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OBJECTIVES  Water-borne diseases caused by  Vibrio parahemolyticus  are often known to cause gastritis when raw or undercooked seafood is eaten. It is very rare that  Vibrio  gastritis caused by ingesting non-seafood products occurs on a large scale. On September 19, 2017, a large-scale  Vibrio  gastritis occurred after the city residents consumed food at a bazaar held in a welfare center in Jungnang-gu, Seoul.    METHODS  The total number of visitors was approximately 299, and 237 (79.3%) of them showed symptoms. Among those who showed symptoms, 116 (48.9%) consulted the hospital, and 53 (45.6%) were hospitalized. Among the 299 exposed individuals, 174 (58.1%) responded to this survey: 163 (93.6%) with and 11 (6.4%) without symptoms. This study was retrospectively conducted by investigating the exposed individuals. To investigate the spread of infection, medical staff of hospitals in the epidemic area were interviewed, exposed individuals surveyed, microbiological testing conducted, and ingredient handling and cooking processes investigated.    RESULTS  A total of 237 individuals, including 6 food handlers, were affected (prevalence, 79.2%). During the microbiological testing,  V. parahemolyticus  was found in 34 patients and 4 food handlers. In the consumption analysis, the relative risk of kimbap was 6.79 (confidence interval 1.10 to 41.69). In-depth investigation found that squid, an ingredient of Korean pancake, and egg sheets, an ingredient of kimbap, were prepared using the same cutting board and knife, which were thought to be the cause of cross-contamination that led to a large-scale outbreak of  Vibrio  gastritis.    CONCLUSIONS  A recent large-scale outbreak of  Vibrio  gastritis occurred due to the cross-contamination with kimbap during the preparation process of squid rather than the actual consumption of seafood. Thus, a more stringent hygiene management is necessary during the processing and management of food to prevent infections associated with  V. parahemolyticus .

A foodborne outbreak of gastroenteritis caused by Vibrio parahaemolyticus associated with cross-contamination from squid in Korea