Investigation of an Outbreak of Gastrointestinal Illness at an Apartment Complex in Savannah

Symptoms and Cases

Cases have watery diarrhea, stomach cramps, nausea, vomiting, dehydration, and lack of appetite. Cases will show up at three hospitals and one urgent care clinic. Communication needed to determine that four cases live at the apartment complex while 

Ingrid (age 9) and Everett (age 12) (brother and sister) live in Columbia, South Carolina. These two children were visiting their Aunt Cindy and her husband Keith, who live at the apartment complex. The two children did swim at the pool. Aunt Cindy and Keith also went swimming and suffer those symptoms. All four of them were swimming in the pool over the weekend, which was five days ago.

Matt (age 7) and his mother Angela (age 32) went to the urgent care clinic. Matt has watery diarrhea and cannot eat. Angela has felt nauseated and has been vomiting. They live at the apartment complex and were swimming at the pool each day for the past week.

Matt: on summer vacation and starts second grade in two months. Matt plays youth baseball and soccer. He lives with his mom, Angela and his dad, Peter. 

Angela is a dentist and Peter is a realtor. Angela and Peter took Matt to the local zoo two days ago and Matt was able to pet goats, pigs, and sheep.

Ingrid and Everett live in South Carolina. Their parents dropped them off at Cindy and Keith’s apartment while they went on a weekend getaway to Florida. Ingrid plays the violin and Everett plays the piano. Both are avid swimmers and compete on their local swim team. While in Savannah, Ingrid and Everett played outside a lot, catching fireflies, roasting marshmallows and making S’mores with their aunt and uncle, and playing on a Slip-and-Slide. 

Ingrid and Everett’s parents take them to the Memorial Health University Medical Center ER one week after their visit to Cindy and Keith’s.

Cindy started complaining of cramps, nausea, and vomiting four days following Ingrid and Everett’s visit. Keith took Cindy to Landmark Hospital of Savannah.

1.What appear to be common themes among the ill cases? From a nursing perspective, what samples would you collect from cases and tests would you run to determine the causative agent? 

2.From a nursing and epidemiologic perspective, what communication strategies must you implement to determine an outbreak may be occurring in Savannah? Will you contact other healthcare facilities and if so, what will you discuss? 

3.What questions would you ask to the cases? What would you ask the parents (keep in mind, some of these children are rather young)? 

4.Since you answered this before, what would you look for / sample in and around the pool area? Do a little Google research and find a potential agent(s) you might find in a pool? 

5.What needs to be done to prevent others from the apartment complex and elsewhere (visitors) from becoming ill? 

6.What messages can you provide to the media to help protect others who may have pools (homeowners, apartments, hotels, parks, etc.)?