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Epidemiology of foodborne norovirus outbreaks, United States, 2001-2008.
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MedLine Citation:
PMID:  23017158     Owner:  NLM     Status:  MEDLINE    
Noroviruses are the leading cause of foodborne illness in the United States. To better guide interventions, we analyzed 2,922 foodborne disease outbreaks for which norovirus was the suspected or confirmed cause, which had been reported to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention during 2001-2008. On average, 365 foodborne norovirus outbreaks were reported annually, resulting in an estimated 10,324 illnesses, 1,247 health care provider visits, 156 hospitalizations, and 1 death. In 364 outbreaks attributed to a single commodity, leafy vegetables (33%), fruits/nuts (16%), and mollusks (13%) were implicated most commonly. Infected food handlers were the source of 53% of outbreaks and may have contributed to 82% of outbreaks. Most foods were likely contaminated during preparation and service, except for mollusks, and occasionally, produce was contaminated during production and processing. Interventions to reduce the frequency of foodborne norovirus outbreaks should focus on food workers and production of produce and shellfish.
Aron J Hall; Valerie G Eisenbart; Amy Lehman Etingüe; L Hannah Gould; Ben A Lopman; Umesh D Parashar
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Emerging infectious diseases     Volume:  18     ISSN:  1080-6059     ISO Abbreviation:  Emerging Infect. Dis.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2013-02-19     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  9508155     Medline TA:  Emerg Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1566-73     Citation Subset:  IM    
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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MeSH Terms
Caliciviridae Infections / epidemiology*,  virology
Centers for Disease Control and Prevention (U.S.)
Child, Preschool
Disease Outbreaks*
Food Contamination
Food Handling / methods
Foodborne Diseases / epidemiology*,  etiology,  virology*
Fruit / virology
Middle Aged
Mollusca / virology
Norovirus / isolation & purification*
Population Surveillance / methods
Shellfish / virology
United States / epidemiology
Vegetables / virology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text
Journal Information
Journal ID (nlm-ta): Emerg Infect Dis
Journal ID (iso-abbrev): Emerging Infect. Dis
Journal ID (publisher-id): EID
ISSN: 1080-6040
ISSN: 1080-6059
Publisher: Centers for Disease Control and Prevention
Article Information
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Print publication date: Month: 10 Year: 2012
Volume: 18 Issue: 10
First Page: 1566 Last Page: 1573
PubMed Id: 23017158
ID: 3471645
Publisher Id: 12-0833
DOI: 10.3201/eid1810.120833

Epidemiology of Foodborne Norovirus Outbreaks, United States, 2001–2008 Alternate Title:Foodborne Norovirus Outbreaks
Aron J. Hall
Valerie G. Eisenbart
Amy Lehman Etingüe
L. Hannah Gould
Ben A. Lopman
Umesh D. Parashar
Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A.J. Hall, V.G. Eisenbart, A. Lehman Etingüe, L.H. Gould, B.A. Lopman, U.D. Parashar);
University of Illinois, Urbana, Illinois, USA (V.G. Eisenbart);
and North Carolina State University, Raleigh, North Carolina, USA (A. Lehman Etingüe)

Medscape CME Activity

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at; (4) view/print certificate.

Release date: September 17, 2012; Expiration date: September 17, 2013

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe general characteristics and outcomes of US norovirus outbreaks, based on an analysis of data reported during 2001-2008 to the CDC Foodborne Disease Outbreak Surveillance System
  • Describe sources of US norovirus outbreaks, based on an analysis of data reported during 2001-2008 to the CDC Foodborne Disease Outbreak Surveillance System
  • Describe recommended interventions to reduce the frequency and effects of foodborne norovirus outbreaks, based on an analysis of data reported during 2001-2008 to the CDC Foodborne Disease Outbreak Surveillance System

CME Editor

Carol E. Snarey, MA, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Carol E. Snarey, MA, has disclosed no relevant financial relationships.

CME Author

Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.


Disclosures:Aron J. Hall, DVM, MSPH; Valerie G. Eisenbart, DVM; Amy Lehman Etingüe, DVM; L. Hannah Gould, PhD; Ben A. Lopman, PhD;andUmesh D. Parashar, MBBS,have disclosed no relevant financial relationships.


Suggested citation for this article: Hall AJ, Eisenbart VG, Etingüe AL, Gould LH, Lopman BA, Parashar UD. Epidemiology of foodborne norovirus outbreaks, United States, 2001–2008. Emerg Infect Dis [Internet]. 2012 Oct [date cited].

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