Abstract
A common source outbreak of small round structure virus (SRSV) gastroenteritis affected 81 patients and 114 staff in four hospitals served by one central hospital kitchen. Eating salad items was found to be significantly associated with illness. In a cohort study of a staff buffet function eating turkey salad sandwiches was associated with illness (relative risk = 2.4; 95% CI = 1.4-4.1; P = 0.003), and a case control study of patients in one hospital showed an odds ratio of 6.6 (95% CI = 1.0-71.6; P = 0.04) for eating tuna salad and becoming ill. One of two food handlers who prepared the salads became ill the day following food preparation; she also had a young child at home who had been ill with a gastrointestinal illness during the previous two days. Contamination of food by mechanical transmission of the virus from the child via clothes and hands of the mother, or pre-symptomatic faecal excretion in the mother are possible explanations of contamination of food.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Curry A., Riordan T., Craske J., Caul E. O. Small round structured viruses and persistence of infectivity in food handlers. Lancet. 1987 Oct 10;2(8563):864–865. doi: 10.1016/s0140-6736(87)91061-0. [DOI] [PubMed] [Google Scholar]
- Greenberg H. B., Wyatt R. G., Kapikian A. Z. Norwalk virus in vomitus. Lancet. 1979 Jan 6;1(8106):55–55. doi: 10.1016/s0140-6736(79)90508-7. [DOI] [PubMed] [Google Scholar]
- Griffin M. R., Surowiec J. J., McCloskey D. I., Capuano B., Pierzynski B., Quinn M., Wojnarski R., Parkin W. E., Greenberg H., Gary G. W. Foodborne Norwalk virus. Am J Epidemiol. 1982 Feb;115(2):178–184. doi: 10.1093/oxfordjournals.aje.a113289. [DOI] [PubMed] [Google Scholar]
- Gross T. P., Conde J. G., Gary G. W., Harting D., Goeller D., Israel E. An outbreak of acute infectious nonbacterial gastroenteritis in a high school in Maryland. Public Health Rep. 1989 Mar-Apr;104(2):164–169. [PMC free article] [PubMed] [Google Scholar]
- Gunn R. A., Terranova W. A., Greenberg H. B., Yashuk J., Gary G. W., Wells J. G., Taylor P. R., Feldman R. A. Norwalk virus gastroenteritis aboard a cruise ship: an outbreak on five consecutive cruises. Am J Epidemiol. 1980 Dec;112(6):820–827. doi: 10.1093/oxfordjournals.aje.a113054. [DOI] [PubMed] [Google Scholar]
- Ho M. S., Glass R. I., Monroe S. S., Madore H. P., Stine S., Pinsky P. F., Cubitt D., Ashley C., Caul E. O. Viral gastroenteritis aboard a cruise ship. Lancet. 1989 Oct 21;2(8669):961–965. doi: 10.1016/s0140-6736(89)90964-1. [DOI] [PubMed] [Google Scholar]
- Iversen A. M., Gill M., Bartlett C. L., Cubitt W. D., McSwiggan D. A. Two outbreaks of foodborne gastroenteritis caused by a small round structured virus: evidence of prolonged infectivity in a food handler. Lancet. 1987 Sep 5;2(8558):556–558. doi: 10.1016/s0140-6736(87)92933-3. [DOI] [PubMed] [Google Scholar]
- Kaplan J. E., Gary G. W., Baron R. C., Singh N., Schonberger L. B., Feldman R., Greenberg H. B. Epidemiology of Norwalk gastroenteritis and the role of Norwalk virus in outbreaks of acute nonbacterial gastroenteritis. Ann Intern Med. 1982 Jun;96(6 Pt 1):756–761. doi: 10.7326/0003-4819-96-6-756. [DOI] [PubMed] [Google Scholar]
- Kuritsky J. N., Osterholm M. T., Greenberg H. B., Korlath J. A., Godes J. R., Hedberg C. W., Forfang J. C., Kapikian A. Z., McCullough J. C., White K. E. Norwalk gastroenteritis: a community outbreak associated with bakery product consumption. Ann Intern Med. 1984 Apr;100(4):519–521. doi: 10.7326/0003-4819-100-4-519. [DOI] [PubMed] [Google Scholar]
- Osterholm M. T., Forfang J. C., Ristinen T. L., Dean A. G., Washburn J. W., Godes J. R., Rude R. A., McCullough J. G. An outbreak of foodborne giardiasis. N Engl J Med. 1981 Jan 1;304(1):24–28. doi: 10.1056/NEJM198101013040106. [DOI] [PubMed] [Google Scholar]
- Pether J. V., Caul E. O. An outbreak of food-borne gastroenteritis in two hospitals associated with a Norwalk-like virus. J Hyg (Lond) 1983 Oct;91(2):343–350. doi: 10.1017/s0022172400060368. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reid J. A., Caul E. O., White D. G., Palmer S. R. Role of infected food handler in hotel outbreak of Norwalk-like viral gastroenteritis: implications for control. Lancet. 1988 Aug 6;2(8606):321–323. doi: 10.1016/s0140-6736(88)92367-7. [DOI] [PubMed] [Google Scholar]
- Sawyer L. A., Murphy J. J., Kaplan J. E., Pinsky P. F., Chacon D., Walmsley S., Schonberger L. B., Phillips A., Forward K., Goldman C. 25- to 30-nm virus particle associated with a hospital outbreak of acute gastroenteritis with evidence for airborne transmission. Am J Epidemiol. 1988 Jun;127(6):1261–1271. doi: 10.1093/oxfordjournals.aje.a114918. [DOI] [PubMed] [Google Scholar]
- Thornhill T. S., Kalica A. R., Wyatt R. G., Kapikian A. Z., Chanock R. M. Pattern of shedding of the Norwalk particle in stools during experimentally induced gastroenteritis in volunteers as determined by immune electron microscopy. J Infect Dis. 1975 Jul;132(1):28–34. doi: 10.1093/infdis/132.1.28. [DOI] [PubMed] [Google Scholar]
- White K. E., Osterholm M. T., Mariotti J. A., Korlath J. A., Lawrence D. H., Ristinen T. L., Greenberg H. B. A foodborne outbreak of Norwalk virus gastroenteritis. Evidence for post-recovery transmission. Am J Epidemiol. 1986 Jul;124(1):120–126. doi: 10.1093/oxfordjournals.aje.a114356. [DOI] [PubMed] [Google Scholar]