Case B Microbiology Discussion

Meg and her family were going on a cruise.  Everyone was very excited.  The Ship had 4000 passengers and 2000 crew members.  Meg notice that there were lots of handwashing stations on the ship and she wondered why so many.  The cruise was heading for the Caribbean with many stops along the way.  Islands included Puerto Rico, St. Thomas and St. John, Barbados and other stops.  Two days into the cruise, after a stop in Puerto Rico, Meg noticed that there were some signs of people being sick.  The symptoms varied greatly among the passengers.  Some passengers had headaches, and stomach aches, others were vomiting, others had diarrhea.  Not all the passengers had disembarked.  Only the passengers who went ashore were sick?

Meg grew very concerned for her family as she had two individuals over 80 years of age and two children under two.  The had not gone ashore.

Please discuss:

1.  What Meg should do first

2.  What measures  the ship Captain should institute?

3.  What was the possible  cause of the gastrointestinal illness?

4.  Define the the criteria for the illness? 

5. Timing of illness?

6.  Was there commonality in the subjects who went ashore and got sick?

7.  Was the illness food born?  How would you determine this?

8.  Why is age of concern?

9.  Possible causes would include?

10. What testing would you do?

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