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Principles of Epidemiology and Public Health

5-3 Milestone Two 5-3 Milestone Two IHP-330 Southern New Hampshire University Kimberly Zinn November 28, 2021 5-3 Milestone Two A study was conducted from 1988-1997 on the residents of the Caribbean islands. Trinidad and Tobago, about the Salmonella outbreak that plagued its residents and tourists alike. An increase in diarrhea led to an investigation which resulted in confirming an outbreak of Salmonella virus. Among the populations of both islands, all genders, ages, and ethnicities were affected by the virus, including the tourist population visiting the islands during the outbreak. This information can help single out the source of the outbreak, and thus start some control over the spread of the virus. Three social and behavioral determinants associated with the Salmonella outbreak in Trinidad and Tobago are education, government, and location. Some areas of these locations don't have the easy access to education on hygiene and proper food handling to avoid contamination. The government did not fully prepare its population with said education to prevent and/or stop the rapid spread of the virus in time to contain it. And the location, according to data collected in the study by Indar-Harrinauth et al. (2004) narrowed down the contaminated foods to egg farms, "Ten egg-producing farms across the country were selected, nine of which were the largest and most popular commercial table egg farms in Trinidad." The first known disparity associated with the health issue at hand is the lack of communication at a government level with reporting diagnosed cases of Salmonella. "The average reporting delay (i.e., from diagnosis to receipt of the report by CAREC) was 56 days." (Indar-Harrinauth et al., 2004). That means there were 56 days where the Salmonella virus was able to spread, uncontained. The second disparity is the lack of safe hygiene and food handling protocols by the contaminated farms, including the flocks, eggs, and employees. The third known disparity would be the social gatherings for the holidays (the same time during the outbreak). In Table 2 of the Salmonella in the Caribbean article, it states that the contaminated egg products 5-3 Milestone Two happen to be ingredients used in popular holiday food items. Thus, increasing the spread because of the popularity of the contaminated item. The identified social and behavioral determinants stated above directly relate the disparities involved. The population was extremely vulnerable because the health and safety measures were not strictly enforced. The outbreak was not prioritized during reporting, so salmonella continued to spread without precautions taken until the cases dramatically rose. Training and educating the population about salmonella and how easily it is to spread contamination, would be extremely beneficial to stopping the spread of a disease. During my research, I have come to know that Salmonella flourishes more in humid environments, in this study case, Trinidad and Tobago are especially humid, averaging 82% humidity. The increased humidity causes food safety protocols to fall to the wayside, especially in lower socioeconomic locations like the Caribbean. Simple education to the population about proper hygiene and food