Ariungerel Dashtseren, Seonghui Cho, Chiara Achangwa, Yeongseon Ko, Bryan Inho Kim, Sukhyun Ryu, Joon Sup Yeom
On March 18, 2025, the National Center for Communicable Diseases received reports of acute gastroenteritis among employees at a remote mining company in Omnogovi Province, Mongolia. We investigated this outbreak to identify the likely source, characterize its transmission, and recommend control measures. Utilizing a retrospective case-control design, we interviewed employees regarding their symptoms, restaurant visits, and menu exposures between March 14 and 17. A confirmed case was defined as gastrointestinal illness with Salmonella spp. detected in a rectal swab specimen. We tested clinical, retained-food, environmental, and water samples from Restaurants A, B, and C. Food-specific odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Of 204 surveyed employees, 68 (33.3%) reported gastrointestinal illness, and 30 (14.7%) satisfied the confirmed case definition. Symptom onset among cases clustered from March 16 to 19, peaking on March 17. Confirmed cases were reported among patrons of Restaurants A (n = 9), B (n = 15), and C (n = 6). Several menu items served from March 14 to 16 were associated with confirmed cases, including kimbap at Restaurant A (OR: 118.2; 95% CI, 11.22-6,245); millet porridge with milk (OR: 40.02; 95% CI, 3.25-2,241), steamed dough soup with garlic (OR: 33.19; 95% CI, 4.79-407), broccoli soup at Restaurant B (OR: 16.08; 95% CI, 2.05-196.8); and dessert at Restaurant C (OR: 16.68; 95% CI, 1.00-1,089). Salmonella spp. was detected in 12 prepared-food samples and on a wooden meat-cutting board, and Salmonella Enteritidis was isolated from clinical specimens. Escherichia coli was also detected on food-contact surfaces. The diverse food associations across multiple restaurants, coupled with environmental contamination, strongly suggest cross-contamination within the shared catering system. This highlights the critical need for enhanced food safety management in remote mining-camp catering operations.