Objective: On 2 September 2023, the Regional Epidemiology and Surveillance Unit of the Department of Health’s Center for Health Development in Calabarzon, Philippines, received a report of foodborne illness due to the ingestion of tuba-tuba (Jatropha curcas) seeds in Talao Talao Village, Lucena City. The objective of this study was to describe the public health event. Methods: A descriptive study was conducted. Cases were defined as previously well individuals who developed at least one of the following symptoms after eating tuba-tuba seeds: vomiting, abdominal pain, diarrhoea, headache or dizziness. Health records were reviewed, and key informant interviews and environmental surveys were conducted. Results: Ten cases were identified, ranging in age from 10 to 12 years. The onset of symptoms ranged from 1 to 4 hours after consumption. Six of the cases were taken to the hospital, although two went home before being admitted; all recovered after 3 days. The most common symptom was vomiting (100%); other symptoms included abdominal pain, diarrhoea, dizziness and headache. Discussion: This investigation confirmed that tuba-tuba seeds were the cause of symptoms among school-aged children in Lucena City. To prevent similar events in the future, we recommend intensifying educational campaigns at both the community and school levels, as tuba-tuba is common in the area.

Objective: An investigation team was deployed to determine the cause of an outbreak of a cluster of cases of fever and rash in a public elementary school in Antipolo City, Philippines, after the Public Health Unit was notified on 24 October 2022. The team also aimed to identify the source of the outbreak and to guide prevention measures. Methods: Active case-finding for hand, foot and mouth disease was conducted at the school. A suspected case was defined as any learner who developed acute febrile illness with a papulovesicular rash on the palms and soles of the feet during 16–30 October 2022. Interviews with key informants were conducted and included school staff and parents. Oropharyngeal swabs were collected for polymerase chain reaction (PCR) testing. Results: Nineteen suspected cases of hand, foot and mouth disease were detected, predominantly in grade 1 learners (16, 84%). Most cases (14, 74%) were 6 years old, and just over half were male (11, 58%). The first case occurred in a 6-year-old in grade 1 who attended class with a papulovesicular rash. Twelve learners (63%) from the same section developed symptoms, two of whom were seatmates of the first case. Two out of the 10 swabs collected were tested by PCR, both of which were positive for coxsackievirus A16. Discussion: The causative agent of this outbreak was identified as coxsackievirus A16. Disease transmission occurred through close contact with the index case and possibly through shared classroom objects. Follow-up actions included dissemination of a memorandum about preventing the disease to all public elementary and secondary schools that emphasized symptom screening (i.e. for fever and rash), self-isolation at the onset of symptoms, regular disinfection of classroom surfaces and regular handwashing, especially before and after eating.

Introduction: On 18 August 2014, cases of food poisoning in San Vicente Village were reported to the Event-Based Surveillance & Response Unit of the Philippine Department of Health. An investigation was conducted to identify the implicated source, describe the outbreak and evaluate the risk factors. Methods: A case-control study was conducted. A suspected case was a previously well individual of Medina who attended the village festival and developed abdominal pain and vomiting with or without nausea, diarrhoea and fever from 18 to 19 August. A confirmed case was a suspected case with a rectal swab positive for bacterial culture. Rectal swabs, water and food samples were sent to the national reference laboratories. Food source and consumption interviews and environmental inspections were conducted. Results: Sixty-four cases and 123 unmatched controls were identified. The median incubation period was 1 hour 15 minutes. Five cases (8%) were positive for Staphylococcus aureus, one (2%) for Aeromonas hydrophilia and one (2%) for Shigella boydii. One (14%) water sample was positive for Aeromonas spp. Of the collected food samples, beef steak was positive for Staphylococcus aureus. Risk factors were consumption of Filipino-style beef stew (odds ratio [OR]: 6.62; 95% confidence interval [CI]: 2.90–15.12) and stir-fried noodles (OR: 3.15; 95% CI: 1.52–6.50). Prolonged serving time and improper food storage were noted. Discussion In this foodborne outbreak, Staphylococcus aureus was the likely causative agent. Meals were contaminated due to improper food handling practices. We recommend that a policy be created to mandate that village-appointed food handlers undergo food safety training.

Background：Middle East respiratory syndrome (MERS) is an illness caused by a coronavirus in which infected persons develop severe acute respiratory illness. A person can be infected through close contacts. This is an outbreak investigation report of the first confirmed MERS case in the Philippines and the subsequent contact tracing activities.Methods：Review of patient records and interviews with health-care personnel were done. Patient and close contacts were tested for MERS-coronavirus (CoV) by real time-polymerase chain reaction. Close contacts were identified and categorized. All traced contacts were monitored daily for appearance of illness for 14 days starting from the date of last known exposure to the confirmed case. A standard log sheet was used for symptom monitoring.Results：The case was a 31-year-old female who was a health-care worker in Saudi Arabia. She had mild acute respiratory illness five days before travelling to the Philippines. On 1 February, she travelled with her husband to the Philippines while she had a fever. On 2 February, she attended a health facility in the Philippines. On 8 February, respiratory samples were tested for MERS-CoV and yielded positive results. A total of 449 close contacts were identified, and 297 (66%) were traced. Of those traced, 15 developed respiratory symptoms. All of them tested negative for MERS.Discussion：In this outbreak investigation, the participation of health-care personnel in conducting vigorous contact tracing may have reduced the risk of transmission. However, being overly cautious to include more contacts for the outbreak response should be further reconsidered.