Mass food poisoning in Ain-al-basha District/Jordan 2020: a mid-pandemic outbreak investigation
Areej Hamed Shoubaki, Mohammad Maayeh, Ashraf Aqel, Majed Asad
Corresponding author: Areej Hamed Shoubaki, Surveillance Department, Directorate of Communicable Diseases, Jordan Ministry of Health, Amman, Jordan 
Received: 08 Jan 2025 - Accepted: 30 Oct 2025 - Published: 20 Feb 2026
Domain: Epidemiology,Infectious diseases epidemiology,Population Health
Keywords: Outbreak investigation, foodborne diseases, Salmonella, Jordan
Funding: This work received no specific grant from any funding agency in the public, commercial, or non-profit sectors.
This article is published as part of the supplement Teaching Case Studies in Field Epidemiology and Public Health for the Eastern Mediterranean Region, commissioned by Eastern Mediterranean Public Health Network (EMPHNET).
©Areej Hamed Shoubaki et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Areej Hamed Shoubaki et al. Mass food poisoning in Ain-al-basha District/Jordan 2020: a mid-pandemic outbreak investigation. Pan African Medical Journal. 2026;53(1):9. [doi: 10.11604/pamj.supp.2026.53.1.46349]
Available online at: https://www.panafrican-med-journal.com//content/series/53/1/9/full
PDF in process Case study 
Mass food poisoning in Ain-al-basha District/Jordan 2020: a mid-pandemic outbreak investigation
Mass food poisoning in Ain-al-basha District/Jordan 2020: a mid-pandemic outbreak investigation
Areej Hamed Shoubaki1,&, 
Mohammad Maayeh2, Ashraf Aqel2, Majed Asad2
&Corresponding author
In the summer of 2020, coinciding with relaxation of COVID-19 lockdown restrictions, residents of Ain-al-Basha celebrated Eid-Al-Adha by eating shawarma at a popular restaurant. Unfortunately, a week-long mass food poisoning outbreak ensued. With the Ministry of Health preoccupied with COVID-19 testing and vaccination campaigns, this report describes the epidemiological investigation and control measures swiftly undertaken by a strained health care system engaged on multiple fronts. A case-control study was conducted. A case was defined as any resident of Ain-al-Basha who presented to the emergency departments of Balqa governorate from July 26 to August 2, 2020 with at least any two of the following symptoms: fever, abdominal pain, diarrhea, vomiting, or headache. Controls were well family members. All laboratory samples were processed centrally. Data analysis utilized MS Excel and SPSS v.24. One thousand and one hundred and nine (1109) people met the case definition. Six hundred and thirteen (613) required hospitalization, and 2 deaths occurred. Most cases aged between 6 and 40 years old. The epidemic curve indicated a point source and a 24-48-hour incubation period. All cases reported eating from a restaurant which served chicken shawarma meals [OR=21.7 CI=11.5-40.7]. Salmonella enteritidis was isolated from 60 stool samples from randomly selected cases. Environmental and biological samples taken from the restaurant showed bacterial contamination related to food preservation methods. The restaurant in question was promptly shut down and strict food health control measures reinforced on the entire food sector. The post-lockdown reopening of restaurants was predicated on strict compliance with infection control measures. However, these were inadequate to prevent a salmonellosis outbreak, highlighting the needed vigilance and flexibility of surveillance systems to competently cover all possible sources of infection under any conditions.
General instructions: this case study should be used as adjunct training material for novice epidemiology trainees to reinforce the concepts taught in prior lectures. The case study is ideally taught by a facilitator in groups of about 20 participants. Participants are to take turns reading the case study, usually a paragraph per student. The facilitator guides the discussion on possible responses to questions. The facilitator may make use of flip charts to illustrate certain points. Additional instructor´s notes for facilitation are coupled with each question in the instructor´s guide to aid facilitation.
Audience: this case study was developed for novice field epidemiology students. These participants are commonly health care workers working in the county departments of health whose background may be as medical doctors, nurses, environmental health officers or laboratory scientists who work in public health-related fields. Most have a health science or biology background.
Prerequisites: before using this case study, participants should have received lectures on disease surveillance and outbreak investigation.
Materials needed: Flash drive, flip charts, markers, computers with MS Excel, Analytical software: Epi info or SPSS
Level of training and associated public health activity: Novice - Outbreak investigation
Time required: 2-3 hours
Language: English
- Download the case study student guide
- Request the case study facilitator guide
The authors declare no competing interests.
We wish to acknowledge the Eastern Mediterranean Public Health Network (EMPHNET) for their support to develop this case study. Additionally, all public health officers, doctors, nurses, laboratory technicians, and food and drug administration agents for their efforts in curtailing this outbreak.
Figure 1: map of Ain al Basha District
Figure 2: shawarma restaurant serving customers during the COVID-19 pandemic
Figure 3: epidemic curve of Ain al Basha foodborne outbreak, July, 2020
- World Health Organization. Foodborne disease outbreaks: guidelines for investigation and control. World Health Organization. 2008. Google Scholar
- Hoffmann SA, Maculloch B, Batz M. Economic burden of major foodborne illnesses acquired in the United States. United States Department of Agriculture, Economic Research Service. 2015. Google Scholar
- Akil L, Ahmad HA. Socioeconomic impacts of COVID-19 pandemic on foodborne illnesses in the United States. Eur J Environ Public Health. 2023 Apr;7(2):em0128. PubMed | Google Scholar
- Byrd K, Her E, Fan A, Almanza B, Liu Y, Leitch S. Restaurants and COVID-19: What are consumers' risk perceptions about restaurant food and its packaging during the pandemic?. 2021 Apr;94:102821. Google Scholar
Search
This article authors
On Pubmed
On Google Scholar
Citation [Download]
Navigate this article
Similar articles in
Key words
Tables and figures
Article metrics
Recently from the PAMJ
Authors´ services
