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File: 970207_aadch_015.txtk. December 1990, Jeddah: 23 cases of AGE were treated. The suspected food was catered vanilla pudding/custard filled cake, from which Staphylococcus aureus enterotoxin and bacillus cereus were cultured. 1. January 1991, Cairo West: eight cases of AGE seen over a 24 hour period. There were other complaints of personnel reportedly ill but not seeking medical treatment. The suspected food was ham/tuna casserole which was served cold the next day. Patrons had reheated individual portions in a microwave oven. m. January 1991, Jeddah: 648 cases, Implicated meal was smoked veal sandwich in catered boxed lunch prepared in off base local national facility and served all day 20 January. Clostridium perfringens was the suspected pathogen. All stool specimens were negative. However, the local host nation laboratory did not include testing for anaerobes. n. February 1991, Jeddah: 59 cases of AGE were treated, 14 of which were admitted. The suspect meal was catered undercooked baked turkey. Salmonella enteritidis type d was cultured from stools. The local national caterer cited complacency of one of their middle managers as cause or problem. The manager was subseauently transrerred. o. March 1991, A1 Dhafra: 10 cases with a mixture of GI symptoms approximately six - eight hours after eating dinner. A I case-control study showed an association with eating yakisoba at chow hall #2. Food samples were not available. Leftovers had been discarded. Food handling practices were evaluated and found acceptable as was personal hygiene. These symptoms and incubation were consistent with staphylococcal or Bacillus cereus food poisoning. p. March 1991, Doha: 14 cases of AGE, five hospitalized. Five had stools positive for Salmonella enteritidis Type D. Although no common meal was implicated, a USAF dining facility was suspected. No food remained for testing. Rectal swaps of foodhandlers were obtained. V. PROBLEMS ENCOUNTERED: 1. There was no dedicated vehicle for use by Environmental Health and Bioenvironmental Engineering in the conduct of preventive medicine tasks. Access to a vehicle was a limiting factor in efforts to inspect food facilities and food. 2. The Wing Commander did not have tradition control over feeding facilities run by local nationals. USAF sanitary standards could not be enforced in some cases. 5
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