{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:43:21Z","timestamp":1786725801733,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Packaged curd is a rarely reported source of food poisoning. We analyzed a simultaneous outbreak across two stations located 95 km apart in the Kutch region of Gujarat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A descriptive observational study was conducted using interviews and clinical data from affected individuals. Case identification, symptom analysis, food consumption history, and laboratory investigations were used to trace the source and cause of the outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 280 individuals\u2014including personnel and family members\u2014reported gastrointestinal illness over a four-day period following the consumption of curd or curd-based food items at both affected locations. The majority of cases were male (71%) and within the age group of 15\u201345 years (77%). All reported cases were epidemiologically linked to curd procured from a common dairy source serving the Kutch region. The highest food-specific attack rate was observed for curd, at 33.4%. The median incubation period ranged from 18 to 23.5 hours across the two stations. The predominant clinical manifestations included loose stools (78.2%), abdominal pain (65%), and fever (59.6%). Microbiological analysis confirmed the presence of\n                      <jats:italic toggle=\"yes\">Salmonella enterica<\/jats:italic>\n                      serovar Chester in stool samples from affected individuals. Although\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      was detected in the curd samples, the clinical profile of the cases and the epidemiological pattern were strongly indicative of\n                      <jats:italic toggle=\"yes\">Salmonella<\/jats:italic>\n                      as the primary causative pathogen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      This large Kutch outbreak has an unusual source of contamination with rare\n                      <jats:italic toggle=\"yes\">Salmonella<\/jats:italic>\n                      enterica serovar Chester in packaged curd, thereby contributing to a rare identification in foodborne outbreaks. Collaborative efforts in a unique way across public health, food safety, and microbiology were important for the timely identification of the agent and source. The study accentuates the importance of keeping suspicion high and strong interagency protocols in place to effectively manage an outbreak.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijcm.ijcm_79_25","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:00:15Z","timestamp":1774548015000},"page":"S332-S338","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Packaged Curd and Food Poisoning in Kutch: An Outbreak Across Logistically Challenged Stations"],"prefix":"10.4103","volume":"51","author":[{"given":"Prem","family":"Vardhan","sequence":"first","affiliation":[{"name":"Graded Specialist, Community Medicine, Armed Forces Medical Services (AFMS), Jamnagar, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biju M","family":"John","sequence":"additional","affiliation":[{"name":"Professor and Consultant Paediatrics, Armed Forces Medical Services (AFMS), Gandhinagar, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Neelakantan","sequence":"additional","affiliation":[{"name":"Professor and Senior Advisor, Community Medicine, Armed Forces Medical Services (AFMS), Gandhinagar, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Bajannavar","sequence":"additional","affiliation":[{"name":"Medical Officer, Armed Forces Medical Services (AFMS), Naliya, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indrulu Vijay","family":"Vardhan","sequence":"additional","affiliation":[{"name":"Graded Specialist, Aerospace Medicine, Armed Forces Medical Services (AFMS), Bhuj, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhuri","family":"Girdhar","sequence":"additional","affiliation":[{"name":"Medical Officer, Armed Forces Medical Services (AFMS), Naliya, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayjaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Medical Officer, Armed Forces Medical Services (AFMS), Naliya, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranvir","family":"Kumar","sequence":"additional","affiliation":[{"name":"Medical Officer, Armed Forces Medical Services (AFMS), Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Ex DGMS(Air), Professor Community Medicine, Armed Forces Medical Services (AFMS), New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"R2-20260507","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-14-147","article-title":"Measuring underreporting and under-ascertainment in infectious disease datasets: A comparison of methods","volume":"14","author":"Gibbons","year":"2014","journal-title":"BMC Public Health"},{"key":"R3-20260507","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/B978-0-12-816679-6.00012-7","article-title":"Food safety issues associated with Milk: A review","volume":"1","author":"Singhal","year":"2020","journal-title":"Safety Issues Beverage Prod"},{"key":"R4-20260507","first-page":"40","article-title":"Bacterial contamination of dairy products","volume":"43","author":"Pal","year":"2016","journal-title":"Beverage Food World"},{"key":"R5-20260507","article-title":"Milk and Dairy Products in Human Nutrition","author":"Muehlhoff","year":"2013","journal-title":"Food and Agriculture Organization of the UN (FAO)"},{"key":"R6-20260507","doi-asserted-by":"crossref","first-page":"907","DOI":"10.3390\/foods10050907","article-title":"Salmonella, food safety and food handling practices","volume":"10","author":"Ehuwa","year":"2021","journal-title":"Foods"},{"key":"R7-20260507","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1108\/00070701211229954","article-title":"Foodborne diseases in India \u2013 A review","volume":"114","author":"Vemula","year":"2012","journal-title":"Br Food J"},{"key":"R8-20260507","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1086\/650733","article-title":"International Collaboration on Enteric Disease \u201cBurden of Illness\u201d Studies. 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