Norovirus outbreak: why do bad things seem to happen at Chuck E Cheese?

Health officials say they’re seriously concerned about an outbreak of Norovirus linked to a well-known restaurant. Hundreds of people walk through the doors for birthday parties – but when Kelly Green left this Chuck E Cheese’s she was not celebrating.

“I started getting really sick to my stomach and feeling super nauseous. I got an extreme case of bad, bad diarrhea,” Kelly Green said. “It was like worse than I ever experienced.

norovirus-2After talking to others who attended the party, Green soon learned she had a case of Norovirus.

Green said she contacted The Hennepin County Health Department. Soon after, health officials asked her to submit a stool sample to see if she had contracted the virus.

No one from Chuck E Cheese’s would talk on camera. A spokesperson told KARE 11 News employees sanitize hard surfaces throughout the day and perform a deep clean at night. Late Thursday, the Chuck E Cheese’s released the following statement:

We are aware that the Maple Grove Health Department launched an investigation this week into a few reported cases of Norovirus contraction potentially stemming from a birthday party at a Chuck E. Cheese’s location. We are also aware that Minnesota has seen numerous outbreaks across the state this year – more than 40 reported cases since Jan. 1, according to the Minnesota Department of Health, so we are cooperating fully with officials to learn as much as possible about this situation.

While the investigation is ongoing, preliminary reports have determined that someone entered our restaurant while ill and transmitted the virus to other patrons through close contact. The cleanliness of our facility has not been called into question. As we are always concerned about the health and safety of the families who visit our stores and we are aware that the Norovirus has plagued many residents this spring, we will continue to be hyper vigilant in maintaining our rigorous sanitation standards.

Chuck E Cheese’s also provided video showing dispensers with hand sanitizer throughout their restaurants.

But hand sanitizers don’t work so well on Norovirus.

7 outbreaks of Norovirus in Vegas

The Southern Nevada Health District Office of Epidemiology has, since March 29, 2014, identified 7 clusters and outbreaks of acute gastroenteritis illness in the Las Vegas area. Venues associated with these clusters and outbreaks include a hotel conference, several private gatherings, and long–term and memory-care facilities. Seventeen persons reported seeking medical care and 2 persons were hospitalized in association with the hotel conference.

norovirus-2Testing by the Southern Nevada Public Health Laboratory (SNPHL) confirmed NoV in multiple stool specimens obtained from ill persons.

SNHD, SNPHL, and the Nevada Division of Public and Behavioral Health (NDPBH), Office of Public Health Informatics and Epidemiology collaborated on the investigation and response to these outbreaks.

Strict hand hygiene is the most important method to prevent NoV infection and control transmission. Proper hand washing with soap and running water for at least 20 seconds is the most effective way to reduce NoV contamination of the hands. Hand sanitizers might serve as an adjunct in between proper hand washings, but should not be considered a substitute for frequent soap and water hand washing.

The efficacy of sodium hypochlorite (chlorine bleach) has been widely documented to disinfect human NoV from environmental surfaces. When possible, chlorine bleach solution should be applied to hard, nonporous, environmental surfaces at a concentration of 1,000–5,000 ppm (5–25 table-spoons household bleach [5.25%] per gallon of wa-ter) and leave in place for at least 4 minutes. A list of EPA-approved commercial cleaning products that are effective against feline caliciviruses (which in-clude NoV) is available at Personnel performing environmental services should adhere to the manufacturer’s instructions for dilution, application, and contact time.

Additional infection control measures for healthcare and LTCFs are included in the SNHD Guidelines for the Prevention and Control of NoV in Extended Care Facilities and Nursing Homes available online at 

Crown Princess cruise ship hit with fourth norovirus outbreak in four years

Earlier this year Time Magazine included Princess Cruise Line’s ship, the Crown Princess on a list of the 13 worst cruise-related norovirus outbreaks.


4. Princess Cruises, Crown Princess (January 2010)

Total number sick: 396

In 2010, there were 14 outbreaks of illnesses on ships , including this one. Eight were attributed to norovirus.Crown Princess

5. Princess Cruises, Crown Princess (February 2012)

Total number sick: 363

The cruise, which embarked just a month after another outbreak on the ship, returned to Ft. Lauderdale two days early as passengers started falling ill.
Something is up with that ship as AP reports that 37 patrons of the Crown Princess are yet again barfing onboard.
Princess Cruises spokeswoman Karen Candy says about 37 passengers on the Crown Princess reported being sick while the ship was in San Francisco on Monday.
Candy says the ship’s staff began intense disinfecting of surfaces, and all sick passengers are being encouraged to remain in their rooms.

Fancy food ain’t safe food – NZ edition

As New York City somewhat quietly enacted its first paid sick leave law on April 1, wedding guests and eight serving staff at the exclusive Northern Club in Auckland, New Zealand fell sick in a suspected norovirus outbreak.

The wedding was held at the club in Princes St, central Auckland, on Saturday, March 29. People began to fall ill two days later.
norovirus-2Dr Hoskins said the club had alerted the Auckland Regional Public Health Service.

He said the service’s investigation was still in progress, and he did not know last night how many of the 100 guests had become ill.

Contact details had been obtained for 77 guests, of whom 44 had been interviewed.

Club’s president Tenby Powell (no relation) said that although the health service’s investigation had not yet identified the source of the outbreak, “we are very confident it’s got nothing to do with the Northern Club’s food handling processes”.

The eight affected employees were serving staff – “they serve plates” – and none of the food preparation staff had been affected.


Over 300 report Norovirus symptoms linked to Japanese steakhouse in Michigan

With more than 300 people now reporting symptoms consistent with norovirus linked to the Wild Chef Japenese Steakhouse in Michigan, public health types have now said it’s safe to reopen.

Ottawa County Public Health spokeswoman Kristina Wieghmink said the department is still awaiting laboratory results to determine what the cause of outbreak was. Results are expected in the next few days.

“Media coverage and public response has aided in data collection and has contributed greatly to the investigation of this event,” Wieghmink said.

Wild Chef met a series of requirements before it was allowed to reopen, including cleaning and disinfecting of all of its equipment, floors, walls and Wild-Chef-Japanese-SteakHouse-Grill-Bar-300x225ceilings. It also has developed new written policies and procedures, and provided staff training on proper washing of hands, food preparation, use of gloves and reporting of illnesses, Wieghmink said.

145 sick? Norovirus fingered in Michigan restaurant outbreak

Norovirus was identified as a source of a food illness outbreak among customers of the Beltline Bar, the Kent County Health Department reported Wednesday, April 2.

Three cases tested positive for norovirus, confirming investigators’ suspicions about the reports of gastrointestinal illness linked to the norovirus-2restaurant at 16 28th St. SE, said Lisa LaPlante, spokeswoman for the health department.

The health department reported March 26 that it had received dozens of calls from people who said they became sick after eating at the restaurant. By Wednesday, April 2, 145 complaints were reported.

The Beltline Bar staff did a thorough cleaning to disinfect the restaurant after hours, LaPlante said.

If someone has norovirus, if possible, the person should use a separate bathroom from others in the home, she said. The bathroom should be cleaned with a solution that includes a ¼ cup of bleach to a gallon of water – typical cleaning products do not kill norovirus.

Food Safety Talk 58: Where’s my wallet?

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour.  They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.1396369706543

In Episode 58 the guys started the show admiring Ben’s new computer, and his House of Clay beer, before talking about Don and Victoria Backham’s treadmill desksRicky Gervais bathtub photosdressing up like a realtor, and confidence intervals.

Don and Ben then welcomed Bill Marler to the show. Bill’s notoriety started with the Jack-in-the-Box outbreak (documented in the book Poisoned). The discussion moved to the Jensen farm legal case, in particular, the criminal aspects of unknowingly shipping contaminated food and the involvement of service providers, i.e. auditors. The guys also discussed the impact on apportioning liability as a result of the recent North Carolina limiting farmers liability law. The conversation then turned to Salmonella and Foster Farm’s chicken and no one could understand why there hadn’t been a recall.

The guys then discussed Listeria and cantaloupes, including CDC’s recommendations and Don’s paper on “Modeling the growth of Listeria monocytogenes on cut cantaloupe, honeydew and watermelon.”

After a short detour via the AVN Awards, Bill got the chance to explain why he generally doesn’t take on norovirus cases and the lengths he goes to before taking on a case, using the Townsend Farm Hepatitis A outbreak as an example. The conversation then turned to auditors and what the impact of the Jensen Farm litigation case might be.

After saying farewell to Bill, Don and Ben talked about podcasting, including Lex Friedman, and Libsyn’s Rob Walch.

In the after dark the guys chatted about House of CardsTrue Detective, Ben’s quirky Aussie accent, Malaysia Airlines flight 370 andLost.

Blame the consumer – norovirus on cruise lines edition

The first official norovirus outbreak on a cruise ship this year, according to Jim Walker of Cruise Law News, involved the Norwegian Cruise Line (NCL) Norwegian Star. 

The outbreak occurred during a cruise from January 5-19, 2014. The virus sickened 130 of 2318 cruise passenger (5.61%) and 12 of 1039 crew members vomit cruise(1.15%).  You can read the CDC report here.

The CDC concluded that the virus in question which sickened the 142 or so people was norovirus. This was the “causative factor” in CDC parlance. The CDC can usually figure out the “causative factor” and most of the time norovirus is the culprit. But I have never seen a CDC report in the last 10 or 15 years where the CDC figured out how the norovirus came aboard the cruise ship.

The cruise lines always blame the passengers. Sometimes the blame is direct with a cruise line public relations representative pointing the finger at their guests. Sometimes it is more subtle with no blame assessment but in the form of “passengers-need-to-wash-their-hands” type of admonishment. 

Determining the cause of a norovirus outbreak is a scientific process to be made by epidemiologists and doctors, not cruise line PR people.

University of Pittsburgh at Johnstown identifies norovirus outbreak, takes steps to limit virus exposure

A few years ago fellow graduate student Brae Surgeoner had a fun idea to collect behavior data in the midst of an outbreak. The University of Guelph was dealing with a bunch of illnesses that seemed to be linked to residence halls and the symptoms looked like norovirus. The local health folks worked with the universities housing group and placed alcohol-based sanitizer at the entrance to one of the cafeterias (which was thought to be ground zero). Looking back, the hand sanitizer step wasn’t the greatest public health intervention (not with commercially available products), but what we wanted to know was whether students heeded the warnings and advice. student-cafeteria-02

By using ethnography, we found that only 17 per cent of the observed students followed the hand hygiene recommendations, but self-reported surveys of the same population showed that 83 per cent of students said that they had been following the guidance (we published the results in the Journal of Environmental Health, abstract below).

Health officials often put up posters and signs and rely on self-reporting to determine whether interventions are effective. People may say they are washing their hands more, but our study showed that the behavior and reports don’t always match up.

Faced with a bunch of students ill with norovirus, the decision-makers running the show at the University of Pittsburgh at Johnstown, according to Global Dispatch, made a good disease management call by canceling all events and closing the cafeteria to limit virus transfer.

Several University of Pittsburgh at Johnstown students have reported an illness–with the symptoms of  fever, chills, nausea, vomiting, diarrhea, and general abdominal discomfort, to campus Health Services during the past 48 hours prompting the university to cancel all in-door social events for the weekend. In addition, the decision has been made to suspend cafeteria services at all dining facilities on campus. Instead, prepackaged meals will be available in the Student Union for pick-up.

In an effort to respond to students who feel that they need medical attention, the Office of Health and Counseling will be open on both Saturday and Sunday, 8:30 A.M. to 5:00 P.M.

University Students’ Hand Hygiene Practice During a Gastrointestinal Outbreak in Residence: What They Say They DO and What They Actually Do

Journal of Environmental Health, 72(2):24-28

Brae V. Surgeoner, M.S., Benjamin J. Chapman, Ph.D., Douglas A. Powell, Ph.D.


Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to postoutbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

Europe assesses the risk of Salmonella and Norovirus in leafy greens

Rainfall, use of contaminated water for irrigation or contaminated equipment are among the factors that cause contamination of leafy greens with Salmonella and Norovirus. These are some of the findings of EFSA’s latest opinion on risk factors that contribute to the contamination of leafy greens at different stages of the food chain. The BIOHAZ Panel has lettuce.skull.e.coli.O145recommended that producers use good agricultural, hygiene and manufacturing practices to reduce contamination. The Panel has also proposed specific microbiological criteria at primary production.

Leafy greens eaten raw as salads are minimally processed and widely consumed foods. Risk factors for leafy greens contamination by Salmonella spp. and Norovirus were considered in the context of the whole food chain including agricultural production and processing. Available estimates of the prevalence of these pathogens (together with the use of Escherichia coli as an indicator organism) in leafy greens were evaluated. Specific mitigation options relating to contamination of leafy greens were considered and qualitatively assessed. It was concluded that each farm environment represents a unique combination of numerous characteristics that can influence occurrence and persistence of pathogens in leafy greens production. Appropriate implementation of food safety management systems, including Good Agricultural Practices (GAP), Good Hygiene Practices (GHP) and Good Manufacturing Practices (GMP), should be primary objectives of leafy green producers. The relevance of microbiological criteria applicable to production, processing and at retail/catering were considered. The current legal framework does not include microbiological criteria applicable at primary production which will validate and verify GAP and GHP. It is proposed to define a criterion at primary production of leafy greens which is designated as Hygiene Criterion, and E. coli was identified as suitable for this purpose.

A Process Hygiene Criterion for E. coli in leafy green packaging plants or fresh cutting plants was considered and will also give an indication of the degree to which GAP, GHP, GMP or HACCP programs have been implemented. A Food Safety Criterion for Salmonella in leafy greens could be used as a tool to communicate to producers and processors that Salmonella should not be present in the product. Studies on the prevalence and infectivity of Norovirus are limited, and quantitative data on viral load are scarce making establishment of microbiological criteria for Norovirus on leafy greens difficult.