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Epidemiology of foodborne Norovirus outbreak in Incheon, Korea.

Yu JH, Kim NY, Koh YJ, Lee HJ - J. Korean Med. Sci. (2010)

Bottom Line: Consumption of cucumber-crown daisy salad (RR=2.71), fresh cabbage mix (RR=2.23), dried radish salad (RR=3.04) and young radish kimchi (RR=2.52) were associated with illness.Interviews with kitchen staff indicated the likelihood of contamination from an infected food handler to the dried radish salad during food processing.The excretion of Norovirus from asymptomatic food handlers may be an infection source of Norovirus outbreaks.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. dubogi@hanmail.net

ABSTRACT
On June 14, 2008, an outbreak of gastroenteritis occurred among elementary school students in Incheon. We conducted an investigation to identify the source and described the extent of the outbreak. We performed a retrospective cohort study among students, teachers and food handlers exposed to canteen food in the elementary school. Using self-administered questionnaires we collected information on symptoms, days of canteen food eaten, food items consumed. Stool samples were collected from 131 symptomatic people and 11 food handlers. The catering kitchen was inspected and food samples were taken. Of the 1,560 people who ate canteen food, 117 were symptomatic cases, and the attack rate was 7.5%. Consumption of cucumber-crown daisy salad (RR=2.71), fresh cabbage mix (RR=2.23), dried radish salad (RR=3.04) and young radish kimchi (RR=2.52) were associated with illness. Sixty-four (45%) of the 142 stool specimens were positive for Norovirus. Norovirus was detected in 2 food handlers. Interviews with kitchen staff indicated the likelihood of contamination from an infected food handler to the dried radish salad during food processing. The excretion of Norovirus from asymptomatic food handlers may be an infection source of Norovirus outbreaks.

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The epidemic curve by symptom onset date, an elementary school, Incheon, Korea, 2008.
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Figure 1: The epidemic curve by symptom onset date, an elementary school, Incheon, Korea, 2008.

Mentions: Day of illness onset for 88 cases is shown in Fig. 1; information on date of onset was missing for 29 cases. The epidemic curve showed characteristics of a single exposure route. The canteen food and drinking water were provided during lunch time (12:00-13:00). The first patient developed symptoms beginning at approximately 1 a.m. on June 13. After a slight increase beginning in the morning on June 13, the number of cases rose sharply to a distinct peak in the afternoon on June 13 and decreased then exponentially during the following 2 days. The cases' main symptoms were vomiting (82.1%) and abdominal pain (65.8%). Fever (29.1%) and tenesmus (12.0%) were less frequent (Table 2).


Epidemiology of foodborne Norovirus outbreak in Incheon, Korea.

Yu JH, Kim NY, Koh YJ, Lee HJ - J. Korean Med. Sci. (2010)

The epidemic curve by symptom onset date, an elementary school, Incheon, Korea, 2008.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908779&req=5

Figure 1: The epidemic curve by symptom onset date, an elementary school, Incheon, Korea, 2008.
Mentions: Day of illness onset for 88 cases is shown in Fig. 1; information on date of onset was missing for 29 cases. The epidemic curve showed characteristics of a single exposure route. The canteen food and drinking water were provided during lunch time (12:00-13:00). The first patient developed symptoms beginning at approximately 1 a.m. on June 13. After a slight increase beginning in the morning on June 13, the number of cases rose sharply to a distinct peak in the afternoon on June 13 and decreased then exponentially during the following 2 days. The cases' main symptoms were vomiting (82.1%) and abdominal pain (65.8%). Fever (29.1%) and tenesmus (12.0%) were less frequent (Table 2).

Bottom Line: Consumption of cucumber-crown daisy salad (RR=2.71), fresh cabbage mix (RR=2.23), dried radish salad (RR=3.04) and young radish kimchi (RR=2.52) were associated with illness.Interviews with kitchen staff indicated the likelihood of contamination from an infected food handler to the dried radish salad during food processing.The excretion of Norovirus from asymptomatic food handlers may be an infection source of Norovirus outbreaks.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. dubogi@hanmail.net

ABSTRACT
On June 14, 2008, an outbreak of gastroenteritis occurred among elementary school students in Incheon. We conducted an investigation to identify the source and described the extent of the outbreak. We performed a retrospective cohort study among students, teachers and food handlers exposed to canteen food in the elementary school. Using self-administered questionnaires we collected information on symptoms, days of canteen food eaten, food items consumed. Stool samples were collected from 131 symptomatic people and 11 food handlers. The catering kitchen was inspected and food samples were taken. Of the 1,560 people who ate canteen food, 117 were symptomatic cases, and the attack rate was 7.5%. Consumption of cucumber-crown daisy salad (RR=2.71), fresh cabbage mix (RR=2.23), dried radish salad (RR=3.04) and young radish kimchi (RR=2.52) were associated with illness. Sixty-four (45%) of the 142 stool specimens were positive for Norovirus. Norovirus was detected in 2 food handlers. Interviews with kitchen staff indicated the likelihood of contamination from an infected food handler to the dried radish salad during food processing. The excretion of Norovirus from asymptomatic food handlers may be an infection source of Norovirus outbreaks.

Show MeSH
Related in: MedlinePlus