280 sickened with Norovirus: UK carvery victims a step closer to compensation

Nearly 300 people look set to receive compensation after falling ill as a result of a norovirus outbreak at Exeter’s Toby Carvery.

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Law firm Irwin Mitchell, which is representing those affected, said they have reached the next stage of their legal battle after restaurant owners Mitchells & Butlers Retail Ltd admitted breach of duty to the group.

This means the company will pay compensation to all clients who can establish that their illness and other related losses, such as lost earnings, were caused through the breach of duty.

A total of 280 people instructed the specialist public health department at Irwin Mitchell to investigate the cause of an illness outbreak over the Easter period in April 2015 during which the restaurant was closed on more than one occasion for deep cleaning.

The law firm has now secured the admission from the company which means victims are one step closer to receiving fair settlements for the illness they suffered, which left many unable to work for a number of days and ruined other customers’ holidays in the area.

It is estimated that total damages for the group action will be over £500,000, though lawyers are still gathering medical evidence.

Those seeking compensation include John Williams, 68, from Bangor, Wales, who was staying at the Exeter Arms on holiday when he fell ill with diarrhoea and sickness. The symptoms he suffered lasted three weeks and ruined his holiday.

He said: “The symptoms I suffered were absolutely horrendous and stayed with me long after I left Exeter and returned home to Wales. It really did take its toll on me.

“I don’t think enough was done to control the outbreak at the pub and the hotel and I hope that the management has learned lessons from what happened last year so this never happens again.

“The Exeter Arms failed to inform me before travelling to the restaurant and hotel that there were problems with illness. My holiday was absolutely ruined and I want to know why more wasn’t done to control the outbreak.”

Fancy food ain’t safe food: Heston-in-Australia edition

Heston Blumenthal is like a rock star of the cooking world, and so is his food.

gretzkyNo, this is what a rock star looks like (right, exactly as shown).

But there’s one thing he wishes people would stop doing in his restaurants — taking pictures of their food.

“Chefs always have this problem now, it’s across the board and you can’t control people,” he told news.com.au while in Melbourne to film Heston Week which starts tonight on MasterChef. “

“I would prefer if they (diners) didn’t take any photos and just enjoyed themselves at the table and certainly not take them throughout the whole meal.

I’d prefer it if they didn’t barf, and wish rock-star Heston and his excess shared that concern.

Australia is like Canada in that they both have an anxiety-driven need to be recognized – even if they say they don’t.

And if Heston is coming to town, that must validate things.

(Note, this is different than Wayne Gretzky coming to Australia in that he actually seeks to promote the spread of ice hockey whereas Heston seeks to promote himself.)

The UK Health Protection Agency report into an outbreak of Norovirus that felled 529 diners at Heston Blumenthal’s Fat Duck restaurant in early 2009, clearly identified poor reporting and employees working while sick as contributing factors to the outbreak.

Blumenthal decided to ignore this and take to the Interwebs with his own revisionist version of what went wrong earlier this year.

Television presenter Jim Rosenthal, who was sickened, called Blumenthal’s response, “pathetic.”

“He has basically attempted to re-write the HPA report and its conclusions in his favour. It is pathetic and a complete PR disaster. There isn’t even a hint of apology.

At first I was extremely sympathetic to Heston Blumenthal, but the way this has been mishandled beggars belief. I could not believe what I was reading in this email – it was like we had been sent different reports. I am taking them to court and a lot of other people are too. A simple apology might have ended all this a long time ago.”

vomit.birdBut on with the fawning.

For many people, dinner at Blumenthal’s The Fat Duck in London, which recently took up a six-month residency at Crown Casino in Melbourne, is high on their bucket list.

So much so that 15,000 Aussies forked out $525 per person (excluding wine) for the pleasure.

Heston Week, which sees Blumenthal open four MasterChef Australia pop-ups in four days, commences tonight on Ten.

I won’t be watching.

A large foodborne outbreak of norovirus in diners at a restaurant in England between January and February 2009

Epidemiology and Infection September 2012 140 : pp 1695-1701

J. Smith, N. McCarthy, L. Saldana, C. Ihekweazu, K. McPhedran, G. K. Adak, M. Iturriza-Gómara, G. Bickler and É. O’Moore

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8647625

An outbreak of gastroenteritis affected at least 240 persons who had eaten at a gourmet restaurant over a period of 7 weeks in 2009 in England. Epidemiological, microbiological, and environmental studies were conducted. The case-control study demonstrated increased risk of illness in those who ate from a special ‘tasting menu’ and in particular an oyster, passion fruit jelly and lavender dish (odds ratio 7·0, 95% confidence interval 1·1–45·2). Ten diners and six staff members had laboratory-confirmed norovirus infection. Diners were infected with multiple norovirus strains belonging to genogroups I and II, a pattern characteristic of molluscan shellfish-associated outbreaks. The ongoing risk from dining at the restaurant may have been due to persistent contamination of the oyster supply alone or in combination with further spread via infected food handlers or the restaurant environment. Delayed notification of the outbreak to public health authorities may have contributed to outbreak size and duration.

Mass norovirus food poisoning at Japanese nurse

A mass food poisoning outbreak caused by Norovirus occurred at a nursery school located in Tokyo’s Shibuya Ward earlier this month.

norovirus-2According to the Tokyo Metropolitan Government, the norovirus outbreak infected a total of 41 kindergarteners and two nursery school teachers at Yoyogi Nursery School, Fuji TV reported. Over the course of three days from June 6 to 9, the infected children and nursery school staff exhibited symptoms of vomiting and diarrhea, and complained of fever as well.

While none of the infected infants and adults were hospitalized, 35 stool samples tested positive for the norovirus. Furthermore, all infected patients consumed the same school meal on June 6, which ward officials said was deep fried chicken, meat and potato stew, and potato salad.

Shibuya Ward suspended the nursery from serving lunches for three days.

Nightmares from camp: Norovirus infects 60 Dutch students on class trip

At least 55 school children from Assen were infected with the Norovirus while on a school trip to a recreation park in Annen, RTV Drenthe reports.

meatballsThe kids are all from primary schools the Marskramer and De Scharmhof. they were visiting the Annen park for a few days.

On Friday about 40 children were suffering from diarrhea, nausea and headaches. Over the weekend another 15 fell sick. GGD doctor Jorien Van Pelt confirmed that they were infected with the highly contagious virus.

Public health service GGD believes that one sick child infected the rest. All children who start showing symptoms are advised to stay at home.

 

Handwashing can limit spread of Norovirus

Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010.

sponge.bob.handwashingWe suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay.

We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap.

The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.

Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza

Epidemiol Infect. 2016 Jun 15:1-7., ahead of print

Inaida, Y. Shobugawa, S. Matsuno, R. Saito, H. Suzuki

http://www.ncbi.nlm.nih.gov/pubmed/27301793

Outbreak of something at Lumby Days in Canada

I can’t help but think that Lumby, British Columbia, is named after lumberjacks, but perhaps I’m stereotyping.

Lumby Interior Health is investigating following an outbreak at a Lumby Days’ event left at least two dozen people sick.

lumberjackDr. Silvina Mema, IH medical health officer, said the health authority has received reports of 24 people falling ill after attending the delegates’ luncheon.

She said the event was attended by 75-80 people and more could have been sick, but did not report it.

Among those who fell victim to illness were Vernon Mayor Akbal Mund, Liberal MLA Eric Foster and North Okanagan Regional District board chair Rick Fairbairn.

Mema said officials do not suspect food poisoning, but rather a viral outbreak, possibly norovirus.

People had diarrhea, vomiting and a fever.

“We are thinking it’s a viral disease,” said Mema. “It is quite common and it gets around quite easily. Food poisoning usually develops faster – within a few hours. This was a longer incubation period.” (fail – dp)

Those attending the luncheon will be asked to fill out a questionnaire as officials try to find a common link.

Mema said there were also leftovers that people took home and IH would like to get samples from that food – if any is left – and to speak to anyone who became sick after eating it.

Oregonian newsroom staffers sickened by Norovirus at morale booster

A May 31 cake-and-coffee gathering to recognize outstanding staff performance at The Oregonian went awry according to Williamette Week.

The Multnomah County Health Department is now investigating a potential norovirus outbreak after at least 14 people came down with stomach pain and severe diarrhea after the event.

The county sent samples of the cake to a laboratory for testing, according to health department spokeswoman Julie Sullivan-Springhetti. “One person did test positive to norovirus,” Sullivan-Springhetti says, referring to the stomach-flu-like ailment sometimes called “cruise-ship disease.”

As The Oregonian has reported, norovirus and other foodborne disorders are increasingly common.

“It was definitely unfortunate,” Oregonian Editor Mark Katches says in an email. “But it won’t stop us from doing these types of celebrations in the future.”

Norovirus: Best way to assess risk?

The application of quantitative microbial risk assessments (QMRAs) to understand and mitigate risks associated with norovirus is increasingly common as there is a high frequency of outbreaks worldwide.

norovirus.qmraA key component of QMRA is the dose–response analysis, which is the mathematical characterization of the association between dose and outcome. For Norovirus, multiple dose–response models are available that assume either a disaggregated or an aggregated intake dose. This work reviewed the dose–response models currently used in QMRA, and compared predicted risks from waterborne exposures (recreational and drinking) using all available dose–response models.

The results found that the majority of published QMRAs of norovirus use the 1F1hypergeometric dose–response model with α = 0.04, β = 0.055. This dose–response model predicted relatively high risk estimates compared to other dose–response models for doses in the range of 1–1,000 genomic equivalent copies. The difference in predicted risk among dose–response models was largest for small doses, which has implications for drinking water QMRAs where the concentration of norovirus is low.

Based on the review, a set of best practices was proposed to encourage the careful consideration and reporting of important assumptions in the selection and use of dose–response models in QMRA of norovirus.

Finally, in the absence of one best norovirus dose–response model, multiple models should be used to provide a range of predicted outcomes for probability of infection.

Comparison of risk predicted by multiple norovirus dose–response models and implications for quantitative microbial risk assessment

Nicole Van Abel, Mary E. Schoen, John C. Kissel, J. Scott Meschke

Risk Analysis, June 2016, DOI: 10.1111/risa.12616

http://onlinelibrary.wiley.com/doi/10.1111/risa.12616/abstract

The risks of running through mud

Being in France, I’m reminded that on June 20, 2015, about 1,000 of the almost 8,400 runners who took part in Mud Day activities in Nice on the French Riviera were stricken with gastroenteritis.

TMSplash-300x224And now, the paper.

An acute gastroenteritis (AG) outbreak occurred among participants in an obstacle race in France in the summer of 2015.

An investigation in two phases was conducted to identify the source of infection and document the extent of the outbreak.

First, a message on a social media website asked racers to report any symptoms by email to the Regional Health Agency of Provence-Alpes-Côte d’Azur. Second, a retrospective cross-sectional study was conducted through an interactive questionnaire for all participants, followed by an analytical study of potential risks factors.

Of 8,229 persons registered, 1,264 adults reported AG resolved within 48 hours. Of adults who reported AG, 866 met the case definition. Age group, departure time and ingestion of mud were associated with AG. Twenty stool specimens tested negative for bacteria. All four stool samples tested for viruses were positive for Norovirus genogroup I and genotype 2. No indicator bacteria for faecal contamination were found in drinking water but muddy water of ponds tested positive.

The outbreak was possibly caused by human-to-human transmission of a norovirus introduced by one or more persons and transmitted through contaminated mud. Risks related to similar races should be assessed and recommendations be proposed to raise awareness among health authorities and organisers.

Outbreak of diarrhoeal illness in participants in an obstacle adventure race, Alpes-Maritimes, France, June 2015

Eurosurveillance, Volume 21, Issue 23

Six C, Aboukais S, Giron S, D’Oliveira J, Peloux-Petiot F, Franke F, Terrien H, Dassonville F, Deniau J, Ambert-Balay K, Chesnot T, Ruimy R, Pélandakis M, Basset P, Munoz Rivero M, Malfait P.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22499

Exposure to Norovirus at the beach

Swimming in fecally-contaminated natural waterbodies can result in gastrointestinal (GI) infections and associated symptoms. However, the pathogenic microorganisms responsible are often unidentified because studies nearly always rely on self-reported symptoms. Noroviruses have been considered a likely cause because they are relatively resistant to conventional wastewater treatment and can survive in the environment.

norovirus-2Symptoms among swimmers usually occur within a few days of exposure, consistent with a short incubation period characteristic of noroviruses.

In the summer of 2009, we conducted an epidemiology study at a beach in Puerto Rico. We previously reported no association between swimming and self-reported GI symptoms at this beach. As part of this study, we also collected saliva samples from a subset of participants (N=1300) using an Oracol oral swab: on the day of the beach visit (S1); after 10-12 days (S2); and after approximately three weeks (S3), and tested them for IgG antibody responses to two common noroviruses (Norwalk and VA387) using a Luminex platform and a previously published method. An immunoconversion, indicating a potential new infection, was defined as at least a fourfold increase in norovirus-specific median fluorescence intensity (MFI) from the S1 to the S2 sample with the S3 sample remaining at least two times above the baseline (S1) MFI.

Approximately 4.7% (N=61) immunoconverted to at least one of the noroviruses. Swimmers who immersed their head in water had a higher rate of immunoconversion (5.5%) compared to non-swimmers (2.0%) (OR=3.32, 95% CI 1.2-9.5). Immunoconversion to norovirus was not associated with increased self-reported GI symptoms, indicating these infections were largely asymptomatic.

To our knowledge, this is the first epidemiology study to show an association between norovirus infection and swimming exposure. This abstract does not reflect EPA policy.

Evidence for asymptomatic norovirus infection transmission associated with swimming at a tropical beach

Soceity for Epidemiology Research, Miami, FL, June 07 – 16, 2016

Wade, Tim, S. Augustine, S. Griffin, K. Simmons, T. Eason, K. Oshima, E. Sams, A. Egorov, AND A. Dufour

https://cfpub.epa.gov/si/si_public_record_Report.cfm?dirEntryId=318202