Gastrointestinal Illness Associated with Consumption of a Soy Protein Extender 1.

In July and August 1976, an outbreak of acute gastrointestinal illness occurred among persons who had consumed a commercially marketed soy protein tunafish salad extender. After a public warning of a possible product contamination, representatives of 350 households reported 508 persons ill with an afebrile gastrointestinal syndrome that occurred usually within 1 h after the salad-extender was eaten. Interviews of randomly selected reported ill persons (cases) showed that the principal symptoms were nausea (91%), abdominal cramps (71%), diarrhea (53%), headache (42%), difficulty breathing (36%), and vomiting (22%). A survey of persons in the community who had eaten tuna extender revealed an illness attack rate (5.1%), which was significantly higher than the background incidence of gastrointestinal illness (1.1%) in persons who did not eat the tuna extender (p < .05). A case-control study showed that significantly more cases than controls had a history of "allergy" (p < .02). Tests of the product prepared by the manufacturer with volunteers implicated texturized soy protein as the cause of the illness. The findings in this study demonstrated that consumption of textured soy protein may elicit an adverse gastrointestinal response in a small but significant number of individuals, especially those with a history of "allergy."

Outbreak of typhoid fever in Trinidad in 1971 traced to a commercial ice cream product

In April 1971, a nationwide outbreak of typhoid fever involving 132 persons occurred in Trinidad; there were no deaths. Eighty per cent of cases occurred in children ages 5-14, and more than 90 percent of ill persons lived or went to school in the main towns or in smaller communities along their connecting roads. The epidemic curve suggested a common source, and a series of food preference questionaires implicated a nationally distributed ice cream product. Further investigation indicated that the product was distributed on only one day, March 23. The mean incubation period was 19 days, and the attack rate for those at risk was slightly greater than 1 percent. Samples of the ice cream product obtained a month after the outbreak were found to contain greater than 1100 Escherichia coli per 100 ml. Inspection of the plant revealed frequent hand contact with the product and an absence of pasteurization facilities. Although rectal swabs and stool cultures obtained after purgation from employees failed to identify the carrier, epidemiologic evidence suggested that an employee in the plant, rather than a contaminated ingredient, was the source of the outbreak. This outbreak emphasizes the need for mandatory pasteurization of milk and ice cream products, especially when strict sanitary procedures cannot be adhered to or enforced (AU)

Tendencias de la disentería de shiga en el Salvador, 1969-1973 / The rise and fall of shiga dysentery in El Salvador, 1969-1973

En julio de 1969 surgió en el Salvador una gran epidemia de disentería de shiga, que llegó al máximo en julio de 1970 y luego descendió rápidamente a niveles casi endémicos en 1973. Los casos registrados excedieron de 197,000, con unas 11,750 defunciones

Base epidemiológica del control del cólera / The epidemiologic basis of cholera control

En los programas de control del cólera es de importancia fundamental prestar atención especial al tratamiento óptimo de los casos, a la vigilancia y a la identificación de las vías de transmisión mediante la investigación epidemiológica. De un modo persuasivo se corrobora esa afirmación en el examen minucioso de las investigaciones pasadas, las experiencias recientes y las medidas de control comúnmente empleadas