An outbreak of norovirus gastroenteritis associated with wedding cakes

Abstract

We sought to determine the source of a norovirus outbreak among attendees of 46 weddings taking place during a single weekend. Norovirus-compatible illness was experienced by 332 (39%) of wedding guests surveyed; the outbreak affected up to 2700 persons. Illness was associated with eating wedding cake provided by a bakery common to the weddings (adjusted RR 4.5, P<0.001). A cake requiring direct hand contact during its preparation accounted for the majority of illness. At least two bakery employees experienced norovirus-compatible illness during the week preceding the weddings. Identical sequence types of norovirus were detected in stool specimens submitted by two wedding guests, a wedding hall employee, and one of the ill bakery employees. It is likely that one or more food workers at the bakery contaminated the wedding cakes through direct and indirect contact. These findings reinforce the necessity of proper food-handling practices and of policies that discourage food handlers from working while ill.

Outbreak of Norovirus Infection among River Rafters Associated with Packaged Delicatessen Meat, Grand Canyon, 2005

“…Hepatitis A virus is also resistant to environmental challenge and has caused several widespread outbreaks of infection associated with contamination of fruit and produce [29,30]. Bare-hand contact with bakery products or with ingredients such as frosting has been associated with outbreaks of norovirus infection [31][32][33]. Delicatessen meats have been implicated elsewhere as a vehicle for norovirus transmission, but contamination occurred at the point of service and not at the processing plant [34].…”

Analytical performance of norovirus real-time RT-PCR detection protocols in Canadian laboratories

“…2 Large outbreaks are a common feature of norovirus infections, with a variety of reported transmission routes including person-toperson contact, food, water and contaminated fomites. [3][4][5][6][7][8][9][10] These outbreaks can be extremely difficult to control and have a major financial impact. 11 A number of factors contribute to the spread of these viruses in the community.…”

Rapid Detection of Norovirus from Fresh Lettuce Using Immunomagnetic Separation and a Quantum Dots Assay

“…NoV has been isolated from contaminated water and food such as shellfish, cold cooked ham, commercial ice, and ready-toeat food products, including fruit salad, celery, melons, frozen raspberries, and lettuce (5,7,9,11,20,25,26).…”