An outbreak of viral gastroenteritis associated with consumption of sandwiches: implications for the control of transmission by food handlers

Epidemiol Infect. 1998 Dec;121(3):615-21. doi: 10.1017/s0950268898001150.

Abstract

Although food handlers are often implicated as the source of infection in outbreaks of food-borne viral gastroenteritis, little is known about the timing of infectivity in relation to illness. We investigated a gastroenteritis outbreak among employees of a manufacturing company and found an association (RR = 14.1, 95% CI = 2.0-97.3) between disease and eating sandwiches prepared by 6 food handlers, 1 of whom reported gastroenteritis which had subsided 4 days earlier. Norwalk-like viruses were detected by electron microscopy or reverse transcriptase-polymerase chain reaction (RT-PCR) in stool specimens from several company employees, the sick food handler whose specimen was obtained 10 days after resolution of illness, and an asymptomatic food handler. All RT-PCR product sequences were identical, suggesting a common source of infection. These data support observations from recent volunteer studies that current recommendations to exclude food handlers from work for 48-72 h after recovery from illness may not always prevent transmission of Norwalk-like viruses because virus can be shed up to 10 days after illness or while exhibiting no symptoms.

MeSH terms

  • Caliciviridae Infections / epidemiology*
  • Caliciviridae Infections / prevention & control
  • Caliciviridae Infections / transmission
  • Disease Outbreaks*
  • Food Handling*
  • Food Microbiology*
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / prevention & control
  • Humans
  • Norwalk virus / isolation & purification*
  • Reverse Transcriptase Polymerase Chain Reaction