8. Case Resolution

  1. Case 1: The situation described in the case presentation can be considered an epidemic, taking into account the number of cases observed in the club, which would not to be expected. It is important to remember that an epidemic is defined as an increase in the number of cases at a given time and in a given place, as compared with those observed at the same time and place in previous years.
  2. Case 2: Diseases that can be considered in the differential diagnosis of an outbreak of acute gastroenteritis include:
    • Bacterial: Salmonella typhi, Shigella, Staphylococcus aureus (toxin)
    • Viral: Rotavirus
  3. Case 3: Incubation times associated with the different potential etiologic agents vary. Therefore, the estimation of the time interval between food ingestion and the onset of symptoms may help identify the probable etiology of this epidemic outbreak.
  4. Case 4: The likely vehicle is one of the foods ingested during dinner.
  5. Case 5: It would be appropriate to culture fecal samples from the individuals responsible for the preparation and distribution of meals, as well as from the sites in which meals were prepared and stored. It would also be adequate to obtain samples for culture from meals served during dinner, if they have been stored or not yet eliminated.
  6. Case 6: Implement strict hygiene measures in the club kitchen, and insist on careful hand washing by the persons responsible for the preparation of meals. If a carrier of one of the potential etiologic agents of the described outbreak is identified, isolate the carrier until the pathogen is eradicated.