EPIDEMIOLOGY Epidemiology

Epidemiology

Case tracking: gastrointestinal illness log, otherwise known as GI log. This document is the foundational document for the Vessel Sanitation Program surveillance system. It is actually a line listing of cases of gastrointestinal illness reporting to the ship's medical staff. This document is used to gather information to manage and report cases of gastrointestinal illness. It is also used in all outbreak investigations. Please note this document is also required for each cruise or voyage. The data elements that are required to be collected in the GI log include the date the case first reported to the clinic or reported to the medical staff, the case patient name, age, and gender, the designation of whether the case is a passenger or crew, if it's a crew member, the crew member position, assigned cabin number, as well as assigned dining room meal seating. Generally, this is usually recorded as either the first or the second seating. In some instances, your ship may not have assigned seating for meals, and therefore this element could be excluded. Continuing with additional elements that are required in the GI log, the date and time of illness onset is extremely important to outbreak investigations, as well as illness symptoms including diarrhea, vomiting, and other symptoms that we'll describe later in the presentation, stool specimens, whether they were requested and/or whether the specimens were received, whether any antidiarrheal medication was dispensed to control the illness, and whether there are any underlying medical conditions that may cause the doctor not to count the individual as a case of reported GI illness. Examples include irritable bowel syndrome and other conditions that may mimic GI illness.

Cases of GI illness per 100,000 passenger days on cruise ships, 2001 through 2004. Data in the Vessel Sanitation Program surveillance system indicate that in 2001, roughly 18 cases per 100,000 passenger days were identified among passengers on cruise ships. This rate appears to have increased to about 31 cases per 100,000 passenger days in 2002, to approximately 32 cases per 100,000 passenger days in 2003, and to a high of approximately 33 cases per 100,000 passenger days in 2004. So we're seeing an increase in the overall rate of cases of gastrointestinal illness in the United States on passenger cruise ships.

Outbreaks of acute gastroenteritis, AGE, on cruise ships, 2001 to 2004. In 2001, we saw roughly two outbreaks of acute ...