ABSTRACT
A. Introduction When foodbome illness occurs in health care institutions, hospitals, or long-term care facilities (LTCFs), large numbers of people are usually affected because food is prepared en masse. An equally important contributing factor is the increased susceptibility of the residents. In LTCFs, nursing homes, and homes for the aged, the elderly are often debilitated with chronic diseases, immunologically weak, and/or, occasionally, undernourished. In developed countries more than half of the documented deaths from gastroenteritis (30), some of them due to foodbome ill ness, occur in the elderly. In hospitals, patients may be in a weakened state after having undergone surgery or chemotherapy. However, foodbome illness is largely preventable if proper control strategies are followed by staff in the kitchen and by the health care providers. These strategies are increasingly important in reducing morbidity and mortality in our growing population of elderly (> 65 years), which is projected to increase from 32 million in 1990 to 76 million by 2020 in the United States (72).
