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Outbreak of Invasive Escherichia Coli Gastroenteritis on a Cruise Ship^*

John D. Snyder^,,, Joy G. Wells, John Yashuk, Nancy Puhr AND Paul A. Blake

Enteric Diseases Branch, Division of Bacterial Disease, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia 30333,
U.S. Quarantine Station, U.S. Public Health Service, Miami, Florida 33132
Department of Pediatrics, Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts 02114

An invasive strain of Escherichia coli (ONT:NM) was isolated from stool specimens from 7 of 10 ill passengers who developed diarrhea during a 5-day ocean cruise. The ill passengers had shared no common exposures off the ship before or during the cruise. Three of the persons whose stools were cultured were part of a tour group of 219 persons, and a food consumption and health history questionnaire was completed by 190 members (87%) of this tour group. Forty-seven (25%) had had diarrhea during the cruise; other symptoms among those with diarrhea included nausea (72%), abdominal cramps (68%), headache (68%), chills (60%), dizziness (53%), myalgias (43%), subjective fever (36%), and vomiting (26%). The median duration of symptoms was 3 days. Eating at cold buffets on ship and eating potato salad, a buffet food item, were significantly associated with illness. No evidence of secondary spread of illness in household contacts of the ill person was found.

Accepted for publication October 6, 1983.

^* Address reprint requests to: John D. Snyder, M.D., CID;DBD:EDB 1-5428, Centers for Disease Control, Atlanta, Georgia 30333.

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