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American Journal of Epidemiology Vol. 115, No. 2: 173-177
Copyright © 1982 by The Johns Hopkins University School of Hygiene and Public Health

research-article

NORWALK VIRUS ENTERIC ILLNESS ACQUIRED BY SWIMMING EXPOSURE

JAMES S KOOPMAN1,, EDWARD A ECKERT1, HARRY B GREENBERG2, BRIAN C STROHM3, RICHARD E ISAACSON1 and ARNOLD S MONTO1

1Dept. of Epidemiology, The University of Michigan Ann Arbor MI.
2National Institute of Allergy and Infectious Diseases Bethesda, MD.
3Oakland County Health Division Pontiac, MI.

Send reprint requests to: Dr. James S. Koopman, The University of Michigan, School of Public Health, Dept of Epidemiology, 109 Observatory St., Ann Arbor, MI 48109

In an epidemic of gastrointestinal illness strongly associated with swimming at a recreational park in Macomb County, Michigan, in July, 1979, the authors demonstrated the value of serologic testing to detect Norwalk virus infection. Rises in antibody titer to Norwalk virus were noted in all 11 individuals tested. Electron microscopy on stools from 20 III individuals revealed only one with Norwalk virus-like particles. This particle was shown by radioimmunoassay and immune electron microscopy not to be Norwalk virus and not to have stimulated detectable antibodies in this individual. These results not only indicate that electron microscopy is insensitive in detecting Norwalk virus, but that it has the potential to mislead. A low rate of respiratory symptoms was associated with gastrointestinal illness in this Norwalk virus out break. The route of exposure might have been important for this. The outbreak was also noteworthy in that, although there was evidence of familial clusters of resistance, a very high percentage of the population was proved to be susceptible to the Norwalk virus.

diarrhea; gastroenteritis; microscopy electron; radioimmunoassay; viruses


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