Dale Bass of Kamloops This Week (that’s in British Columbia, Canada) writes that when norovirus hit customers at one Greek restaurant in the city, there were headlines with the name of the Victoria Street eatery — and it was shut down for days.

medzedesWhen norovirus struck another Greek restaurant just 16 months later, there was nothing in media releases identifying the eatery and it was not ordered closed.

Doug Dick was one of several people who became sick with the virus after eating at Minos restaurant on Tranquille Road in North Kamloops earlier this month. He asked KTW why Minos was not closed, since Dorian’s Greek House in downtown Kamloops was closed in December 2013.

Dick wondered if the reaction to Dorian’s situation came as a result of it being Royal Inland Hospital medical staff becoming ill there, something Joyce Michaud, the Interior Health Authority’s environmental-health officer — and the person who oversees inspections of places like restaurants — said is incorrect.

She said when her team is advised of a suspicious health outbreak, it doesn’t consider the occupations of those who are sick unless there is a direct link.

The focus, Michaud said, is identifying the bug, figuring out where it came from and, if possible, where it is, and helping the facility take steps to eradicate it.

Part of that is ensuring people who need to have medical tests get them done and often, which means delivering the test kits to sick people, Michaud said, rather than asking them to leave their homes.

Dick also wondered why IHA didn’t issue a press release warning people about about Minos.

Michaud noted the IHA didn’t issue a press release about Dorian’s, either. Because RIH operating-room staff becoming ill, a release was sent out advising the public surgeries were being cancelled.

Because the medical staff had not eaten at the restaurant — Dorian’s catered an event for them — the first task was to identify where the virus had come from, Michaud said. Soon there were many more people contacting the IHA with norovirus symptoms and, when it became apparent there was a public-health risk linked to Dorian’s, the restaurant was identified.

With Minos, there was one report on May 4 of someone becoming ill after eating there on May 2. An inspector was sent to the restaurant and, in the absence of any leftover food from that date, reviewed food-safety practices with the staff and told them the facility had to be thoroughly cleaned because the virus could linger on surfaces.

“The next day, we got another call and we called the restaurant again,” Michaud said, noting the IHA did not see it as an ongoing risk to the public since the restaurant had undergone a thorough cleaning.

“With Dorian’s, there was an order issued [to close until it was given permission from IHA to reopen] ,but there was no need for an order at Minos,” Michaud said.

Orders like that issued to Dorian are also posted on the authority’s website at interiorhealth.ca.

While it did confirm the name of the restaurant to people calling the authority to report illness, Michaud said a decision to release a name “is typically done on the basis of ongoing risk to the community and/or where it would aid ongoing investigation by having those at risk contact IH.

“The situation at Minos was not one where it appeared the restaurant was contributing to ongoing illness,” she said.

193 take part in mass lawsuit over UK Toby Carvery Norovirus outbreak

Almost 200 people are taking part in a group legal action against an Exeter restaurant following the outbreak of norovirus.

sorry-technical-difficulties-600x337-300x169Lawyers who specialize in helping victims of illness outbreaks in the UK and abroad are investigating the norovirus outbreak at Toby Carvery at the Exeter Arms, Middlemoor.

Initially it was thought that in excess of 100 people could have been affected by the outbreak in March.

But solicitors Irwin Mitchell have now revealed that it is representing 193 people in relation to the case.

The restaurant chain confirmed that tests run by the Environmental Health department, after a man was sick in the restaurant foyer in the evening of Sunday, March 29, tested positive for the virus.

the-exeter-arms-in-middlemoorThe pub underwent a deep clean overnight on Thursday, April 2, but continued to trade over the busy Easter bank holiday weekend when more customers fell ill, finally closing on Tuesday, April 7.

Scores of people claim to have visited Toby Carvery between Monday, March 30, and Easter Sunday, April 5, and since become ill with sickness and diarrhea for several days. Restaurant staff were also affected.

Norovirus from swimming in a lake

In July, 2014 a norovirus outbreak linked to a lake near Portland, Oregon sickened 70 people. Those who swam in the lake were 2.3 times more likely to develop vomiting or diarrhea than those who visited the park but didn’t go in the water.

kids.cottage.00More than half of those who got ill were children between 4–10 years old. Experts believe the outbreak began after a swimmer infected with norovirus had diarrhea or vomited in the water and other swimmers swallowed the contaminated water. To prevent other people from getting sick, park officials closed the lake to swimmers for 10 days.

“Children are prime targets for norovirus and other germs that can live in lakes and swimming pools because they’re so much more likely to get the water in their mouths,” said Michael Beach, Ph.D, CDC’s associate director for healthy water. “Keeping germs out of the water in the first place is key to keeping everyone healthy and helping to keep the places we swim open all summer.”

 Norovirus Outbreak Associated with a Natural Lake Used for Recreation — Oregon, 2014


Morbidity and Mortality Weekly Report

Amy Zlot, MPH, Maayan Simckes, MPH, Jennifer Vines, MD, Laura Reynolds, MPH, Amy Sullivan PhD, Magdalena Kendall Scott, MPH, J. Michael McLuckie, Dan Kromer, MPA, Vincent R. Hill, PhD, Jonathan S. Yoder, MPH, Michele C. Hlavsa, MPH



Why I now boil all frozen berries: Norovirus source in Sweden

Norovirus struck the care home in Ljungby a week ago, initially causing the deaths of two people, with another guest dying later in the week.

raspberrySweden’s national food agency (Livsmedelsverket) said in a statement on Monday that tests had confirmed that imported frozen fruits were the source of the sickness outbreak.

It is suspected that the raspberries became contaminated during the packing process, when boxes of berries were hand-packed by a worker who was carrying the virus.

“It is not uncommon for imported frozen raspberries to be contaminated with Norovirus,” Livsmedelsverket said in a statement on its website.

‘They should have been boiled’ 2 dead, 60 sick from Norovirus in frozen raspberries in Swedish retirement homes

I didn’t think about it much until a couple of years ago, but now I boil all frozen berries.

frozen_raspberries(1)(1)Apparently that’s a good idea.

But sad that consumers have to be the critical control point.

Two people have died of suspected food poisoning and another hospitalized. Some 60 people have suffered food poisoning on several retirement homes in Ljungby municipality. The cause is believed to be the raspberries in a dessert.

The raspberries served at several retirement homes in Ljungby municipality boiled never – contrary to the recommendations contained.

One should always boil the frozen foreign raspberries, says Elsie Castro, a molecular biologist at the National Public Health Agency.”

Mariana Axelsson, nutrition manager in Ljungby municipality, admits that the infected raspberries that caused an outbreak of Norwalk virus should have been cooked. The procedures have failed and will now be reviewed.

Hallonparfaiten served on several retirement homes in Ljungby and caused 60 people fell ill with Norwalk virus. Two elderly also have died , probably as a result of the disease.

100 sick onboard Celebrity cruise ship

Up to 100 passengers have are being reported as sick from a possible Norovirus outbreak onboard the Celebrity Infinity.

vomit cruiseAccording to the Centre for Disease Control (CDC) 95 out of 2,117 passengers along with 5 crew members have been reported sick from gastrointestinal illness. The CDC has not yet confirmed that it’s Norovirus but in most outbreaks onboard it usually is. Passengers and crew have been having vomiting and diarrhea.

The CDC has also stated that 8 stool specimens from passenger and crew have been collected for testing. A CDC Vessel Sanitation Program environmental health officer and one epidemiologist are to board the 91,000 gross ton ship once it arrives in San Diego, CA on April 13. The Celebrity Infinity began the voyage on March 29th from Fort Lauderdale, Florida on a 15 night Panama Canal cruise.

It’s Norovirus and 100 sick: Toby Carvery Exeter recloses today due to “technical difficulties”

A city pub and restaurant has reclosed, two days after an outbreak of norovirus was confirmed as the cause of it temporarily shutting.

sorry-technical-difficulties-600x337In excess of 100 people are thought to have been affected by the outbreak at Toby’s Carvery at the Exeter Arms, Middlemoor.

The Exeter Arms remains closed.

A spokesperson for the chain confirmed this morning that Toby Carvery re-closed today due to “technical difficulties” – no further details were given.

Can humans get Norovirus from their dogs?

Human norovirus may infect our canine companions, according to research published online April 1 in the Journal of Clinical Microbiology, a publication of the American Society for Microbiology.

sadie.dog.powellThat raises the possibility of dog-to-human transmission, said first author Sarah Caddy, VetMB, PhD, MRCVS, a veterinarian and PhD student at the University of Cambridge, and Imperial College, London, UK. Norovirus is the leading cause of food-borne illness in the United States, according to the Centers for Disease Control and Prevention (CDC).

The research showed that some dogs can mount an immune response to human norovirus, said Caddy, who will be a junior research fellow at the University of Cambridge, beginning in August. “This strongly suggests that these dogs have been infected with the virus. We also confirmed that that human norovirus can bind to the cells of the canine gut, which is the first step required for infection of cells.”

Caddy and collaborators performed the latter research using non-infectious human norovirus particles, which consist solely of the virus’ outer protein, called the capsid. The capsid is the part of the virus that binds to host cells. By itself, it is non-infectious because it lacks genetic material. (The non-infectious capsid is the basis for a new norovirus vaccine which is being tested in clinical trials, said Caddy).

Nonetheless, it is not clear just how much of a problem canine infection and transmission may represent for humans, said Caddy. Despite dogs’ apparent susceptibility, the investigators failed to find norovirus in canine stool samples, including those from dogs with diarrhea. They found it in serum samples of only about one seventh of 325 dogs tested.

Additionally, it is not yet known whether human norovirus can cause clinical disease in dogs Assuming that dogs become infected with human norovirus as per this study, it also remains unknown whether they could shed the virus in quantities sufficient to infect humans—although clinical investigators have estimated that as few as 18 virus particles can cause human infection.

Moreover, it is yet to be determined whether dogs play a role in the epidemiology of some outbreaks of human norovirus. Some of the biggest outbreaks occur in places from which dogs are absent, such as on cruise ships and in hospitals.

Over 100 sick: Probable Norovirus shuts Toby Carvery in UK

I never knew what a carvery was until I went to the UK in 2010 with Amy and a young Sorenne.

We visited my great-uncle Keith in Newport, Wales, and I drove us to the carvery for lunch, and almost killed us because they drive on the wrong side of the road in the UK and those menacing traffic circles.

long.fin.tuna.apr.15We ate at a carvery the other night while taking a couple of days at the beach: worst meal we ever had, but the line-dancing display by the retirees at Coolangatta was awesome.

This dude (right, exactly as shown) went with a buddy in a plastic kayak to go snorkeling at Cook Island, decided to put his line out on the way (no rod, just a line), and within 10 minutes landed this long-fined tuna off the beach at Fingal Head.

He said sashimi for dinner, frozen steaks for later.

I said, better get that thing on ice.

And then I thought Amy would kill us driving back through Mt. Tamborine. There’s so much within 100km of Brisbane.

A suspected outbreak of norovirus at a popular city pub and restaurant is believed to have affected large numbers of people across the city as well as visitors and holidaymakers.

The Echo has been inundated with reports from people, including children, the elderly and an eight month pregnant woman, claiming to have visited Toby Carvery at the Exeter Arms in Rydon Lane, Middlemoor, between Monday, March 30, and Easter Sunday, April 5, and since becoming ill with sickness and diarrhea for several days.

It is thought the number of people who may have been affected could be in excess of 100.

The restaurant and hotel temporarily closed on Tuesday, April 7, after an investigation led by Environmental Health was launched.

Concerns have also been expressed that the venue failed to close sooner and remained open over the Easter weekend.

amy.mt.tamborine.apr.15A spokesman for Toby Carvery confirmed to the Echo that on Wednesday, April 1, staff became aware that a customer had been suffering from norovirus – the most common stomach bug in the UK.

The spokesman confirmed that a steam clean was subsequently carried out in the restaurant and pub on Thursday after it closed, but normal trading continued over the Easter bank holiday – one of the busiest trading periods of the year.

The spokesman confirmed that on becoming aware of the threat, restaurant officials contacted the Environmental Health department at Exeter City Council, and an officer who visited on Thursday said the restaurant had followed correct safety procedures and could continue to trade.

Environmental Health officers subsequently returned to the restaurant and pub on Tuesday, April 7, after which the restaurant issued a statement on its website announcing the voluntary closure of the restaurant and adjoining hotel until further notice.

Of those affected, one person claimed to have required hospitalisation and countless others reported battling with unpleasant sickness and diarrhoea for many days.

Around 24 staff members at an animal shelter on the outskirts of the city claim to have become ill following a staff meal at the restaurant on March 31, leaving them operating the charity with worrying low staffing numbers.

Will Jennings, from Budleigh Salterton, said he visited The Exeter Arms on the afternoon of Wednesday, April 1, and by the following evening had started to vomit violently every 10 minutes for several hours.

Mr Jennings said he has suffered with a rare autoimmune disease called Behçets Syndrome with neurological involvement for two years and, similar to the elderly and very young, is particularly vulnerable to the effects of any illness, infection or virus which can be a case of “life or death” for him.

He said he had been left “very frail” by the sickness and three more of his party of six were also taken ill with the same symptoms.

Following medical advice, he said he was rushed to hospital by ambulance in a very poorly, semi-conscious state.

“I was suffering substantial pain and dehydration,” he recalled. “I was treated with intravenous fluids, anti sickness and morphine for pain relief.”

Can norovirus get into plants? Apparently, yes

Human norovirus (NoV) is the leading cause of foodborne disease in the United States, and epidemiological studies have shown that fresh produce is one of the major vehicles for the transmission of human NoV. However, the mechanisms of norovirus contamination and persistence in fresh produce are poorly understood.

sorenne.strawberry.13The objective of this study is to determine whether human NoV surrogates, murine norovirus (MNV-1) and Tulane virus (TV), can attach and become internalized and disseminated in strawberries grown in soil.

The soil of growing strawberry plants was inoculated with MNV-1 and TV at a level of 108 PFU/plant. Leaves and berries were harvested over a 14-day period, and the viral titer was determined by plaque assay. Over the course of the study, 31.6% of the strawberries contained internalized MNV-1, with an average titer of 0.81 ± 0.33 log10 PFU/g. In comparison, 37.5% of strawberries were positive for infectious TV, with an average titer of 1.83 ± 0.22 log10 PFU/g. A higher percentage (78.7%) of strawberries were positive for TV RNA, with an average titer of 3.15 ± 0.51 log10 RNA copies/g as determined by real-time reverse transcriptase quantitative PCR (RT-qPCR).

In contrast, no or little virus internalization and dissemination were detected when TV was inoculated into bell peppers grown in soil.

strawberryCollectively, these data demonstrate (i) virally contaminated soils can lead to the internalization of virus via plant roots and subsequent dissemination to the leaf and fruit portions of growing strawberry plants and (ii) the magnitude of internalization is dependent on the type of virus and plant.

 Evidence of the Internalization of Animal Caliciviruses via the Roots of Growing Strawberry Plants and Dissemination to the Fruit

Applied and Environmental Microbiology, April 2015, Volume 81, Number 8, doi:10.1128/AEM.03867-14

DiCaprio E, Culbertson D, Li J