title: Selection tool for foodborne norovirus outbreaks.
abstract: Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.
authors.affiliation: Virology Division of the Diagnostic Laboratory for Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. linda.verhoef@rivm.nl
authors.forename: Linda P B
authors.initials: LP
authors.lastname: Verhoef
authors.forename: Annelies
authors.initials: A
authors.lastname: Kroneman
authors.forename: Yvonne
authors.initials: Y
authors.lastname: van Duynhoven
authors.forename: Hendriek
authors.initials: H
authors.lastname: Boshuizen
authors.forename: Wilfrid
authors.initials: W
authors.lastname: van Pelt
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D016208:Databases, Factual; D018563:Disease Notification / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005506:Food Contamination; D005759:Gastroenteritis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D006801:Humans; D020407:Internet; D008954:Models, Biological; D029322:Norovirus / Q000145:classification / Q000302:isolation & purification; D011159:Population Surveillance / Q000379:methods; D011237:Predictive Value of Tests