The aetiology of diarrhoea in five hotels in Jamaica

ABSTRACT

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)