Multiple outbreaks of a novel norovirus GII.4 linked to an infected post-symptomatic food handler

• Published in: Epidemiology and infection 2013-08, Vol.141 (8), p.1585-1597
• Main Authors: THORNLEY, C. N., HEWITT, J., PERUMAL, L., VAN GESSEL, S. M., WONG, J., DAVID, S. A., RAPANA, J. P., LI, S., MARSHALL, J. C., GREENING, G. E.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Caliciviridae Infections - epidemiology; Caliciviridae Infections - transmission; Caliciviridae Infections - virology; Catering; Cohort Studies; Cooking; Diarrhea; Disease Outbreaks; Epidemics; Feces - virology; Female; Food contamination & poisoning; Food Handling; Fundamental and applied biological sciences. Psychology; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - virology; Genotype; Humans; Illnesses; Male; Microbiology; Middle Aged; Miscellaneous; Molecular Sequence Data; New Zealand - epidemiology; Norovirus; Norovirus - classification; Norovirus - genetics; Norovirus - physiology; Original Papers; Phylogeny; Polymerase Chain Reaction; Public health; Retrospective Studies; Risk factors; RNA, Viral - genetics; RNA, Viral - metabolism; Sequence Analysis, RNA; Time Factors; Virology; Vomiting; Young Adult
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268813000095

Multiple norovirus outbreaks following catered events in Auckland, New Zealand, in September 2010 were linked to the same catering company and investigated. Retrospective cohort studies were undertaken with attendees of two events: 38 (24·1%) of 158 surveyed attendees developed norovirus-compatible illness. Attendees were at increased risk of illness if they had consumed food that had received manual preparation following cooking or that had been prepared within 45 h following end of symptoms in a food handler with prior gastroenteritis. All food handlers were tested for norovirus. A recombinant norovirus GII.e/GII.4 was detected in specimens from event attendees and the convalescent food handler. All catering company staff were tested; no asymptomatic norovirus carriers were detected. This investigation improved the characterization of norovirus risk from post-symptomatic food handlers by narrowing the potential source of transmission to one individual. Food handlers with gastroenteritis should be excluded from the workplace for 45 h following resolution of symptoms.