Question

The following information has just come into a State Department of Health.

Clinical laboratories reported a significant increase in demand for the media to perform routine stool cultures, resulting in requests to other labs and the State Department of Health for additional supplies. Pharmacists are reporting difficulty keeping over the counter and prescription antidiarrheal medication in stock. The local water authority was deluged by complaints from customers about increased water turbidity and water that tasted and smelled unpleasant. Additionally, school nurses have reported increased absences for diarrheal illness. Finally, citizens have jammed health department telephone lines with concerns about diarrheal illness sweeping across their community.

Signs and symptoms.

A review of the complaint logs generated by calls to the health department, reveals that all of those affected are experiencing watery diarrhea accompanied by stomach cramps and pain. Some patients, particularly children, are also experiencing nausea, vomiting, anorexia, and fever.

Question 1: Do you think the illnesses are foodborne, waterborne, sexually transmitted, or another form of transmission?

Question 2: Do you think the illnesses represent an outbreak?

Question 3: Given your response to question 1, who would you involve in the investigation?