[Norwalk virus-like food poisoning after eating oysters].
BACKGROUND
The aim of this study was to conduct a clinical-epidemiological and microbiological investigation into an outbreak of food-borne disease due to the consumption of oysters.


METHODS
A historic cohort study was conducted into the consumption of 15 food items and clinical symptoms. The influence of each foodstuff was assessed by Mantel-Haenzel stratified relative risk (RRM-H) at 95% confidence intervals, and was confirmed by dose-response analysis with a chi 2 test tendency. We investigated sample stools from 5 patients and 2 food-handlers.


RESULTS
The overall attack rate was 38.0% (19/50). The median period of incubation was 39.0 h (maxim 62 and minimum 3 h). The symptoms were: fever 17.6% (3/17), diarrhoea 57.9% (11/19), vomits 84.2% (16/19), nausea 89.5% (17/19) and abdominal pain 89.5% (17/19). In stratified analysis, the Mantel-Haenzel method revealed a statistically risk for oysters (RRM-H = 3.3; IC 95%: 1.1-8.7), while the RRM-H value for sea snails was not significant (RRM-H = 2.8; IC 95%: 0.9-41.1). For oyster consumption, the dose-response test was statistically significant (p = 0.005). Examination by electron microscopy revealed small round structured viruses compatible with Norwalk-like virus. The oyster contamination was reported to the public health authority.


CONCLUSIONS
This research highlights the usefulness of dose-response analysis in presenting epidemiological evidence, reveals the potential role of oyster consumption in food-borne disease such us Norwalk-like virus and show the need for monitoring production centres and oyster beds in order to prevent further cases of contamination.
Facultad de Medicina, Universidad de Lleida. godoy@slle.scs.es
P
P
Godoy
J
J
Torres
S
S
Guix
A
A
Prat
M
M
Alsedà
A
A
Domínguez
A
A
Bosch
L
L
Salleras
D000328:Adult; D000818:Animals; D017250:Caliciviridae Infections / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D009663:Norwalk virus; D010125:Ostreidae / Q000821:virology*; D012758:Shellfish / Q000821:virology*; D013030:Spain / Q000453:epidemiology