perlu

SAKIT

(Nyatakan

Onset)

Gejala

Jenis

makanan/minuman

(Tanda ∀ jika makan, X

jika tidak makan,

tinggalkan kosong jika

tidak pasti)

Bil.

Nama

Jantina

Um

ur

Ba

ng

sa

Ma

sa

Ta

rik

h

TID

AK

S

AK

IT

Page 64: FWBD KRM GP 001

57

Page 65: FWBD KRM GP 001

58


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