Outbreak of Norovirus at a University Cafeteria Deli with Pre Sliced Ham- Texas 2015

Catherine Cadang, Lawrence Ayers, Kaitlyn West, Raya Rafat, Theodore Mitchell
On March 11 the Texas Department of Health (TDH) in the city of Austin was
received a call from University student claiming to be suffering from food poisoning as
evidences by report of emesis and diarrhea. TDH staff began an inquiry with local health
providers. Contact with the local hospital near the University revealed that twenty three students
had presented with gastroenteritis in a 24-hour period. There had only been three other patients
with similar reports in the past three days none of which were associated with the University.
Contact with the Universities Student Health Center reported that twenty students presented that
morning with symptoms of vomiting and diarrhea. By the next day March 12th, 75 people had
been reported to (TDH) with symptoms of gastroenteritis. A series of interviews and water ice
food and stool samples were used to narrow cause and source of outbreak. A case control study
was done to determine most likely source of the outbreak. The investigation revealed that the
source of the outbreak was the pre sliced ham served at the University cafeterias deli bar. The
food handler responsible was not ill but had contact with virus via exposure to child, and was
practicing poor hygiene. Fresh stool and food samples revealed that 50% of the infected parties
and the ham served at the deli were infected with the viral agent Norwalk Live Virus NLV or
Norovirus. By the end of the outbreak 149 cases of illness had been reported from March 10-12.
Careful handwashing and food safety practices resulted in prevention of secondary infection.
Norovirus is the fifth leading cause of gastroenteritis in the world. The virus is
transmitted via poor sanitation on the part of humans (70% of cases). Fecal-oral, aerosolvomitus, or contact with contaminated food water or the general. Most people infected present
with the typical signs of gastroenteritis: vomiting and diarrhea, abdominal cramps and fever
chills nausea etc. The incubation period is 10-51 hours with symptoms lasting 2-3 days.

Norovirus cause outbreaks globally year round and are very contagious due to low infectious
dose (1, 3, 4, 5)

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