title: A norovirus outbreak related to contaminated surfaces.
abstract: We investigated an outbreak of norovirus infection affecting 12 of 16 auto dealership employees (75%) subsequent to a staff meeting. Take-out sandwiches initially seemed the likely source, but a cohort study found no association between illness and food consumption. Employees reported seeing a toddler with diarrhea in a dealership restroom shortly before the luncheon. Indistinguishable norovirus was isolated from employees and the child (genotype GII6.C) and from a diaper-changing station in the restroom (genogroup GII). Counterintuitively, this point-source outbreak following a meal was caused by environmental exposures, not food. Environmental exposures should be considered even in routine outbreak investigations.
authors.affiliation: Washington County Department Health and Human Services, Hillsboro, OR 97124, USA. kimberly_repp@co.washington.or.us
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Repp
authors.forename: Trevor P
authors.initials: TP
authors.lastname: Hostetler
authors.forename: William E
authors.initials: WE
authors.lastname: Keene
mesh_terms: D000328:Adult; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000235:genetics / Q000821:virology*; D015331:Cohort Studies; D004196:Disease Outbreaks; D004781:Environmental Exposure; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000235:genetics / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D009922:Oregon / Q000453:epidemiology; D012189:Retrospective Studies; D017132:Workplace; D055815:Young Adult
keywords: diaper changing station; disease outbreak; environmental contamination; norovirus