title: A large common-source outbreak of norovirus gastroenteritis in a hotel in Singapore, 2012.
abstract: An outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: P
authors: P
authors: Raj
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: J
authors: J
authors: Tay
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: L W
authors: LW
authors: Ang
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: W S
authors: WS
authors: Tien
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: M
authors: M
authors: Thu
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: P
authors: P
authors: Lee
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: Q Y
authors: QY
authors: Pang
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: Y L
authors: YL
authors: Tang
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: K Y
authors: KY
authors: Lee
authors: A*STAR Singapore,Singapore.
authors: S
authors: S
authors: Maurer-Stroh
authors: A*STAR Singapore,Singapore.
authors: V
authors: V
authors: Gunalan
authors: Ministry of Health, Singapore,College of Medicine Building,Singapore.
authors: J
authors: J
authors: Cutter
authors: National University of Singapore,Singapore.
authors: K T
authors: KT
authors: Goh
mesh_terms: D000293:Adolescent; D000328:Adult; D000332:Aerobiosis; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004783:Environmental Microbiology; D004926:Escherichia coli; D005243:Feces / Q000821:virology; D005260:Female; D005506:Food Contamination; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D009663:Norwalk virus; D012846:Singapore / Q000453:epidemiology; D055815:Young Adult
keywords: Common source; crockery; cutlery; epidemiological investigation; norovirus