At least 305 individuals became ill with norovirus gastroenteritis after patronizing Golden Corral in Casper, WY from November 17, 2012 through December 19, 2012.

The Wyoming Department of Health has issued a complete report on the outbreak, and identified a number of potential environmental health concerns through both patron and employee interviews.

Investigators received several reports of dirty dishes being stacked for use in the buffet line, vomitus accidents in the dining area, raw or undercooked food being set out for consumption, employees working while ill with gastrointestinal symptoms, refilling food on buffets without replacing service bowl or service utensils, lack of glove use when handling ready-to-eat foods, cross-contamination between raw and cooked foods, and other reports of general poor food-handling practices.

Both patrons and employees independently reported several vomitus accidents in the dining area and in the restaurant’s bathrooms. Investigators noted these events when the interviewee was able to provide a concise date of occurrence.

Recommendations were made for immediate control and as a result of the investigation.

 The restaurant must follow all rules and regulations contained in the Wyoming Food Safety Rule.

 The Wyoming Food Safety Rule currently states that any food-handling staff person who is known to be ill due to gastrointestinal symptoms such as diarrhea or vomiting should be excluded from work until at least 48 hours has passed since that individual’s last bout of diarrhea or vomiting (whichever occurred last). The 48 hour recommendation is the minimum, as many foodborne pathogens, including norovirus, can be shed by previously-ill persons for longer than 48 hours.

 The Wyoming Food Safety Rule also specifies that the restaurant shall require food-handling employees (i.e., kitchen staff, servers, etc.) to report to the person-in-charge information about their health and activities as they relate to diseases that are transmissible through food. A food-handling employee shall report the information in a manner that allows the person-in-charge to reduce the risk of foodborne disease transmission, including providing necessary additional information, such as date of onset of symptoms and illness, or of a diagnosis with symptoms if the food-handling employee has diarrhea, vomiting, jaundice, sore throat with fever or lesions containing pus, an infected wound, has been diagnosed with Salmonella, Shigella, E. coli, Hepatitis, or norovirus.

 Enhanced surface disinfection with a product effective against norovirus. A concentrated bleach solution was suggested.

 To minimize bare hand contact with ready-to-eat foods, such as lettuce, the restaurant should consider requiring the use of gloves when employees are handling those food items. Please note that glove use does not negate the need for proper hand-washing.

 All vomitus accidents should be treated as if they are highly contagious. Staff should use gloves and a concentrated bleach solution to disinfect affected areas. Staff should try to quarantine the area of the accident until the area is adequately disinfected. Staff should quarantine any rags, towels, or mops that were used to clean up the vomitus until they are adequately disinfected to prevent further transmission.

 Report any suspected cases of foodborne illness to health officials. Public health officials provide important services to business owners which include an objective investigation of the problem and providing quick, accurate, and effective mitigation strategies.

 Continue to consult with local environmental health specialists when questions arise about safe food-handling and consider ServSafe training for all kitchen staff.