Chapter 12 : Asymptomatic Carriers and Captive Audiences

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This chapter talks about the asymptomatic carriers and captive audiences. Biofilm formation by , according to researchers, most likely was essential to the development of a carrier state. Understanding the mechanism of the biofilm formation may help the medical profession to develop effective methods to eliminate or prevent asymptomatic carriage of . While Mary Mallon put a face to the concept of asymptomatic carriage of disease, the scope of the problem extends far beyond carriage of , or of other bacterial pathogens. Viruses such as norovirus and hepatitis A can also be spread rapidly and broadly by carriers who either are asymptomatic, are in the early, presymptomatic stages of illness, or are convalescent but still shedding infectious virus particles. Although outbreaks of typhoid fever that occur in underdeveloped countries are usually linked to contaminated water, the most common mode of serotype Typhi transmission in the United States is the asymptomatic carrier. The Minnesota Department of Health first received word of the possible outbreak on September 27, 1989, after four patients with symptoms of salmonellosis visited the local hospital emergency room between September 23 and 25. The study’s authors estimated that a compulsory vaccination program would cost $8.1 million, which would be offset by savings due to reduced loss of work days and reduced need for outbreak investigations. Vessel Sanitation Program (VSP) personnel conduct sanitation inspections of ships that call at U.S. ports and investigate disease outbreaks, among other related activities.

Citation: Entis P. 2007. Asymptomatic Carriers and Captive Audiences, p 217-242. In Food Safety. ASM Press, Washington, DC. doi: 10.1128/9781555816186.ch12

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Infectious Diseases
Norwalk virus
Hepatitis E virus
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Figure 12.1

Frequency of reported outbreaks of gastroenteritis due to norovirus on cruise ships: 1994 –2005 ( ). Solid columns, norovirus; open columns, other gastroenteritis outbreaks.

Citation: Entis P. 2007. Asymptomatic Carriers and Captive Audiences, p 217-242. In Food Safety. ASM Press, Washington, DC. doi: 10.1128/9781555816186.ch12
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Generic image for table
Table 12.1

Hardee's 1989 outbreak: probable timeline ( )

Citation: Entis P. 2007. Asymptomatic Carriers and Captive Audiences, p 217-242. In Food Safety. ASM Press, Washington, DC. doi: 10.1128/9781555816186.ch12
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Table 12.2

Examples of nosocomial outbreaks of gastrointestinal disease

Citation: Entis P. 2007. Asymptomatic Carriers and Captive Audiences, p 217-242. In Food Safety. ASM Press, Washington, DC. doi: 10.1128/9781555816186.ch12

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