What additional historical information will assist in the identification of the etiologic organism?
• What foods did Marcus and Andrea consume in the previous week? In particular, which foods/ beverages did they consume that the other family members did not? • Did either Marcus or Andrea consume undercooked meats, runny eggs, unpasteurized milk, raw shellfish, or untreated water? • Is there a reptile in the home? • Marcus was prescribed antibiotics for otitis media 1 week prior to the onset of his gastrointestinal symptoms. Has Andrea been prescribed antibiotics during the month prior to the onset of her diarrheal illness? • Have there been other cases of diarrhea recognized in the cruise ship travelers, in their community, or at Marcus’ school? An open-ended food history reveals multiple common meals eaten by Andrea and Marcus. Andrea denies the consumption of unpasteurized milk, raw shellfish, and undercooked meats. She does report that, unlike the rest of the family, she and Marcus used to wake up early enough to enjoy the breakfasts served on board the cruise. Breakfast served on
