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. 2017 Jun;96(6):1370-1377.
doi: 10.4269/ajtmh.16-0456.

Impact of a Food Safety Campaign on Streptococcus suis Infection in Humans in Thailand

Dan Takeuchi  1 , Anusak Kerdsin  2 , Yukihiro Akeda  3 , Piphat Chiranairadul  4 , Phacharaphan Loetthong  4 , Nutchada Tanburawong  4 , Prasanee Areeratana  5 , Panarat Puangmali  5 , Kasean Khamisara  5 , Wirasinee Pinyo  5 , Rapeepun Anukul  5 , Sutit Samerchea  6 , Punpong Lekhalula  7 , Tatsuya Nakayama  8 , Kouji Yamamoto  9 , Masayo Hirose  10 , Shigeyuki Hamada  1 , Surang Dejsirilert  11 , Kazunori Oishi  12
Affiliations

Impact of a Food Safety Campaign on Streptococcus suis Infection in Humans in Thailand

Dan Takeuchi et al. Am J Trop Med Hyg. 2017 Jun.

Abstract

AbstractStreptococcus suis is an important zoonotic pathogen in swine and humans that causes sepsis and meningitis. Our previous study in Thailand showed that the prevalence of S. suis infection in humans, especially in northern areas of Thailand, and the transmission of the pathogen occurred mainly through the consumption of traditional raw pork products. Considering the high incidence proportion and mortality rate of the disease as an important public health problem, we implemented a food safety campaign in the Phayao Province in northern Thailand in 2011. We evaluated the effects of a food safety campaign by comparing the sociodemographic, clinical, and bacteriological characteristics of cases before and after the campaign. The follow-up study showed a marked decrease of the incidence proportion in the first 2 years, indicating the effectiveness of the campaign. In the third year, however, the incidence proportion slightly increased again, indicating the existence of deep-rooted cultural behaviors and the necessity of continuous public health intervention. Furthermore, epidemiological analysis of the cases made it possible to estimate the infectivity of the pathogen via the oral route of infection. In the present study, we showed the effectiveness of the food safety campaign for controlling the S. suis infection, and we present a role model public health intervention for prevalent areas affected by S. suis infection in humans.

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Figures

Figure 1.
Figure 1.
Location of the study site. (A) Location of the Phayao Province (black) in northern Thailand (brown). (B) Location of the nine districts in the Phayao Province.
Figure 2.
Figure 2.
Behavior changes recommended by the food safety campaign. The two pages of the pamphlet are shown at the bottom of the figure, and the recommendation is described in Thai. Recommendation is translated in English above the pamphlet.
Figure 3.
Figure 3.
Flow diagram of the food safety campaign. The preexisting public health network established by the Phayao Public Health Office was used to distribute knowledge to the local people.
Figure 4.
Figure 4.
Examples of the campaign materials. Pamphlets were used in educational lectures for the local people, and the banner and poster were distributed and displayed in every district in the Phayao Province.
Figure 5.
Figure 5.
Seasonal distribution of the cases and temperature changes from 2010 to 2013 in the Phayao Province. The period of the food safety campaign is shown by a bidirectional arrow.
Figure 6.
Figure 6.
Places where the patients consumed raw pork products. The places were divided into two groups: public (e.g., restaurants and markets) and private (e.g., homes and village parties). The Fisher's exact test was used to compare the data before and after the campaign.
Figure 7.
Figure 7.
The number of people who consumed raw pork products at the same place with the patient. The cases were divided into three groups: 1 (only the patient), 2–9 (2–9 persons including the patient), and ≥ 10 (large groups such as village parties of ≥ 10 persons including the patient).
See this image and copyright information in PMC

References

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