Norovirus and Foodborne Disease, United States, 1991–2000

Widdowson, Marc‐Alain; Sulka, Alana; Bulens, Sandra N.; Beard, R. Suzanne; Chaves, Sandra S.; Hammond, Roberta; Salehi, Ellen; Swanson, Ellen; Totaro, J.; Woron, R.; Mead, Paul S.; Bresee, Joseph S.; Monroe, Stephan S.; Glass, Roger I.

doi:10.3201/eid1101.040426

Cited by 246 publications

(144 citation statements)

References 35 publications

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“…Transmission of viruses associated with the consumption of contaminated bivalve shellfish, particularly, oysters which are eaten uncooked, is regularly reported (Koopmans and Duizer 2004;Widdowson et al 2005). Other foods, including raspberries (Cotterelle et al 2005;Le Guyader et al 2004;Gaulin et al 1999;Korsager et al 2005;Hedlund et al 2000;Falkenhorst et al 2005;Hjertqvist et al 2006;Fell et al 2007;Ponka et al 1999) and salads (Vivancos et al 2009), have caused outbreaks after being contaminated by polluted water or virus-infected food handlers.…”

Section: Introductionmentioning

confidence: 99%

Analytical Methods for Virus Detection in Water and Food

et al. 2010

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Potential ways to address the issues that relate to the techniques for analyzing food and environmental samples for the presence of enteric viruses are discussed. It is not the authors' remit to produce or recommend standard or reference methods but to address specific issues in the analytical procedures. Foods of primary importance are bivalve molluscs, particularly, oysters, clams, and mussels; salad crops such as lettuce, green onions and other greens; and soft fruits such as raspberries and strawberries. All types of water, not only drinking water but also recreational water (fresh, marine, and swimming pool), river water (irrigation water), raw and treated sewage are potential vehicles for virus transmission. Well over 100 different enteric viruses could be food or water contaminants; however, with few exceptions, most well-characterized foodborne or waterborne viral outbreaks are restricted to hepatitis A virus (HAV) and calicivirus, essentially norovirus (NoV). Target viruses for analytical methods include, in addition to NoV and HAV, hepatitis E virus (HEV), enteroviruses (e.g., poliovirus), adenovirus, rotavirus, astrovirus, and any other relevant virus likely to be transmitted by food or water. A survey of the currently available methods for detection of viruses in food and environmental matrices was conducted, gathering information on protocols for extraction of viruses from various matrices and on the various specific detection techniques for each virus type.

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Section: Introductionmentioning

confidence: 99%

Analytical Methods for Virus Detection in Water and Food

et al. 2010

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“…18,19 Our reported rate of detection of norovirus in specimens from outbreaks in Georgia was consistent with several recent studies documenting the relatively high frequency of foodborne norovirus outbreaks. A U.S. national study that extrapolated laboratory data correcting for incomplete testing 5 and a multisite study that used stool kits to enhance the collection and testing of specimens for norovirus both found that norovirus may be a cause of up to 50% of foodborne outbreaks. 20 By use of epidemiologic criteria elaborated by Kaplan et al, 21 one study in Minnesota attributed norovirus to 41% of foodborne outbreaks from 1981 to 1998.…”

Section: Discussionmentioning

confidence: 99%

“…1 Norovirus disease often presents as large outbreaks of vomiting and diarrhea among people of all ages and in diverse settings, such as cruise ships, nursing homes, and the food industry. [2][3][4][5] These viruses are highly infectious and are transmitted by multiple modes: directly, from person to person; via contaminated food or water; and via airborne droplets of vomitus. Environmental contamination has also been well documented as a source of continuing infection in outbreaks.…”

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Enhanced Surveillance of Norovirus Outbreaks of Gastroenteritis in Georgia

et al. 2011

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SYNOPSISObjectives. The role of noroviruses in both foodborne and person-to-person outbreaks of acute gastroenteritis (AGE) has been difficult to determine in the U.S. because of lack of routine norovirus testing and of national reporting of person-to-person outbreaks. We conducted a prospective study in one state in which enhanced testing for noroviruses was performed to better understand the relative contribution of all gastroenteric pathogens.Methods. During the two-year period, 2000-2001, we took all fecal specimens from AGE outbreaks reported in Georgia that were negative for bacteria and tested these for norovirus.Results. We investigated 78 AGE outbreaks, from which suitable fecal samples were collected from 57 of them. Norovirus was identified in 25 (44%) outbreaks, bacteria in 20 (35%) outbreaks, and parasites in one (2%) outbreak. Forty-three (75%) of the outbreaks tested were foodborne, of which 17 (40%) were attributable to norovirus and 18 (42%) were attributable to bacteria. Adjusting for incomplete testing, we estimated that 53% of all AGE outbreaks were attributable to norovirus. A total of 2,674 people were reported ill in the 57 outbreaks, and norovirus infections accounted for 1,735 (65%) of these cases. Norovirus outbreaks tended to be larger than bacterial outbreaks, with a median number of 30 vs. 16 cases per outbreak, respectively (p0.057).Conclusions. This study provides further evidence that noroviruses are, overall, the most common cause of AGE outbreaks in the U.S. Improved specimen collection, reporting person-to-person outbreaks, and access to molecular assays are needed to further understand the role of these viruses and methods for their prevention.

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“…While there have been improvements in surveillance and investigation of foodborne disease outbreaks [31] and improvements in laboratory diagnostics for some pathogens [32], it is still very challenging to confirm leafy vegetables as the source of foodborne disease outbreaks. By the time the outbreak is confirmed, usually 2–4 weeks after the exposure [33], the contaminated leafy vegetables have usually already been consumed or discarded, with nothing left to analyse.…”

Section: Contamination Of Leafy Vegetable Ingredients In Mixed-ingredmentioning

confidence: 99%

Is your lunch salad safe to eat? Occurrence of bacterial pathogens and potential for pathogen growth in pre-packed ready-to-eat mixed-ingredient salads

Söderqvist

2017

Infection Ecology & Epidemiology

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As part of a trend toward healthy convenience foods, ready-to-eat (RTE) mixed-ingredient salads have become popular products among consumers. A mixed-ingredient salad contains combinations of raw (e.g. leafy vegetables and tomatoes) and processed (e.g. chicken, salmon, ham, pasta and couscous) ingredients. Contamination of leafy vegetables can occur during any step in the production chain and, since there is no step that kills pathogens, a completely safe final product can never be guaranteed. Meat ingredients, for example poultry meat and ham, are generally heat-treated before preparation, but may be contaminated after this treatment, e.g. when diced or sliced. When several ingredients are mixed together, cross-contamination may occur. Preparation of mixed-ingredient salads requires human handling, which presents an additional risk of bacterial contamination. With high-protein ingredients, e.g. cooked meat, the mixed-ingredient salad represents an excellent substrate for bacterial growth. This article reviews current knowledge regarding human bacterial pathogen prevalence in mixed-ingredient salads and the potential for pathogen growth in this product during storage.

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Norovirus and Foodborne Disease, United States, 1991–2000

Abstract: Analysis of foodborne outbreaks shows how advances in viral diagnostics are clarifying the causes of foodborne outbreaks and determining the high impact of norovirus infections.

Cited by 246 publications

References 35 publications

Analytical Methods for Virus Detection in Water and Food

Analytical Methods for Virus Detection in Water and Food

Enhanced Surveillance of Norovirus Outbreaks of Gastroenteritis in Georgia

Is your lunch salad safe to eat? Occurrence of bacterial pathogens and potential for pathogen growth in pre-packed ready-to-eat mixed-ingredient salads

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