Published Date: 2005-11-06 23:50:00
Subject: PRO/EDR> Viral gastroenteritis update 2005 (16)
Archive Number: 20051106.3253
VIRAL GASTROENTERITIS UPDATE 2005 (16)
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In this update:
[1] Norovirus - Austria
[2] Norovirus, school - Canada (Vancouver)
******
[1] Norovirus - Austria
Date: Sun 6 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance weekly, Volume 10, Issue 10, Thu 20 Oct 2005 [edited]
<http://www.eurosurveillance.org/ew/2005/051020.asp#7>
Austria: Outbreak of norovirus infections
associated with consuming food from a catering company, September 2005
-----------------------------------------------
On 7 Sep 2005, a cluster of acute gastroenteritis
cases was reported to a public health department
in southern Austria. All cases were in staff at a
factory manufacturing electrical appliances and
had symptom onset on 6 Sep 2005. About 120 of
1357 employees had vomiting and/or diarrhea
(attack rate 8.8 percent). The large number of
cases with symptom onset on the same day
indicated a point-source outbreak. The factory
provides food items from a local caterer for its
staff, including snacks (with sandwiches, for
breakfast and afternoon breaks), lunch, and
dinner for workers on the 2nd shift.
Initial investigations, including interviews of
the catering company's staff, revealed that a
female catering company staff member reported
having been ill from 4-5 Sep 2005. She had worked
on these days and prepared sandwiches without
wearing gloves. Further interviews revealed that
one of the cooks at the catering company had
become ill on 1 Sep 2005, and further employees
had become ill on 4 Sep 2005 (one employee), 6
Sep 2005 (2 employees), 7 Sep 2005 (one
employee), and 8 Sep 2005 (2 employees).
A cohort study of the staff of the appliance
factory is underway to identify the cause of the
outbreak and to assess how this outbreak is
related to the cluster of cases among the staff
of the catering company. The regional food
inspection agency closed the catering company
late on 7 Sep 2005 and provided recommendations
for disinfection. The company stayed closed for
one week until hygiene measures were completed
(excluding ill employees from work, cleaning and
disinfection of all areas, and discarding all
foodstuffs prepared by the catering company).
Sick employees from both companies were requested
not to return to work until they had had no
nausea, diarrhea or vomiting for at least 48 hours.
Stool specimens from cases were tested for
bacterial pathogens; all samples were negative.
On 12 Sep 2005, RT-PCR testing of the samples
revealed that norovirus was the causative agent
for the outbreak: all 19 stool samples tested
gave positive results (11 employees from the
catering company and 8 from the factory). The
isolates from the catering staff were
indistinguishable from those of the factory workers.
The source of the outbreak in the electrical
appliance factory has not yet been determined,
but it is likely that the kitchen staff at the
catering company played [a role in contaminating]
a foodstuff with the virus. This outbreak
underlines existing guidelines for food business
managers: anyone suffering from diarrhea and/or
vomiting should report this to the manager and
leave food handling areas immediately. If there
is only one episode of diarrhea and/or vomiting
in a 24-hour period and no fever, then the person
can return to work. If symptoms persist, then he
or she should return to work only when vomiting
has ceased for 48 hours and/or there have been no loose stools for 48 hours.
[Byline: Ingeborg Lederer, Daniela Schmid,
Anna-Margaretha Pichler, Regine Dapra, Peter
Kraler, Andreas Blassnig, Anita
Luckner-Hornischer, Christian Berghold and Franz
Allerberger <Franz.Allerberger@ages.at>, Center
for Infectious Disease Epidemiology,
Österreichische Agentur fur Gesundheit und
Ernahrungssicherheit, Vienna, Austria]
--
ProMED-mail
<promed@promedmail.org>
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[2] Norovirus, school - Canada (Vancouver)
Date: Sun 6 Nov 2005
From: Alfonso Rodriguez <ajrm_msds@yahoo.es>
Source: Komo News, Seattle, Fri 4 Nov 2005 [edited]
<http://komonews.com/news/story.asp?ID=40087>
Canada: Norwalk-Type Virus Closes Vancouver School
-----------------------------------------------
An outbreak of what is believed to be a
Norwalk-type virus [i.e. a virus belonging to the
genus _Norovirus_ of the family _Caliciviridae_]
spread to about 30 percent of the pupils at a
grade school, and classes have been canceled until Monday [7 Nov 2005].
Evergreen School District Superintendent Robert
L. Corley said 143 students and employees at Mill
Plain Elementary School were out with vomiting,
nausea and diarrhea by the end of the day on
Thursday [3 Nov 2005]. He said the school would
be closed on Friday [4 Nov 2005] for extensive
disinfecting with a bleach solution and should reopen Monday.
Norwalk-type virus outbreaks have occurred in
hotels, on cruise ships and in other contained
environments in recent years. The infectious
agent, known as norovirus, is spread through
food, water and close contact with infected
people or items they have touched and causes
vomiting and diarrhea that can last 24 to 48 hours.
Health officials were trying to determine what
strain of the virus was involved in the school
outbreak. Food service at the school is not
believed to be involved, because no kitchen
workers have fallen ill, and health inspection
reports have indicated no problems, officials in
the Clark County Health Department said.
--
ProMED-mail
<promed@promedmail.org>
[Viruses classified in the family _Caliciviidae_
are associated with a variety of hosts and
several disease syndromes. The human
caliciviruses, however, are restricted to 2 of
the 4 genera in the family, the genus _Norovirus_
(type species _Norwalk virus_) and the genus
_Sapovirus_ (type species _Sapporovirus_). These
viruses are associated with similar non-fatal
illnesses; i.e. acute self-limited
gastroenteritis and malaise. The noroviruses are
the more common, whereas the sapoviruses are more
sporadic in occurrence and are also associated
with outbreaks in pigs. The symptoms and rapidity
of onset of illness are so specific that accurate
diagnosis is rarely undertaken. Formerly, human
caliciviruses were know as "small round
structured viruses," and electron microscopy of
fecal samples is sufficient to confirm diagnosis. - Mod.CP]
See Also
Viral gastroenteritis update 2005 (15) 20051016.3017Viral gastroenteritis update 2005 (14) 20050922.2806
Viral gastroenteritis update 2005 (13) 20050717.2047
Viral gastroenteritis update 2005 (12) 20050701.1862
Viral gastroenteritis update 2005 (11) 20050624.1768
Viral gastroenteritis update 2005 (10) 20050428.1188
Viral gastroenteritis update 2005 (09) 20050330.0920
Viral gastroenteritis update 2005 (08) 20050307.0675
Viral gastroenteritis update 2005 (07) 20050227.0614
Viral gastroenteritis update 2005 (06) 20050216.0521
Viral gastroenteritis update 2005 (05) 20050205.0398
Viral gastroenteritis update 2005 (04) 20050130.0325
Viral gastroenteritis update 2005 (03) 20050123.0245
Viral gastroenteritis update 2005 (02) 20050115.0126
Viral gastroenteritis update 2005 20050109.0070
...........................cp/msp/mpp
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