What are the possible etiologic agents of this outbreak of foodborne illness?
Based on its investigation, the health department suspects the vehicle for this outbreak was a food item consumed at Restaurant A, 42 hours before the illness. If this is so, the most likely etiologic agent is a bacterial pathogen as suggested by the moderate incubation period, the lack of vomiting, and the significant duration of illness. Foodborne illness caused by the most common enteric viral pathogens typically has a shorter incubation period, more vomiting, less diarrhea, and a shorter duration of symptoms. By contrast, parasitic infections usually have a longer incubation period (1 to 2 weeks) and a longer duration of illness (>2 to 3 weeks). The bacterial enteric pathogens that should be considered as possible sources of the outbreak are Campylobacter and Salmonella, the two most common causes of bacterial foodborne diseases in the United States. Typically these infections are characterized by fever in addition to abdominal cramps and diarrhea, and bloody stools are possible bu
