01-29-2009, 11:26 AM
On the fifth day of a 7-day cruise in the western Caribbean, a 37-year-old woman develops headaches, fever, chills, abdominal discomfort, and watery diarrhea over a 12-hour period. Many other passengers and crew members have had similar symptoms. Her temperature is 37°C (98.6°F). Abdominal examination shows diffuse tenderness without rebound, bowel sounds are hyperactive. Her leukocyte count is 11,000/mm3. Gram's stain of a stool specimen shows a small number of neutrophils. A stool culture grows Salmonella enteritidis. Two days after treatment with bismuth subsalicylate and oral rehydration, her symptoms subside. Which of the following is the most appropriate immediate measure to prevent further spread of this pathogen?
O A) Cancellation of shore leave for all crew members
O B) Elimination of seafood and shellfish from the ship's menu
O C) Exclusive use of pasteurized eggs
O D) Hyperchlorination of the ship's drinking water
O E) Reassignment of all food-handling personnel to other duties
O F) Treatment of all affected persons with doxycycline
O A) Cancellation of shore leave for all crew members
O B) Elimination of seafood and shellfish from the ship's menu
O C) Exclusive use of pasteurized eggs
O D) Hyperchlorination of the ship's drinking water
O E) Reassignment of all food-handling personnel to other duties
O F) Treatment of all affected persons with doxycycline