title: Lessons from Norovirus Outbreak in Warsaw, Poland, December 2012.
abstract: Efficient foodborne outbreak investigations are important for identification of gaps in food safety and public health practice. This article reports on an investigation of a gastroenteritis outbreak linked to catering food following a Christmas reception at the National Institute of Public Health-National Institute of Hygiene (NIPH-NIH) in Warsaw in December 2012. Of 192 employees eating food at the catering event, 97 (50.5%) developed symptoms. Persons eating dishes with recipes containing frozen carrots were five times more likely to develop gastrointestinal symptoms compared to those who did not eat carrots. Laboratory analysis identified norovirus in stool samples taken from symptomatic persons. Leftover food was not available for testing. The investigators did not collect stool specimens from food handlers and did not conduct trace backs for the suspected food ingredients. This investigation underlines the need for a revision of an existing procedures and importance of their complementation with detailed instructions for the local public health authorities for effective completion of foodborne outbreaks investigations in Poland.
authors.affiliation: Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland. skaminska@pzh.gov.pl.|European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. skaminska@pzh.gov.pl.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kamińska
authors.affiliation: Department of Epidemiology, Local Sanitary Station, Warsaw, Poland.
authors.forename: Żaneta
authors.initials: Ż
authors.lastname: Kruszewska
authors.affiliation: Department of Epidemiology, Regional Sanitary Station, Warsaw, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Lejbrandt
authors.affiliation: Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Sadkowska-Todys
mesh_terms: D000328:Adult; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D018552:Daucus carota / Q000821:virology; D004196:Disease Outbreaks / Q000517:prevention & control; D005243:Feces / Q000821:virology; D005260:Female; D005380:Financing, Government; D005522:Food Services; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D005628:Frozen Foods / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006693:Holidays; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification / Q000472:pathogenicity*; D018517:Plant Roots / Q000821:virology; D011044:Poland / Q000453:epidemiology; D011634:Public Health; D058996:Quality Improvement; D012621:Seasons; D014504:Urban Health; D000078329:Workforce
keywords: Foodborne; Norovirus; Outbreak investigation; Poland; Viral disease