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Life sciences · Journal article
Health Science Reports · September 1, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study identified a strong association between acute gastroenteritis and consumption of hot khichuri packaged in polybags (AR 68%, RR 9.7, 95% CI 4.1–22.6) versus food served on plates (AR 7%). The outbreak appears to be point-source and linked to inadequate sanitation, improper cooling, and polybag packaging, though the causative pathogen was not identified.
Retrospective cohort study. Attendees of a religious ceremony (Mahfil) in Gojiabari, Delduar sub-district, Tangail, Bangladesh, on 13 November 2022; all 400 people who ate food from the event were interviewed.. Intervention: Consumption of khichuri (rice and lentils) served in polybags without proper cooling, placed on banana leaves after cooking in a kitchen with inadequate sanitation.. Compared with: Consumption of food served on plates. n = 400. Delduar sub-district, Tangail, Bangladesh.
Overall attack rate 57% (229/400 attendees); median incubation period 13 hours (IQR 10–19 h) Khichuri in polybag: AR 68% (224/329), RR 9.7 (95% CI 4.1–22.6) vs plate: AR 7% (5/70), RR 0.1 (95% CI 0.05–0.25) Most common symptoms: diarrhea 100%, fever 75%, vomiting 34%
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This outbreak investigation demonstrates a clear association between unsafe food packaging practices (hot food in polybags without cooling) and acute gastroenteritis. Public health professionals and food safety authorities should use this finding to reinforce hygiene protocols during food preparation and the importance of proper cooling before packaging at community food events.
A well-designed retrospective cohort study with clear epidemiological evidence (RR 9.7, 95% CI 4.1–22.6) linking a specific food preparation practice to acute gastroenteritis, but limited by single-site setting, negative pathogen culture, and lack of microbiological confirmation of causation.
As stated by the source record.
Quoted from the source exactly as published.
This outbreak investigation demonstrates a clear association between unsafe food packaging practices (hot food in polybags without cooling) and acute gastroenteritis. Public health professionals and food safety authorities should use this finding to reinforce hygiene protocols during food preparation and the importance of proper cooling before packaging at community food events.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
ABSTRACT Background and Aims Foodborne outbreaks frequently manifest as acute gastroenteritis (AGE) and are threat for public health in Bangladesh. On 17 November 2022, the health‐manager of Delduar sub‐district, Tangail reported an AGE outbreak to the Institute of Epidemiology, Disease Control and Research (IEDCR). A team was deployed to investigate the source and risk factors of the outbreak and contain it. Methods We conducted a retrospective cohort study after verifying that all cases ate food of a religious ceremony (Mahfil) on 13 November, 2022. We defined a case as any person from Gojiabari who developed acute watery diarrhea with or without fever, vomiting, or abdominal cramp after eating food from the Mahfil. We interviewed every person who ate the Mahfil‐food with structured questionnaires. Stool and water samples were analyzed for enteric pathogens. Food‐specific attack rates (AR) and relative risks (RR) were calculated to identify risk factors. Results Overall AR was 57% (229/400). Median incubation period was 13 h [Inter‐Quartile‐Range (IQR): 10–19 h]. Most common symptoms were diarrhea (100%), fever (75%) and vomiting (34%). The epidemic curve suggested a point‐source outbreak. 224 of 329 persons who ate khichuri (rice and lentils) served in a polybag (AR = 68%, RR = 9.7, 95% CI = 4.1–22.6) developed illness compared to 5 of 70 who ate on plate (AR = 7%, RR = 0.1, 95% CI = 0.05–0.25). Khichuri was placed on Banana‐leaves immediately after cooking in a kitchen with inadequate sanitation and packaged in polybags without proper cooling. Stool and water samples were negative for Vibrio cholerae, Salmonella and Shigella. Conclusions The outbreak was strongly associated with packaging hot khichuri in polybags. To prevent a similar outbreak, we recommend maintenance of hygiene during food processing and proper cooling of food before packaging.
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