title: A large foodborne outbreak of norovirus in diners at a restaurant in England between January and February 2009.
abstract: An outbreak of gastroenteritis affected at least 240 persons who had eaten at a gourmet restaurant over a period of 7 weeks in 2009 in England. Epidemiological, microbiological, and environmental studies were conducted. The case-control study demonstrated increased risk of illness in those who ate from a special 'tasting menu' and in particular an oyster, passion fruit jelly and lavender dish (odds ratio 7·0, 95% confidence interval 1·1-45·2). Ten diners and six staff members had laboratory-confirmed norovirus infection. Diners were infected with multiple norovirus strains belonging to genogroups I and II, a pattern characteristic of molluscan shellfish-associated outbreaks. The ongoing risk from dining at the restaurant may have been due to persistent contamination of the oyster supply alone or in combination with further spread via infected food handlers or the restaurant environment. Delayed notification of the outbreak to public health authorities may have contributed to outbreak size and duration.
authors: Thames Valley HPU, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, Didcot, UK. alyson.smith@hpa.org.uk
authors: A J
authors: AJ
authors: Smith
authors: N
authors: N
authors: McCarthy
authors: L
authors: L
authors: Saldana
authors: C
authors: C
authors: Ihekweazu
authors: K
authors: K
authors: McPhedran
authors: G K
authors: GK
authors: Adak
authors: M
authors: M
authors: Iturriza-Gómara
authors: G
authors: G
authors: Bickler
authors: É
authors: É
authors: O'Moore
mesh_terms: D000328:Adult; D000818:Animals; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D016022:Case-Control Studies; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005243:Feces / Q000821:virology; D005260:Female; D005511:Food Handling; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D016017:Odds Ratio; D010125:Ostreidae / Q000382:microbiology; D012147:Restaurants; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D014839:Vomiting / Q000453:epidemiology / Q000821:virology