title: A multistate outbreak of Norwalk virus gastroenteritis associated with consumption of commercial ice.
abstract: Between 19 and 27 September 1987, a cluster of outbreaks of gastrointestinal illness occurred among persons who had attended a museum fund-raiser in Wilmington, Delaware and an intercollegiate football game in Philadelphia. A survey of four groups attending these events showed that 31% (191/614) became ill. Altogether, those who consumed ice were 12 times more likely to experience either vomiting or diarrhea than those who did not (attack rate, 55% vs. 4%, P less than .001). Ice consumed at the events was traced to a manufacturer in southeastern Pennsylvania whose wells had been contaminated when flooded by a nearby creek after a torrential rainfall on 8 September. Of 19 affected persons tested within 1 week of exposure, 13 (68%) had at least a fourfold rise in antibody titer to the Norwalk virus. This report, the first to document an association of contaminated commercial ice with Norwalk gastroenteritis should prompt reassessment of government regulation of the production and distribution of ice.
authors.affiliation: Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
authors.forename: R O
authors.initials: RO
authors.lastname: Cannon
authors.forename: J R
authors.initials: JR
authors.lastname: Poliner
authors.forename: R B
authors.initials: RB
authors.lastname: Hirschhorn
authors.forename: D C
authors.initials: DC
authors.lastname: Rodeheaver
authors.forename: P R
authors.initials: PR
authors.lastname: Silverman
authors.forename: E A
authors.initials: EA
authors.lastname: Brown
authors.forename: G H
authors.initials: GH
authors.lastname: Talbot
authors.forename: S E
authors.initials: SE
authors.lastname: Stine
authors.forename: S S
authors.initials: SS
authors.lastname: Monroe
authors.forename: D T
authors.initials: DT
authors.lastname: Dennis
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D003691:Delaware / Q000453:epidemiology; D004196:Disease Outbreaks; D005759:Gastroenteritis / Q000453:epidemiology*; D006801:Humans; D007053:Ice; D009663:Norwalk virus / Q000276:immunology / Q000302:isolation & purification*; D015143:Philadelphia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014777:Virus Diseases / Q000453:epidemiology*; D014871:Water Microbiology
chemical_list: D000914:Antibodies, Viral; D007053:Ice