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American Journal of Public Health logoLink to American Journal of Public Health
. 1983 Jul;73(7):770–772. doi: 10.2105/ajph.73.7.770

Traveler's diarrhea at sea: two multi-pathogen outbreaks caused by food eaten on shore visits.

R L Berkelman, M L Cohen, J Yashuk, T Barrett, J G Wells, P A Blake
PMCID: PMC1650891  PMID: 6859361

Abstract

In 1976 and 1981, two outbreaks of gastrointestinal illness aboard cruise ships occurred within 24 hours following onshore visits to Haiti and Mexico, respectively. Three hundred eighty-six of 600 (64 per cent) and 98 of 260 (38 per cent) passengers became ill following luncheons in Port-au-Prince, Haiti, and Cozumel, Mexico. No increase in illness was observed among those passengers who did not attend the onshore luncheons. In both outbreaks, unrefrigerated seafood dishes served at outdoor buffets were epidemiologically incriminated as the vehicles of transmission. Several species of Vibrion, Salmonella, and toxigenic Escherichia coli were recovered from stool specimens of ill passengers in both outbreaks. In addition, invasive Escherichia coli and Shigella were isolated from stool specimens of ill passengers who ate at the Haitian buffet. Previous investigations of outbreaks of gastrointestinal illness aboard cruise ships have implicated exposures on board as the source and have involved only a single pathogen.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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