AN OUTBREAK OF SHIGELLOSIS ABOARD A CRUISE SHIP CAUSED BY A MULTIPLE-ANTIBIOTIC-RESISTANT STRAIN OF SHIGELLA-FLEXNERI

被引:46
作者
LEW, JF
SWERDLOW, DL
DANCE, ME
GRIFFIN, PM
BOPP, CA
GILLENWATER, MJ
MERCATANTE, T
GLASS, RI
机构
[1] CTR DIS CONTROL,CTR INFECT DIS,DIV BACTERIAL DIS,ENTER DIS BRANCH,ATLANTA,GA 30333
[2] VIRGINIA MARYLAND REG COLL VET MED,BLACKSBURG,VA
[3] CTR DIS CONTROL,CTR ENVIRONM HLTH & INJURY CONTROL,ATLANTA,GA 30333
关键词
ANTIBIOTICS; DIARRHEA; DISEASE OUTBREAKS; FOOD CONTAMINATION; GASTROENTERITIS; SHIGELLA-FLEXNERI; SHIPS; TRAVEL;
D O I
10.1093/oxfordjournals.aje.a116103
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
From October 23 to October 27, 1989, an outbreak of gastroenteritis occurred aboard a cruise ship in the Caribbean. The 818 passengers and 518 crew members were surveyed for gastrointestinal symptoms; 72 (14%) of 512 passengers and 12 (3%) of 388 crew members who answered the survey reported having a diarrheal illness. Multiple-antibiotic-resistant Shigella flexneri 4a was isolated from 19 ill passengers and two ill crew members. Thirteen people were hospitalized, and prolonged duration of illness was associated with taking an antibiotic to which the isolated strain of Shigella was resistant. A case-control study of food items implicated German potato salad as the vehicle of transmission. It was prepared and probably infected by a food handler from a country where multiple-antibiotic-resistant Shigella is common. Spread may have been facilitated by the limited availability of toilet facilities for the galley crew. This outbreak demonstrates how antibiotic-resistant strains can be introduced into the United States, where they ran pose treatment problems. The continuing problem of foodborne gastrointestinal disease in settings such as cruise ships underscores the need for basic hygienic control for food handlers and food preparation areas. In addition, the availability of adequate working conditions for crew members, including appropriately furnished toilet facilities, may be important issues that must be addressed in order to decrease the frequency of diarrhea outbreaks aboard cruise ships.
引用
收藏
页码:413 / 420
页数:8
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