A Kansas Meals-on-Wheels Operation Involved in Norovirus Outbreak.

A report concluded that a Meals-on-Wheels operation in Kansas was responsible for at least 61 illnesses, although the exact source was not identified.

So someone working for the operation, whether a food preparation person or a delivery person, or even an upstream provider, had to have the illness or had been exposed to someone with the virus.

The clientele served by Meals-on-Wheels would be classified as high risk, so procedures must be in place to prevent employees or volunteers from working when sick, or have exposed to someone who is sick.

Chanute.com
http://www.chanute.com/news/article_86b43810-cdc3-11e4-a460-7f7fd0d80954.html?mode=jqm
Investigative report released in January norovirus outbreakPosted 14 hours ago

JOSHUA VAIL
Tribune reporter

The Kansas Department of Health and Environment Division of Public Health has released its investigative report on the January norovirus outbreak associated with Meals on Wheels.

The investigation concluded that the most likely source of the infection was the Meals on Wheels kitchen in Chanute, but enough data to pinpoint a more specific source could not be obtained.
The outbreak was first reported Jan. 7 after several people reported gastrointestinal distress after eating Meals on Wheels in Neosho, Allen or Woodson counties.

The investigation was a joint effort between the Kansas Department of Health and Environment, Kansas Department of Agriculture and the Neosho, Allen and Woodson County health departments.

Those affected by the outbreak received meals from Meals on Wheels centers from distribution centers in Chanute, Erie, Humboldt, Iola, Moran, Neosho Falls, St. Paul, Toronto, Thayer and Yates Center, all of which receive their food from the central kitchen in Chanute.

Individual county health departments carried out interviews with affected individuals in their counties while KDHE interviewed staff and volunteers at Meals on Wheels.

According to the report, 488 clients were served by Meals on Wheels Jan. 5 and 6. Attempts were made to contact all served. A total of 159 were successfully interviewed, with 123 meeting the criteria for analysis. Of those, 61 reported illness.

Ages of individuals with illness ranged from 55 to 99 and 44 of the 61 were female.

Primary symptoms included nausea, diarrhea and abdominal cramps, with 10 seeking medical care and seven being hospitalized. One death was reported.

A majority of those that reported illness became ill Jan. 6. Forty-three of the individuals had recovered by the time they were interviewed, with recovery time between one and six days.

The investigation found no significant relation between any specific satellite location and illness. The Kansas Department of Agriculture investigation did find a handwashing violation, storage temperature violation and cross-contamination violation at the Chanute kitchen. This could not be directly connected to the outbreak and no employees or volunteers at the kitchen had reported any illness

The report concluded that the Chanute kitchen is the most likely source of the virus, possibly by a food handler who was ill but did not report it or by someone who was carrying the virus but never developed symptoms.

According to the report, the small numbers of those interviewed in the investigation make it difficult to determine a more precise source.