Case C: On a Friday afternoon, 65 individuals attended a farewell party. The age

Question

Case C: On a Friday afternoon, 65 individuals attended a farewell party. The ages of the people attending ranged from 4 to 78 years of age. The event was held in a nearby city park and food was provided by a local catering company. Food was brought to the party by the caterers at approximately 12:30 p.m. Within 20-24 hours after the food had been served, several people began to experience vomiting and diarrhea with moderate to severe abdominal cramps, headache and muscle aches. Some of the elderly patients experienced some typical symptoms of dehydration, such as thirst and dryness of the mucus membranes. Fecal cultures from the patients grew the same microorganism with the following characteristics: Gram-negative bacillus Glucose fermentation: Lactose fermentation H2S production Positive Negative Positive

Explanation / Answer

4. Such type of infection can be highly dehydrating, therefore replenishment of ions and electrolytes is very important. In some cases oral rehydaration works and in some intravenous fluids may be required. Generally the predicted infection is self-healing and will slow down inectious effects in days to weeks time. Medication may include anti-diarrheals like loperamide, which will also help relieve cramps. If the case is not severe, antibiotics will not be prescribed as this will increase the time for which the patient acts as a carrier for the bacteria and can infect others too. In severe cases, antibiotics may be given, like ampicillin, chloramphenicol, trimethoprim-sulfametoxazole etc. but generally, antibiotics are not recommended, only healthy fluid substituents containing electrolytes are given.

5. Prevention of such infections: Avoid eating uncooked or undercooked meals, uncooked eggs or drinking unpasteurized milk. Mother's milk is the best for infants. Food should be particularly checked in case of elderly persons, infants and people who are immunocompromised. Uncooked meat should be paced away from cooked and ready-to-eat foods. Wash hands thoroughly after cleaning diapers of a child or an elderly person infected with such infections. Practice washing hands regularly after contact with any reptile, bird, pets or their faeces. It is advisable to avoid contact with reptile to prevent these type of infections.

6. The organism is most likely Salmonella (Salmonella typhi)

7. Salmonella has a generation time of 21-34 minutes in food. Considering an average of 30 minutes here,

1st generation will give 4 cells after 30 minutes, 2nd generation 8 cells after 1 hr, 3rd generation 16 cells after 1.5hrs and like wise 7th generation results in 256cells, which happens after 3.5 hrs.

Food was cooked at 9am and believd to be contaminated at around that time. The bacteria becomes infectious at 200 microorganism/g food, which happens in less than 3.5 hours after inoculation. Thus 12:30pm, when the food was served, the microbe had increased to infectious dose.

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