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American Journal of Epidemiology Vol. 124, No. 1: 120-126
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health

research-article

A FOODBORNE OUTBREAK OF NORWALK VIRUS GASTROENTERITIS EVIDENCE FOR POST-RECOVERY TRANSMISSION

KAREN E. WHITE1, MICHAEL T. OSTERHOLM1,, JOSEPH A. MARIOTTI1, JACK A. KORLATH1, DON H. LAWRENCE2, TERRY L. RISTINEN1 and HARRY B. GREENBERG3

1Acute Disease Epidemiology and Field Services Sections, Minnesota Department of Health 717 S. E. Delaware Street, P. O. Box 9441, Minneapolis, MN 55440
2City of Moorhead Health Department Moorhead, MN
3Veteran's Administration Medical Center Section of Gastroenterology (111), 3801 Miranda Avenue, Palo Alto, CA

Reprint requests to Dr. Michael T. Osterholm

From November 10–16, 1982, 220 (57%) of 383 attendees at eight banquets for which food had been prepared at a single hotel restaurant and the employees of the hotel had onset of Norwalk virus gastroenteritis. Epidemiologic investigation of the three largest banquets confirmed consumption of potato and fruit salads (banquet A), coleslaw (banquet B), and tossed salad (banquet C) to be significantly associated with illness. Between November 8–19, similar illness occurred in seven (54%) of 13 hotel kitchen employees. The foods implicated in banquets A and B were prepared by one salad worker during her acute illness and up to 48 hours following her recovery. A second salad worker prepared the implicated tossed salad for banquet C 24 hours following her recovery. To the authors' knowledge, this is the first foodbome outbreak investigation demonstrating Norwalk viral excretion and transmission by a food handler after recovery from illness and either person-to-person or vehicle-borne transmission betweell food handlers with subsequent transmission by more than one food handier to patrons.

food poisoning; gastroenteritis; Norwalk agent


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