Document Detail

Food-related norovirus outbreak among people attending two barbeques: epidemiological, virological, and environmental investigation.
MedLine Citation:
PMID:  19147386     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Norovirus (NoV) is commonly associated with gastrointestinal infection. It is normally transmitted person-to-person or from contaminated surfaces, although food-borne transmission is possible. METHODS: We conducted environmental, epidemiological, and microbiological investigations to ascertain the route of transmission of two linked outbreaks of NoV associated with events where food was consumed. Multivariate logistic regression was used to determine food items independently associated with infection. RESULTS: In outbreak A, 19 of the 26 people who completed the food questionnaire fulfilled the case definition. The highest relative risks (RR) were for chicken kebab (RR 3, 95% confidence interval (CI) 0.9-10.4), pork sausages (RR 2.1, 95% CI 0.5-9.1), pasta salad (RR 1.94, 95% CI 0.9-4.1), cheese (RR 1.6, 95% CI 0.9-2.8), and green leaf salad (RR 1.5, 95% CI 0.9-2.4). In outbreak B, 60 of the 106 people surveyed fulfilled the case definition. Green leaf salad (adjusted odds ratio (aOR) 3.2, 95% CI 1.4-9.9) and coleslaw (aOR 8.2, 95% CI 3-22.2) were independently associated with illness in the multivariate logistic regression model. NoV genogroup II genotype 6 (GII-6) was identified in cases of both outbreaks and a food handler who had prepared salads for both events. CONCLUSION: Because outbreak investigations of small cohorts may not yield epidemiological association to food, most of these outbreaks may be attributed to the person-to-person transmission route. Therefore ascertainment of food-borne NoV infection may be low, underestimating the true prevalence of this route of transmission.
Roberto Vivancos; Amir Shroufi; Margaret Sillis; Heather Aird; Chris I Gallimore; Linda Myers; Hamid Mahgoub; Pat Nair
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-01-14
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  13     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-28     Completed Date:  2009-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  629-35     Citation Subset:  IM    
Norfolk, Suffolk and Cambridgeshire Health Protection Unit, Health Protection Agency, St Andrews House, Norwich NR7 0HT, UK.
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MeSH Terms
Aged, 80 and over
Caliciviridae Infections* / epidemiology,  transmission,  virology
Case-Control Studies
Chickens / virology
Cohort Studies
Disease Outbreaks*
Food Contamination*
Food Handling / methods*
Food Services
Gastroenteritis / epidemiology,  virology
Meat Products / virology
Middle Aged
Norovirus / classification,  genetics,  isolation & purification,  pathogenicity*
Vegetables / virology
Young Adult

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