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American Journal of Epidemiology Vol. 126, No. 6: 1173-1180
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

SHJGELLOSIS AT A CARIBBEAN RESORT

HAMBURGER AND NORTH AMERICAN ORIGIN AS RISK FACTORS

JOHN S. SPIKA1,, FRANÇOIS DABIS2 5, NANCY HARGRETT-BEAN1, JOACHIM SALCEDO3, SERGE VEILLARD4 and PAUL A. BLAKE1

1Enteric Diseases Branch, Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control Atlanta, GA
2International Health Program Office, Centers for Disease Control Atlanta, GA
3Pan American Health Organization Port-au-Prince, Haiti
4Gouvernment de Haiti Port-au-Prince, Haiti

Reprint requests to Dr John S. Spika, EDB: DBD:CID 1-5428, Centers for Disease Control, Atlanta, GA 30333

During a three-week period in 1984, 339 tourists and expatriate employees with diarrhea visited the infirmary at a Caribbean resort dub. Epidemiologic studies suggested that over 60% of the 1,893 tourists at the resort club during that time may have been ill. Shigeiia flexnerl 4a was isolated from seven of 18 stool specimens. A few cases of d Illness occurred at the resort club before the onset of the outhreak, which was temporally related to Illness In a butcher. North American residence, eating raw or very rare hamburger, having a roommate who was Ill and younger age were significantly associated with acquiring disease. Control measures, principally elimination of ill food handlers from the kitchens, were followed by a prompt and marked reduction in new cases. Isolated resorts pose problems in disease control similar to those on cruise ships, with hundreds of foods available, large numbers of short-stay visitors with few outside exposures, and many food handlers In whom pathogens can persist between groups of visitors. Resort dubs can reduce the risk of traveler's diarrhea, without using mass prophytaxis against pathogenic bacteria, by appropriate handling and preparation of food and by surveillance for dlarrheal illnesses.

antimalarlals; chioroqulne; diarrhea; dysentery, badliary; meat products; Shigeiie flexneri; travel

5Current address: Department d'Epidemiologie et Biostatistiques, Université; de Bordeauz II, 33076 Bordeauz Cedex, France


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