LOCATION OF FOOD CONSUMPTION AND TRAVELERS' DIARRHEA

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Abstract
Tjoa, W. S., H. L. DuPont (U. of Texas Medical School, Houston, TX 77030), P. Sullivan, L. K. Pickering, A. H. Holguln, J. Olarte, D. G. Evans and D. J. Evans, Jr. Location of food consumption and travelers' diarrhea. Am J Epidemiol 106:61–66, 1977. Daily food histories for one month were obtained in summer, 1975, from students attending a Mexican university to determine the influence of food consumption on the development and etiology of dlarrhea. In newly-arrived students from the U.S. who ate half or more of their meals in the school cafeteria and public restaurants there were significant increases in diarrhea (p ≪ 0.005), shigella infection (p ≪ 0.05) and toxigenic E. coil infection (p ≪ 0.025) compared to the students eating a comparable number of meals in private homes. In the summer U.S. students there was also an association of diarrhea and eating from street vendors (p ≪ 0.05). In full-time U.S. students who had lived in Mexico a year or longer as well as in Latin American students a relationship between location of meals and occurrence of enteric disease was not apparent. High numbers of enteric bacteria were recovered from food from the school's cafeteria, public restaurants, street vendors and small grocery stores. Shigella were isolated from cooked and uncooked hamburger patties from the school cafeteria. Four shigella carriers were found among kitchen personnel at the school. This study demonstrates that food serves as a major vehicle through which travelers' diarrhea occurs.

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