Hotel based surveillance of health conditions amongst travellers to Jamaica

Pursuant of the goal to implement a strategy for prevention and control of travellers' diarrhoea (TD), a programme for the surveillance of selected health conditions amongst visitors and staff was pilot tested in 5 resort hotels in Jamaica. Surveillance reports submitted on a weekly basis by the hotel nurses were analyzed for usage of hotel medical facilities; cases due to accidents, diarrhoea and associated symptoms; and acute respiratory tract infections (ARIs). Diarrhoea visits accounted for the lowest number of visits to the nurses' station of all properties, ARIs for the highest. Highest frequency of diarrhoea visits occurred in hotels 4 and 5 being 9.3 and 7.3 percent of all visits to the nurses' station. 70 percent of guest TD cases and 26 percent of staff reported with more than 6 evacuations per day. Abdominal cramps was the most frequent complaint, being present in 38 percent and 43 percent of staff. Vomiting was an associated symptom in 17.6 percent of guest cases and in 26.4 percent of staff cases. A hotel 1, fever was an associated symptom in 23.6 percent and blood in stool in 4.9 percent of guest cases. At hotel 4, fever was present in 14.1 percent and blood in stool of 1.5 percent of guest cases. Amongst staff at hotels 1 and 4, 22.2 percent and 3.8 respectively, and fever. Blood in stool was infrequent amongst staff. These data confirm the usefulness of the surveillance tool for the analysis of TD in hotels.(AU)

The aetiology of diarrhoea in five hotels in Jamaica

Diarrhoea is a self-limited disease which commonly affects tourists traveling from low risk to high risk destinations. It is estimated to affect 20-50 percent of the residents of industrialized countries who visit a developing country each year. Jamaica and other countries of the Caribbean, Latin America, Sub-Saharan African and South East Asia are considered to be intermediate to high risk tourist destinations. Data generated between 1979 and 1981 estimated that approximately 20 percent of European visitors to the Caribbean are afflicted with travellers' diarrhoea (TD) during their stay. Since the time, tourist arrivals to Jamaica have increased from 0.4 to 1.2 millions. To meet the challenges faced by this rapid growth, significant changes have been made to the tourism product, which may have impacted on the health visitors. Immediately following Jamaica's citation by the US Travel Advisory after an outbreak of typhoid in the parish of Westmoreland in 1991, the country was faced by a threat of a cholera epidemic in neighbouring Latin America. With a view to implementing a strategy for cholera prevention and control of cholera and other foodborne diseases, the Ministry of Health initiated a study of epidemiology and aetiology of TD in Jamaica. The first phase of the study was designed to assess the magnitude of TD amongst travellers to Jamaica, by region and by hotel. Those data have been reported elsewhere. Bacterial enteropathogens cause 80 percent of TD.(AU)