A report published in the Centers for Disease Control andPrevention’s Morbidity and Mortality Weekly Report(MMWR46:1189–1191, 1997) illustrated many important features ofstaphylococcal food poisoning. A total of 18 persons attending aretirement party became ill approximately 3 to 4 hours aftereating. The most common symptoms were nausea (94%), vomiting (89%),and diarrhea (72%). Relatively few individuals had fever orheadache (11%). The symptoms lasted a median of 24 hours. Theillness was associated with eating ham at the party. A sample ofthe cooked ham was positive for staphylococcal enterotoxin type A.A food preparer had cooked the ham at home, transported it to herworkplace and sliced it while it was still hot, and thenrefrigerated the ham in a large plastic container covered withfoil.The ham was served cold the next day. Cooking the ham wouldkill any contaminating S. aureus,so it is likely the ham wascontaminated after it was cooked. The delays involved inrefrigerating the ham and the fact it was stored in a singlecontainer allowed the organism to proliferate and produceenterotoxin.

1. describe the organism causing the disease?

2. explain what virulence factors are important for themanifestion of the disease

3. Staphylococci cause a variety of diseases, includingcutaneous infections, endocarditis, SSSS and TSS. How do theclinical symptoms of these diseases differ from the infection ofthis patient?

4. Which of the staphylococcal diseases are intoxications vs.active infections?

5. What toxins have been implicated in the disease described inthis case?

6. What is the appropriate treatment in this case?