title: Multiple norovirus outbreaks among workplace canteen users in Finland, July 2006.
abstract: Multiple gastroenteritis outbreaks occurred between 25 and 31 July 2006 in 10 workplace canteens in south-western Finland. One vegetable processing plant provided raw vegetables to all the canteens. We conducted cohort studies in the three most visited canteens and environmental investigations in the kitchens and the plant. Patients' stools, food, water and environmental samples were tested for enteric bacteria and viruses. Of the three canteens, 150/273 respondents (response rate 82%) had gastroenteritis. Consumption of mixed raw vegetables was significantly associated with the illness but no single vegetable explains the outbreak. An identical norovirus GII.1 genotype was detected from all genotyped patient samples. Water, food, and environmental samples were negative for norovirus. The facilities had appropriate hygienic conditions and no staff member had gastroenteritis prior to the outbreak. Tracing back the vegetables to the farm level proved unsuccessful. This was the largest foodborne norovirus outbreak in Finland.
authors.affiliation: Department of Infectious Disease Epidemiology, National Public Health Institute (KTL), Helsinki, Finland. peter.makary@ktl.fi
authors.forename: P
authors.initials: P
authors.lastname: Makary
authors.forename: L
authors.initials: L
authors.lastname: Maunula
authors.forename: T
authors.initials: T
authors.lastname: Niskanen
authors.forename: M
authors.initials: M
authors.lastname: Kuusi
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.forename: S
authors.initials: S
authors.lastname: Pajunen
authors.forename: J
authors.initials: J
authors.lastname: Ollgren
authors.forename: N N
authors.initials: NN
authors.lastname: Tran Minh
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D005387:Finland / Q000453:epidemiology; D005506:Food Contamination; D005511:Food Handling; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000821:virology*; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D011795:Surveys and Questionnaires; D014675:Vegetables / Q000821:virology*; D017132:Workplace