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An Outbreak of Ammonia Poisoning from Chicken Tenders Served in a School Lunch

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Abstract:

Although foodborne outbreaks of illness are relatively common, they are rarely caused by chemical agents. An outbreak of gastrointestinal illness occurred among students at two schools shortly after lunch was served. A cohort study, an environmental investigation, and microbiological and toxicological laboratory testing of food samples were performed. A case was defined as a student or teacher who ate food prepared in the kitchen at school A on 25 November 2002 (and served at schools A and B) and who later developed headache or symptoms of gastrointestinal tract irritation, with onset within 180 min of eating lunch. Among 312 persons interviewed, 157 persons became ill (attack rate = 49%; attack rate 41% for school A, 11% for school B). Onset of illness occurred within 60 min for 81% of cases; 91% of students reported that their chicken tenders smelled unusual. Eating chicken tenders that smelled unusual was associated with being a case (relative risk 9.2, 95% confidence interval 1.4 to 62.6, P < 0.05). Ammonia was detected in uncooked chicken tenders at levels as high as 2,468 ppm. The chicken had been contaminated during a warehouse leak of ammonia refrigerant. This outbreak of ammonia poisoning is only the second reported in food, and the first in a solid food. Heated chicken tenders contaminated with ammonia can cause acute illness within a short period of time.

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Document Type: Short Communication

Affiliations: 1: Illinois Department of Public Health, Division of Infectious Diseases, 106 North LaSalle Street, 7th Floor South, Chicago, Illinois 60601 2: Will County Health Department, 501 Ella Avenue, Joliet, Illinois 60433 3: Illinois Department of Public Health, Division of Food, Drugs, and Dairies and Division of Infectious Diseases, 525 West Jefferson, Springfield, Illinois 62716 4: Illinois Department of Public Health, Division of Food, Drugs, and Dairies, 245 West Roosevelt Road, West Chicago, Illinois 60815, USA 5: Division of Infectious Diseases, 525 West Jefferson, Springfield, Illinois 62716

Publication date: June 1, 2004

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