title: Foodborne viruses.
abstract: Foodborne and waterborne viral infections are increasingly recognized as causes of illness in humans. This increase is partly explained by changes in food processing and consumption patterns that lead to the worldwide availability of high-risk food. As a result, vast outbreaks may occur due to contamination of food by a single foodhandler or at a single source. Although there are numerous fecal-orally transmitted viruses, most reports of foodborne transmission describe infections with Norwalk-like caliciviruses (NLV) and hepatitis A virus (HAV), suggesting that these viruses are associated with the greatest risk of foodborne transmission. NLV and HAV can be transmitted from person to person, or indirectly via food, water, or fomites contaminated with virus-containing feces or vomit. People can be infected without showing symptoms. The high frequency of secondary cases of NLV illness and - to a lesser extent - of hepatitis A following a foodborne outbreak results in amplification of the problem. The burden of illness is highest in the elderly, and therefore is likely to increase due to the aging population. For HAV, the burden of illness may increase following hygienic control measures, due to a decreasing population of naturally immune individuals and a concurrent increase in the population at risk. Recent advances in the research of NLV and HAV have led to the development of molecular methods which can be used for molecular tracing of virus strains. These methods can be and have been used for the detection of common source outbreaks. While traditionally certain foods have been implicated in virus outbreaks, it is clear that almost any food item can be involved, provided it has been handled by an infected person. There are no established methods for detection of viruses in foods other than shellfish. Little information is available on disinfection and preventive measures specifically for these viruses. Studies addressing this issue are hampered by the lack of culture systems. As currently available routine monitoring systems exclusively focus on bacterial pathogens, efforts should be made to combine epidemiological and virological information for a combined laboratory-based rapid detection system for foodborne viruses. With better surveillance, including typing information, outbreaks of foodborne infections could be reported faster to prevent further spread.
authors.affiliation: National Institute of Public Health and the Environment, Research Laboratory for Infectious Diseases, Antonie van Leeuwenhoeklaan 9, Bilthoven, The Netherlands. marion.koopmans@rivm.nl
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
authors.forename: Carl Henrik
authors.initials: CH
authors.lastname: von Bonsdorff
authors.forename: Jan
authors.initials: J
authors.lastname: Vinjé
authors.forename: Dario
authors.initials: D
authors.lastname: de Medici
authors.forename: Steve
authors.initials: S
authors.lastname: Monroe
mesh_terms: D017250:Caliciviridae Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D017281:Cost of Illness; D005516:Food Microbiology; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D006505:Hepatitis / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D012306:Risk; D014777:Virus Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D014871:Water Microbiology