TASK FORCE III DESERT SHIELD/STORM

File: aaacf_51.txt
Page: 51
Total Pages: 273
Entameaba histolytica, giardia and salmonella were isolated from patient stools by a 
local national military laboratory. Coliform organisms were cultured from the ice.

		g. October 1990, King Fahd: 100 cases of gastroenteritis presented in less 
than one week. The suspected source was green salad or salad serving utensils from an 
on-base USAF-supervised dining tent.

		h. October 1990, Riyadh: 400 cases of gastroenteritis presented in less 
than one week. Shigella sonnet was cultured from the stools of 15 patients. Green 
salads prepared in a USAF-supervised dining tent by third country nationals and served 
during a dinner meal were implicated as the source of infection by time-distribution 
curve.

		i. November 1990, Cairo West: 15 cases presented over a three hour period 
with sudden onset of vomiting, prostration, abdominal cramping and diarrhea. A 
sanitation evaluation of the dining hall revealed no significant discrepancies. 
Leftover foods were shipped to NAMRU-6 (U.S. Navy laboratory) for analysis. 
Staphylococcus aureus enterotoxin was found in spaghetti and meat sauce.

		j. December 1990, Taif: 86 cases of gastroenteritis presented over a three 
day period, of which 79 were hospitalized. Medical management of these cases involved 
the temporary assignment from other ATHs of two auxiliary nursing teams. Most of the 
more seriously ill patients were transferred to a local national hospital along with 
four nurses, six medical technicians, two physicians, one diet therapist, and one 
laboratory technician. Salmonella, type O was cultured from 41 of 48 patients in a 
local national hospital laboratory. Also, 27% of patient stools reported contained 
Entameoba histolyica cysts. The suspected source was grossly contaminated (feces and 
feathers) raw eggs from an unapproved source which were served undercooked 
(soft-scrambled) for breakfast in a USAF-supervised dining facility. Ninety-seven 
percent of the ill patients had eaten eggs (other foods = 60-631). Patients described 
the eggs as runny. The bottoms of the egg crates were contaminated with straw, feces 
and dirt. Approximately 201 of the eggs arrived cracked. Cracked eggs were not 
segregated and disposed of but rather were cooked and served. Although soiled with 
feces and feathers, no effort was made to wash the egg shells. Receipt inspection by EH 
had not been performed. Contracting and food service officers were reportedly unaware 
of need to involve EH in the receipt inspection and approved source verification 
process. The dining facility handwashing stations for foodhandlers and patrons were 
inadequate and minimal use was made of those available. All eggs in remaining stock 
were subsequently destroyed. Approximately 400 man days of productivity were lost 
because of this outbreak.