REDUCTION OF FECAL CONTAMINATION OF STREET-VENDED BEVERAGES IN GUATEMALA BY A SIMPLE SYSTEM FOR WATER-PURIFICATION AND STORAGE, HANDWASHING, AND BEVERAGE STORAGE

Street-vended foods and beverages, an integral part of urban economies in the developing world, have been implicated in cholera transmission in Latin America. To improve the microbiologic quality of market-vend ed beverages in Guatemala, we tested a simple system consisting of dil ute bleach (4.95% free available chlorine) for water purification, nar row-mouth plastic vessels with spigots for disinfecting and storing wa ter and for preparing and storing beverages, handwashing soap, and edu cation in using the system. We conducted a randomized controlled inter vention trial among 41 vendors who received the intervention and 42 co ntrol vendors, comparing total and fecal coliform bacteria and Escheri chia coli contamination of market-vended beverages, stored water, and vendors' hands. Samples were obtained at baseline and at each of six w eekly follow-up visits. At baseline, fecal coliform bacteria were foun d in 40 (48%) market-vended beverages and E. coli in 14 (17%). When co mpared with samples from control vendors, a significant decrease in to tal coliform (P < 0.001) and fecal coliform (P < 0.001) bacteria in sa mples of stored water and beverages sold by intervention vendors was o bserved over the course of the study. The vessel system was well accep ted by vendors. This simple inexpensive system consisting of hypochlor ite disinfectant, plastic vessels, soap, and education can significant ly reduce fecal contamination of market-vended beverages.