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        IV.  FOODBORNE ILLNESS OUTBREAKS.

             1. Approximately 2500 cases of gastroenteritis attributed to
        foodborne transmission were reported in USAF personnel during 16
        disease outbreaks between August 1990 and 16 March 1991. This
        figure represents 32% of all gastroenteritis cases seen at
        USCENTAF MTFs. It does not include or account for ill persons
        that did not seek treatment or those treated at non-USCENTAF
        MTFs. No food sabotage is suspected. Food facilities implicated
        in these disease outbreaks include hotel and other commercial
        restaurants, local national catering services, US-supervised
        dining tents manned largely by third country nationals, and local
        national military dining facilities. Foods implicated include
        green salad, cream filled pastry, baked turkey, smoked veal
        sandwich, spaghetti/meat-sauce, ham/tuna casserole, scrambled
        eggs, ice, milk, and yakisoba. To our knowledge, MRE's were not
        implicated in any foodborne illness outbreak investigations.

            2. The following information was reported to USCENTAF/SG by
       the USCENTAF MTFs. In most cases, detailed reports were not
       submitted. We've included as much information as is presently
       available to us. Outbreak summaries:

                 a. August 1990, Jeddah: 70 cases of gastroenteritis
       were attributed to food served in a hotel restaurant where
       USCENTAF personnel were temporarily billeted.

                 b. August 1990, Bateen: 30 - 40 cases of
       gastroenteritis were seen daily for 7 - 10 days. The suspected
       source was ice from an off-base host nation ice plant. Entameaba
       histolytica and giardia were detected by a local national
       laboratory in patient stools. Coliform organisms were cultured
       from the suspect ice.

                  c. August 1990, A1 Minhad: 30 - 40 cases of
       gastroenteritis were seen daily for 14 days. Entameoba
       histolytica was detected by a local national laboratory in
       patient stools. The suspected source was uncooked vegetables
       from an on-base host nation military dining hall. Sanitation
       practices were described as grossly inadequate.

                 d. September 1990, Dharhan: 13 U.S. Army personnel were
       diagnosed with laboratory confirmed Salmonellosis. The suspected
       source was a local national chicken stand at a nearby port. USAF
       personnel did not have access to this facility.

                 e. September 1990, Cairo West: "Focdborne illness
       outbreak due to milk served against EH recommendations".

                  f. September, A1 Dhafra: 300 cases cf AGE presented in
       a 10 day period. Ice from a host nation source was suspected.  

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