An outbreak of Norovirus occurred on a cruise ship a few days after leaving port where over 170 people, including both passengers and crew members, became ill. The trip was scheduled for a one month long trip. Because Norovirus can spread so quickly, the boat was docked to allow the sick passenger's to disembark.
Showing posts with label norovirus. Show all posts
Showing posts with label norovirus. Show all posts
Monday, November 17, 2014
Friday, February 28, 2014
2012 Norovirus Outbreak in Germany Linked to Imported Frozen Strawberries
A report details the 2012 outbreak of Norovirus in Germany where approximately 11,000 cases were reported. The report concludes that fresh frozen strawberries imported from China were the food vehicle.
Because the fruit is fresh frozen, there are no destructive processes such as heat to remove or reduce Norovirus. Keys to prevention for the grower / packer are having good personal hygiene programs including employee health policies, and systems to maintain potable wash water.
For the broker or the purchaser, supplier control should include ways to ensure that the grower/packer have these programs in place, especially for these minimally processed RTE items. Testing for Norovirus in not commonly done.
Eurosurveillance
Volume 19, Issue 8, 27 February 2014
Surveillance and outbreak reports
Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20719
H Bernard1,2, M Faber (
)1,2, H Wilking 1, S Haller1,3,4, M Höhle1, A Schielke1, T Ducomble1,4,5, C Siffczyk6, S S Merbecks7, G Fricke8, O Hamouda1, K Stark1, D Werber1, on behalf of the Outbreak Investigation Team9
From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.
Because the fruit is fresh frozen, there are no destructive processes such as heat to remove or reduce Norovirus. Keys to prevention for the grower / packer are having good personal hygiene programs including employee health policies, and systems to maintain potable wash water.
For the broker or the purchaser, supplier control should include ways to ensure that the grower/packer have these programs in place, especially for these minimally processed RTE items. Testing for Norovirus in not commonly done.
Eurosurveillance
Volume 19, Issue 8, 27 February 2014
Surveillance and outbreak reports
Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20719
H Bernard1,2, M Faber (
)1,2, H Wilking 1, S Haller1,3,4, M Höhle1, A Schielke1, T Ducomble1,4,5, C Siffczyk6, S S Merbecks7, G Fricke8, O Hamouda1, K Stark1, D Werber1, on behalf of the Outbreak Investigation Team9From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.
Monday, January 27, 2014
Norovirus outbreak on cruise ship, Over 600 people ill
A Royal Caribbean cruise ship returned to port early as an outbreak of norovirus caused 577 of the passengers (out of 3050 on board) and 49 of the crew to become ill.
Symptoms of norovirus infection include vomiting and diarrhea as well as nausea, stomach pains, headache, fever, and body pain. The symptoms can last from one to several days. The vomiting can often be described as acute onset vomiting, which means that as soon as you feel like you have to vomit, you vomit...and that can be anywhere you are standing or sitting, including the dinner table. This is one reason it can be spread so easily within a captive group of people, such as on a cruise ship. The virus can be aerosolized on the vomitus particles as it leaves the person's mouth
Another reason is that the virus is stable on surfaces unless that surface is effectively sanitized. So it can get onto people's hands, onto food, onto dinner tables, and unless properly cleaned and sanitized, it will remain there until it is transferred to another's hands or to a food item.
People can continue to shed the virus even after the symptoms have subsided. So hand washing continues to be a must.
The cruise ship industry has gone to great measures to prevent such outbreaks. Constant cleaning and quarantining sick people are standard practices. However once the illness gets to a critical mass, it can be next to impossible to control, and that is what appears to have happened here.
This cruise ship will need to undergo extensive cleaning and sanitizing before returning to service. Residual virus-containing vomit not cleaned can serve as the source for the next outbreak. And with that many people reported as being ill, you can imagine the amount of yuck laying around the place.
Symptoms of norovirus infection include vomiting and diarrhea as well as nausea, stomach pains, headache, fever, and body pain. The symptoms can last from one to several days. The vomiting can often be described as acute onset vomiting, which means that as soon as you feel like you have to vomit, you vomit...and that can be anywhere you are standing or sitting, including the dinner table. This is one reason it can be spread so easily within a captive group of people, such as on a cruise ship. The virus can be aerosolized on the vomitus particles as it leaves the person's mouth
Another reason is that the virus is stable on surfaces unless that surface is effectively sanitized. So it can get onto people's hands, onto food, onto dinner tables, and unless properly cleaned and sanitized, it will remain there until it is transferred to another's hands or to a food item.
People can continue to shed the virus even after the symptoms have subsided. So hand washing continues to be a must.
The cruise ship industry has gone to great measures to prevent such outbreaks. Constant cleaning and quarantining sick people are standard practices. However once the illness gets to a critical mass, it can be next to impossible to control, and that is what appears to have happened here.
This cruise ship will need to undergo extensive cleaning and sanitizing before returning to service. Residual virus-containing vomit not cleaned can serve as the source for the next outbreak. And with that many people reported as being ill, you can imagine the amount of yuck laying around the place.
Monday, February 4, 2013
Norovirus 2013 - Sydney Strain
Jeff Mullhollem, Penn State Live 2/1/13
http://live.psu.edu/story/64019
UNIVERSITY PARK, Pa. -- A new strain of norovirus, known as GII.4 Sydney 2012, is making the rounds this winter, causing a significant number of acute outbreaks. According to the U.S. Centers for Disease Control and Prevention, it has become the dominant strain, causing more than 140 reported outbreaks in the United States so far this year.
People should try to limit their exposure to norovirus and try to minimize its spread, advised an expert in Penn State's College of Agricultural Sciences.
"There are some important reasons that lead to so many people becoming ill from norovirus," said Martin Bucknavage, extension food safety specialist.
"One is this virus's low infectious dose. It is estimated that it may take less than 20 viral particles to make someone ill. Then, there is the ability of the virus to survive on dry surfaces for two weeks or more and in water for months."
The virus can be spread in contaminated food or water, from contaminated surfaces, directly from a sick person or from the intake of aerosolized droplets of vomitus. Norovirus is not related to the flu (or influenza), which is a respiratory illness caused by a different virus, and flu shots do not protect against it.
The main symptom of norovirus infection is another factor in its spread -- acute-onset vomiting.
"This prevents people from becoming sick in a secure location," Bucknavage said. "Rather, rapid onset can occur at a dinner table, in a meeting or on the bus. People usually become ill within 12 to 24 hours of exposure, although longer incubation periods do occur."
Once someone is sick, they can experience symptoms for 24 to 72 hours and can remain contagious for up to three days, Bucknavage noted.
"Because of this short incubation time, low infectious dose and ease of spread, one can see why it spreads through a school or a cruise ship so quickly," he said. "While rarely fatal, people who become ill need to be sure to consume liquids so they don't become dehydrated."
The key to preventing infection is frequent, but correct, hand washing -- scrubbing hands with soap and warm water. In addition, it is important for people to stay home when ill, especially when they may have been exposed to someone who has had the illness.
"They also should stay home for at least 48 hours after symptoms have subsided," Bucknavage said. "Contaminated surfaces must be cleaned using a strong chlorine bleach solution, one cup of bleach to one gallon of water. Cooking also will destroy the organism."
To learn more about norovirus, visit the Centers for Disease Control and Prevention website at http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm.
http://live.psu.edu/story/64019
UNIVERSITY PARK, Pa. -- A new strain of norovirus, known as GII.4 Sydney 2012, is making the rounds this winter, causing a significant number of acute outbreaks. According to the U.S. Centers for Disease Control and Prevention, it has become the dominant strain, causing more than 140 reported outbreaks in the United States so far this year.
People should try to limit their exposure to norovirus and try to minimize its spread, advised an expert in Penn State's College of Agricultural Sciences.
"There are some important reasons that lead to so many people becoming ill from norovirus," said Martin Bucknavage, extension food safety specialist.
"One is this virus's low infectious dose. It is estimated that it may take less than 20 viral particles to make someone ill. Then, there is the ability of the virus to survive on dry surfaces for two weeks or more and in water for months."
The virus can be spread in contaminated food or water, from contaminated surfaces, directly from a sick person or from the intake of aerosolized droplets of vomitus. Norovirus is not related to the flu (or influenza), which is a respiratory illness caused by a different virus, and flu shots do not protect against it.
The main symptom of norovirus infection is another factor in its spread -- acute-onset vomiting.
"This prevents people from becoming sick in a secure location," Bucknavage said. "Rather, rapid onset can occur at a dinner table, in a meeting or on the bus. People usually become ill within 12 to 24 hours of exposure, although longer incubation periods do occur."
Once someone is sick, they can experience symptoms for 24 to 72 hours and can remain contagious for up to three days, Bucknavage noted.
"Because of this short incubation time, low infectious dose and ease of spread, one can see why it spreads through a school or a cruise ship so quickly," he said. "While rarely fatal, people who become ill need to be sure to consume liquids so they don't become dehydrated."
The key to preventing infection is frequent, but correct, hand washing -- scrubbing hands with soap and warm water. In addition, it is important for people to stay home when ill, especially when they may have been exposed to someone who has had the illness.
"They also should stay home for at least 48 hours after symptoms have subsided," Bucknavage said. "Contaminated surfaces must be cleaned using a strong chlorine bleach solution, one cup of bleach to one gallon of water. Cooking also will destroy the organism."
To learn more about norovirus, visit the Centers for Disease Control and Prevention website at http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm.
Thursday, May 10, 2012
Reusable grocery bag responsible for transferring norovirus in Oregan outbreak
A reusable grocery bag was found to be the carrier of norovirus that was responsible for girls on an Oregon soccer team getting ill. Investigators conducted tests on the bag and found norovirus on the sides of the bag, below the handle.
Reusable grocery bags have increased in usage as people look try to become more ‘green’. It is important however, that these bags be recognized as a potential source of contamination. Much concern with reusable grocery bags is usually directed to the potential contamination from raw meats (purge from raw meats dripping onto the bags, carrying potential pathogens such as Salmonella or STEC E. coli along with it). Thus it is important to wash afterward. In this case however, a sick individual transferred norovirus to the bag and then the norovirus was transferred from the bag to other individuals who became ill.
Norovirus has a low infectious dose (it does not take a lot of viral particles to make one ill) and is relatively resistant to normal environmental conditions (it has been shown to survive for weeks on carpets, so it probably would be the same with grocery bags). Typical symptoms of norvirus infections are vomiting (acute onset) diarrhea and stomach cramps. Symptoms can occur within 18 to 48 hours of exposure.
Oregon norovirus traced to reusable grocery bagUSA Today 5/10/12
http://www.usatoday.com/news/health/story/2012-05-10/Oregon-norovirus-grocery-bags/54874814/1?csp=34news
PORTLAND, Ore. (AP)–Oregon investigators have traced an outbreak of norovirus to a reusable grocery bag that members of a Beaverton girls' soccer team passed around when they shared cookies.
The soccer team of 13- and 14-year-olds traveled to Seattle for a weekend tournament in October 2010.
Reusable grocery bags have increased in usage as people look try to become more ‘green’. It is important however, that these bags be recognized as a potential source of contamination. Much concern with reusable grocery bags is usually directed to the potential contamination from raw meats (purge from raw meats dripping onto the bags, carrying potential pathogens such as Salmonella or STEC E. coli along with it). Thus it is important to wash afterward. In this case however, a sick individual transferred norovirus to the bag and then the norovirus was transferred from the bag to other individuals who became ill.
Norovirus has a low infectious dose (it does not take a lot of viral particles to make one ill) and is relatively resistant to normal environmental conditions (it has been shown to survive for weeks on carpets, so it probably would be the same with grocery bags). Typical symptoms of norvirus infections are vomiting (acute onset) diarrhea and stomach cramps. Symptoms can occur within 18 to 48 hours of exposure.
Oregon norovirus traced to reusable grocery bagUSA Today 5/10/12
http://www.usatoday.com/news/health/story/2012-05-10/Oregon-norovirus-grocery-bags/54874814/1?csp=34news
PORTLAND, Ore. (AP)–Oregon investigators have traced an outbreak of norovirus to a reusable grocery bag that members of a Beaverton girls' soccer team passed around when they shared cookies.
The soccer team of 13- and 14-year-olds traveled to Seattle for a weekend tournament in October 2010.
Friday, February 24, 2012
Norovirus Outbreaks 2012
The leading cause of foodborne disease is making its mark this winter. Just this February, Norovirus caused more than 200 attendees at a cheerleader camp in Washington State to become ill. In St. Maarten, a cruise ship returned to port as 31 became ill. In Virginia, an elementary school was closed because so many students were ill. And in New Jersey, more than 400 college students become ill at three universities located in the same county.
There are some important reasons that lead to so many people becoming ill from Norovirus. One is the virus’s low infectious dose. It is estimated that it may take only 10 viral particles to make someone ill. Then, there is the ability of the virus to survive for up to two weeks on dry surfaces and in water for months. The virus can be spread through a number of ways including through contaminated food or water, from contaminated surfaces, directly from a sick person, or from the intake of aerosolized droplets of vomitus.
The main symptom of Norovirus infection is another factor for its spread – acute-onset vomiting. This prevents people from becoming sick in a secure location. Rather, rapid onset can occur at a dinner table, on a carpet, or on the bus. People usually become ill within 24 hours of exposure, although longer incubation periods do occur. Once someone is sick, they can experience symptoms for 24 to 72 hours, and can remain contagious for up to 3 days.
Because of this short incubation time, low infectious dose, and ease of spread, one can see why it spreads through a school or a cruise ship so quickly. While rarely fatal, people who become ill need to watch so that they do not become dehydrated.
The most important key in preventing infection is frequent, but correct hand washing – scrubbing hands with soap and warm water. Additionally, it is important for people to stay home when ill, especially when they may have been exposed to someone who has had the illness. They should also stay home for at least 48 hours after systems have subsided. Contaminated surfaces must be cleaned using a strong chlorine bleach solution, 1 cup of bleach o one gallon of water. Cooking will destroy the organism.
CDC link for additional information
http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm
Outbreak cases
http://www.inquisitr.com/193064/norovirus-outbreak-2012-washington-state-cheerleading-competition/
http://www.huffingtonpost.com/2012/02/13/crown-princess-departs-af_0_n_1272706.html
http://www.nbc12.com/story/16958672/norovirus-outbreak-causes-school-to-close
http://www.nj.com/mercer/index.ssf/2012/02/mercer_county_colleges_report.html
There are some important reasons that lead to so many people becoming ill from Norovirus. One is the virus’s low infectious dose. It is estimated that it may take only 10 viral particles to make someone ill. Then, there is the ability of the virus to survive for up to two weeks on dry surfaces and in water for months. The virus can be spread through a number of ways including through contaminated food or water, from contaminated surfaces, directly from a sick person, or from the intake of aerosolized droplets of vomitus.
The main symptom of Norovirus infection is another factor for its spread – acute-onset vomiting. This prevents people from becoming sick in a secure location. Rather, rapid onset can occur at a dinner table, on a carpet, or on the bus. People usually become ill within 24 hours of exposure, although longer incubation periods do occur. Once someone is sick, they can experience symptoms for 24 to 72 hours, and can remain contagious for up to 3 days.
Because of this short incubation time, low infectious dose, and ease of spread, one can see why it spreads through a school or a cruise ship so quickly. While rarely fatal, people who become ill need to watch so that they do not become dehydrated.
The most important key in preventing infection is frequent, but correct hand washing – scrubbing hands with soap and warm water. Additionally, it is important for people to stay home when ill, especially when they may have been exposed to someone who has had the illness. They should also stay home for at least 48 hours after systems have subsided. Contaminated surfaces must be cleaned using a strong chlorine bleach solution, 1 cup of bleach o one gallon of water. Cooking will destroy the organism.
CDC link for additional information
http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm
Outbreak cases
http://www.inquisitr.com/193064/norovirus-outbreak-2012-washington-state-cheerleading-competition/
http://www.huffingtonpost.com/2012/02/13/crown-princess-departs-af_0_n_1272706.html
http://www.nbc12.com/story/16958672/norovirus-outbreak-causes-school-to-close
http://www.nj.com/mercer/index.ssf/2012/02/mercer_county_colleges_report.html
Tuesday, February 7, 2012
Outbreaks in the News this week (2/7/12)
There have been some interesting foodborne illness outbreaks in the news this week (Feb 7, 2012). Here is a quick summary.
Clostridium perfrigens outbreak due to taco meat served at N.D. basketball game. How it probably happened - the spore-forming organism survived the heat treatment and then grew in the taco meat when that cooked meat was not held at the proper temperature. Temperature control of cooked food can be an issue in venues like this. Unfortunately, people are not willing to question servers when they receive meat products that are not hot. People preparing and handling food may not have been trained.
http://www.ksfy.com/story/16689309/clostridium-perfringens-cause-of-pierre-outbreakWatermelon the likely source for Salmonella outbreak – Over 35 people became ill (it occurred in England, so they became unwell) from eating ready-to-eat (pre-sliced) watermelon. How it probably happened - during the watermelon slicing operation Salmonella was transferred from the outer surface to the interior surface. This Salmonella could have originated on the raw fruit, and then been spread through the wash water. If the sliced water melon was not refrigerated, Salmonella could grow on the more pH neutral fruit, making the situation worse.
http://www.telegraph.co.uk/news/uknews/9056645/One-person-dies-after-salmonella-outbreak-linked-to-watermelons.htmlUpdate – Outbreak of Campylobacter from consumption of contaminated raw milk affects 43 people in 4 states. The dairy has resumed sales. (That raw milk group is a dedicated bunch).
http://www.therecordherald.com/news/x962217783/Raw-milk-sales-resume-at-The-Family-Cow-in-Chambersburg3 cruise ships disinfected after norovirus outbreak
http://www.washingtonpost.com/lifestyle/travel/ship-with-stomach-virus-outbreak-sets-sail-from-port-everglades-with-new-passengers/2012/02/06/gIQAc8aztQ_story.html?tid=pm_lifestyle_popFriday, November 5, 2010
Norovirus outbreak at central PA school
A central Pennsylvania school was shut down due to viral gastroenteritis and norovirus is expected. Norovirus is highly contagious and thus has resulted in large outbreaks in confined populations such as on cruise ships, summer camps, nursing homes, etc. The school was shut down in order to perform a thorough sanitation.
A few facts about norovirus:
- Low infectious dose, approximately 10 to 100 viral particles are sufficient to cause disease. It also has a high attack rate of 50 to 70%. These, combined with environmental stability, lead to large outbreaks.
- Resistant to drying, thus can remain on a surface for weeks. In one case, virus remaining in carpeting caused illness 12 days later. Also resistant to refrigeration and freezing.
- Resistant to 3 to 6 mg chlorine/ L (as used in drinking water), but inactivated at 10 mg chlorine/L
- Symptoms of projectile vomiting, diarrhea, and nausea will appear as soon as 12 hours after exposure and then last 12 to 60 hours. Dehydration is a always a concern.
- “Projectile vomiting is a characteristic symptom that can contribute to secondary spread through droplet infection, where droplets containing virus may contaminate surfaces or be swallowed”.
- People with illness shed large numbers of virus in their feces and continue to shed virus for up to 2 weeks following illness.
- Because of genetic variability, people can get norovirus infections many times in their lifetime.
- Ready-to-eat food is a common vector for norovirus, when an infected foodservice employee contaminated the food during handling. Thus the regulation for gloves when working with RTE foods. So glove usage, handwashing and good sanitation are keys in control of norovirus. It is also important that employees with symptoms of illness (vomiting or diarrhea) or who have been diagnosed with the illness, be excluded from food operations.
- (source Viruses in Foods, 2006)
P-O Junior High to be closed Friday due to student illnesses
By Lauren Boyer Centre Daily Times
November 4, 2010 7:09pm EDT
Read more: http://www.centredaily.com/2010/11/04/2319036/p-o-junior-high-to-be-closed-friday.html#ixzz14PXhDFOk
At 1 p.m. Thursday, students were dismissed from the building, normally attended by about 300 seventh and eighth graders, said district spokeswoman Dena Cipriano.
The district is communicating with state Department of Health about best practices and symptoms experiences by students. Cipriano said those symptoms correlate with symptoms that are typical of novoviruses.
Highly contagious, noroviruses cause the “stomach flu,” or gastroenteritis, which leads to symptoms such as nausea, vomiting, diarrhea, and some stomach cramping, according to a state Department of Health fact sheet. The district provided a link to the fact sheet on its website, as part of the announcement of the closing of the junior high.
The Department of Health did not recommend closing the building. That was a precaution taken by the district, Cipriano said.
Before classes resume Monday, the custodial staff will “sanitize the building top to bottom” and replace products like toilet paper and paper towels, Cipriano said.
All other buildings in the district will remain open today, and the MoValley YMCA Youth Theatre Production will still be held today and Saturday at the Junior High School.
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