title: Outbreak of small round structured virus gastroenteritis arose after kitchen assistant vomited.
abstract: A wedding reception at a North Yorkshire hotel was followed by an explosive outbreak of gastroenteritis. The attack rate among the 111 guests was 50% and vomiting was a predominant feature. The results of laboratory and epidemiological investigations were consistent with a common source outbreak of small round structured virus (SRSV) infection genotype II. The source of the outbreak was traced to a kitchen assistant who suddenly became ill on the eve of the reception and vomited into a sink used for preparing vegetables. The sink was cleaned with a chlorine based disinfectant and used the next morning to prepare a potato salad, subsequently identified as the vehicle of infection in a cohort study of guests (odds ratio 3.21; CI 1.78-5.78, p = 0.0001). No other food was associated with illness. The outbreak provides further supporting evidence of the importance of vomiting in the transmission of SRSV infection, highlights the virulence of this group of viruses, and indicates their relative resistance to environmental disinfection and decontamination. It also highlights the need for the adequate training of catering staff and the implementation and enforcement of food hygiene regulations.
authors.affiliation: North Yorkshire Health Authority, York.
authors.forename: W
authors.initials: W
authors.lastname: Patterson
authors.forename: P
authors.initials: P
authors.lastname: Haswell
authors.forename: P T
authors.initials: PT
authors.lastname: Fryers
authors.forename: J
authors.initials: J
authors.lastname: Green
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D016001:Confidence Intervals; D004196:Disease Outbreaks; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000150:complications; D005759:Gastroenteritis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008131:London / Q000453:epidemiology; D009663:Norwalk virus / Q000302:isolation & purification / Q000472:pathogenicity*; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000209:etiology*