Issues and Challenges: Investigation Foodborne Outbreak in Jamaica (50m Lecture)

Objectives: In 1996-1997, a study indicated that the attack rate for diarrhea among travelers in Jamaica was found to be approximately 24%. The findings resulted in the enactment of new regulations in 1998 to reduce the incidence of travel related diarrhea. Outbreak investigation within all-inclusive resorts in Jamaica has always proven to be challenging. This has been compounded by the advent of the mega hotel. The objective of this paper is to review a diarrheal outbreak investigation conducted in a mega hotel to determine the barriers to effective prevention and control.

Method: A review of the epidemiological, environmental and laboratory assessment were conducted to determine the adherence to existing outbreak investigation standards. A gap analysis was then conducted to determine the factors affecting the outcome of the outbreak.
Results: The review revealed that the investigation adhered to the existing standards for the most part. However there were significant gaps identified. These included the late identification of the outbreak, incomplete case history forms and inadequate food samples. There were 80 suspected cases identified. Salmonella enteritidis was isolated from 21 stool samples and phage types were available for 2.
Conclusion: No conclusive epidemiological link could be identified between the cases as there was insufficient evidence. The team was also unable to conclusively identify the source of the organism. The issues identified highlighted the need to revaluate the existing Public Health Tourist Establishment regulations to address the changing trends in the tourism sector.