Community Medicine (PSM) · Epidemiology (Study Designs, Bias, Systematic Review, Measures of Association)

An investigator detects an outbreak of food poisoning with incubation period of 2–4 hours after a hotel buffet. The epi-curve shows a single sharp peak. Attack rate analysis by food item shows: Rice (50% ate, AR 10%), Chicken curry (60% ate, AR 45%), Salad (40% ate, AR 12%), Dessert (70% ate, AR 11%). The vehicle MOST likely responsible is:

  • A Chicken curry — highest attack rate among consumers
  • B Rice — highest proportion consumed
  • C Dessert — highest absolute number of consumers
  • D Salad — exposure to multiple raw ingredients
Correct answer: A. Chicken curry — highest attack rate among consumers

Explanation

In food-borne outbreak investigation, the food with the highest attack rate among those who ate it is the most likely vehicle. Chicken curry showed an attack rate of 45% among consumers — far exceeding other food items (10–12%). A short incubation of 2–4 hours is consistent with Staphylococcal enterotoxin food poisoning, for which poorly refrigerated pre-cooked chicken is a classic vehicle. Attack rate tables compare rates in those who ate versus those who did not eat each food item — the highest rate difference and highest attack rate in consumers identifies the vehicle.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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