The ghost of Heston: Norovirus outbreak in England

After battling the Covid-19 pandemic for almost two years, a new virus outbreak has been reported in the UK, which is spreading like wildfire. Referred to as the vomiting bug, Norovirus is highly infectious and causes vomiting and diarrhoea.

Arushi Bidhuri of The Health Site writes Public Health England issued a warning about this nasty virus after routine surveillance reported that there has been a massive jump in cases of norovirus. According to reports, 154 outbreaks have been recorded in England since May. This is roughly three times the previous five-year average of 53 outbreaks over the same time period. According to PHE, while small children have been affected, there has also been an increase in infection across all age categories.

As we continue to take precautionary measures against Covid-19, here are some precautions you should take to avoid the contraction of the highly infectious, norovirus. Again, the most important thing is to pay close attention to hygiene.

Quarantine yourself in case you experience any symptoms of norovirus.

Wash your hands frequently and thoroughly, using soap and water. Unlike COVID-19, alcohol sanitisers do not kill norovirus, therefore soap and water are the best options.

To disinfect contaminated household surfaces, use a bleach-based household cleaner or a mixture of bleach and hot water.

Avoid cooking or eating with others at least 48 hours after recovering from the infection.

Any contaminated clothes or bedding should be washed with detergent and at 60 C, and contaminated objects should be handled with disposable gloves if feasible.

People infected with the virus should take rest and stay hydrated.

Seek medical attention if symptoms persist for more than 24 hours.

Since young children and the elderly are more prone to rapid dehydration, take extra care and be cautious.

Food safety lessons of the COVID-19 pandemic

While it is, perhaps, premature to look at the COVID-19 pandemic through the rearview mirror only, there is, according to Max Teplitski of The Packer, enough data to extract some useful lessons. 

There has been an 80-95% drop-off in the cases of norovirus infections in the U.S. (and a similar trend in England and Wales) during the COVID-19 pandemic, and another study focusing on a decline in foodborne bacterial infections. 

Similarly, studies in Israel and Spain report a 30-80% decline in reported cases of salmonella, shigella and campylobacter infections. Even though the healthcare system was stressed, authors point out that under-reporting of cases could be ruled out.  

While it is beyond doubt that SARS-CoV2 is not a foodborne pathogen, what can we learn from the measures that were put in place to control COVID-19 that also had a positive impact on food safety?

Even though we cannot eliminate the possibility that lockdowns minimized interpersonal interactions and that limited the spread of some foodborne illnesses, other factors were also likely at play. 

From the first days of the pandemic we were all reminded of the importance of hygiene: washing hands, using alcohol-based sanitizers and doing so often. While hand hygiene is something that is commonplace in the produce and, more broadly, food industry, it was the first time that consumers went to great lengths to sanitize hands before coming into public places and after leaving them.  

The authors of the Israeli study, in fact, make a direct link between an increase in handwashing and a reduction in shigella infections. I firmly believe that continuing handwashing and hand sanitizing habits learned over the past 18 months is the single most effective intervention that the food industry and consumers can implement to reduce the burden of foodborne illness. 

Disinfecting shopping carts was a new practice implemented during the pandemic. While it was put in place to sanitize high-touch surfaces (such as cart handlebars), I have no doubt that this was the second most effective practice in reducing transmission of foodborne pathogens. 

Yes, dogs too: Canine norovirus

Canine norovirus (CNV) is a diarrhea-causing pathogen in canines. In this study, 268 canine diarrheic fecal samples were collected from 13 pet hospitals across three provinces in China between March 2017 and May 2019, and 7.8% (21/268) samples were detected as CNV-positive by RT-PCR. Phylogenetic analysis of twenty-one CNV RdRp fragments showed that eighteen of the strains clustered in GVI.2, two clustered in GVI.1 and one clustered in GIV.2. The complete RdRp, VP1, and VP2 genes of four GVI.2 strains obtained from three provinces were successfully sequenced.

Phylogenetic analyses based on the RdRp, VP1, and VP2 genes showed that the GVI.2 strains from this study were closely related to USA GVI.2 strains. The complete genome of GVI.2 strain Dog/M9/18/CH was successfully sequenced, it was 7905 nucleotides (nt) in length and shared 95.9% nt identity with the sole available, nearly full-length genome of GVI.2 strain genome. To our knowledge, this is first description of the molecular prevalence of CNV in mainland China, and the first report of a complete GVI.2 genome. These findings will extend our understanding of epidemics and the genetic evolution of CNV.

First detection of canine norovirus in dogs and a complete GVI.2 genome in mainland China

Infection, Genetics and Evolution

Huiqiang Maa, Hua Yueab, Yingying Luoa, Siyi Lia, Cheng Tangab

https://doi.org/10.1016/j.meegid.2021.104879

https://www.sciencedirect.com/science/article/abs/pii/S1567134821001763

53 sick: Rare norovirus GIV foodborne outbreak, Wisconsin, USA

We report a norovirus GIV outbreak in the United States, 15 years after the last reported outbreak. During May 2016 in Wisconsin, 53 persons, including 4 food handlers, reported being ill. The outbreak was linked to individually prepared fruit consumed as a fruit salad. The virus was phylogenetically classified as a novel GIV genotype.

Rare norovirus GIV foodborne outbreak, Wisconsin, USA

Emerging Infectious Diseases vol. 27 no. 4

Leslie Barclay, Tim Davis, and Jan Vinjé

https://wwwnc.cdc.gov/eid/article/27/4/20-4521_article?ACSTrackingID=USCDC_331-DM52806&ACSTrackingLabel=Emerging%20Infectious%20Diseases%20Journal%20-%20Volume%2027,%20Issue%204%20-%20April%202021%20Issue%20Now%20Online&deliveryName=USCDC_331-DM52806

Noro spreads: Almost 5% of students and staff sick from schoo

Prairie City Monroe School District (that’s in Iowa, in the U.S.) officials said nearly 5 per cent of the body and staff were absent Friday due to illness.

School officials said on Thursday, schools reported an abrupt increase in students reporting symptoms of vomiting.

“At first, it appeared to be at our middle school, but as the day went on, we began to see similar symptoms in other buildings. Our school health professionals immediately notified county and state health professionals, and are working very closely with them through this situation,” Superintendent Dr. Michelle Havenstrite said.

Havenstrite said health officials believe the illnesses are likely due to norovirus.

The Centers for Disease Control and Prevention lists norovirus as a very contagious virus that causes vomiting and diarrhea. People easily contract the virus by having direct contact with infected people, consuming contaminated food or water or touching contaminated surfaces.

164 sick: Collective food poisoning in France linked to the consumption of oysters contaminated by norovirus

Food World reports that several collective food poisoning infections possibly linked to the consumption of contaminated oysters have been reported since mid-February 2021 in several regions of France.

Since mid-February 2021, 46 mandatory declarations (DO) of collective food poisoning (TIAC) ​​suspected of being linked to the consumption of oysters have been sent to Public Health France and/or to the General Directorate of food . 

The meal dates at the origin of these toxi-infections are between 02/11/2021 and 02/25/2021 with a majority of meals reported on 02/14 (21 TIAC, 46%). All these TIACs took place in the context of a family meal with between 2 and 8 patients. A total of 164 patients were recorded and two people were hospitalized. 

Stool analyzes carried out by the National Reference Center for Gastroenteritis Viruses in patients following 2 TIACs confirmed the presence of norovirus.

Shellfish collected from individuals who were sick after consuming oysters as well as from suppliers were analyzed by reference laboratories and laboratories approved by the Ministry of Agriculture and Food: noroviruses were identified. Noroviruses have also been detected in several production areas of consumed oysters.

164 sickened in Aug. Norovirus found in mass food poisoning at Taiwan’s Chiaohsi hotel

The Yilan County Public Health Bureau said Aug. 12 that several customers and employees in the mass food poisoning case at Hotel Royal Chiaohsi (礁溪老爺酒店) had tested positive for norovirus, though it has not been confirmed as the official cause.

Earlier this month, news broke out that 164 people who dined at the Hotel Royal Chiaohsi’s buffet restaurant had experienced symptoms of food poisoning, including a group of Chailease Finance Co. employees that were on a company retreat. Of all the afflicted individuals, 92 have sought medical assistance, according to the health bureau.

The bureau said that a few customers and hotel staff members, including two restaurant workers, have received a positive result for the norovirus test, but no traces of the virus have been found on any of the kitchenware so far. Since the investigation results will determine the hotel’s responsibility and its follow-up settlement, the bureau said more clarification is needed on the true cause of the incident.

151 sickened: Norovirus outbreak causing gastroenteritis in a hotel in Menorca, Spain

To establish the agent responsible for a gastroenteritis outbreak in a hotel in Menorca (Spain) in September 2016.

Methods

The study included epidemiological and laboratory analysis. Environmental and stool samples were examined for bacterial and viral pathogens.

Results

One hundred and fifty-one cases were detected, 123 among the tourists staying in the hotel and 28 affecting the staff. The presence of genotype 2 norovirus was discovered in the microbiological studies of patient’s faeces, as well as in the surface samples of rooms and common areas. The control plan implemented allowed for control of the outbreak.

Conclusions

This study on a genotype 2 norovirus outbreak reveals the importance of a rapid response for controlling these types of outbreaks.

Norovirus outbreak causing gastroenteritis in a hotel in Menorca, Spain

Enfermedades infecciosas y microbiologia clinica

Antonio Doménech-SánchezabElena LasoaEncarnación GenestaraClara I.Berrocala

https://doi.org/10.1016/j.eimce.2020.11.001

https://www.sciencedirect.com/science/article/abs/pii/S2529993X20302008

Norovirus on planes

Human norovirus (HuNoV) is one of the leading causes of acute gastroenteritis globally. HuNoV outbreaks have been recently reported during air travels. Contaminated surfaces are known as a critical transmission route at various settings. The aim of this study was to provide key information about the survival and the decontamination of HuNoV on three commonly touched airplane cabin surfaces.

In this study, we monitored the survival of HuNoV on seat leather, plastic tray table, and seatbelt for 30 days, with and without additional organic load (simulated gastric fluid). The efficacy of two EPA registered anti-norovirus disinfectants were also evaluated. Results showed that HuNoV was detected at high titers (>4 log10 genomic copy number) for up to 30 days when additional organic load was present. Both tested disinfectants were found highly ineffective against HuNoV when the surface was soiled. The study showed that when the organic load was present, HuNoV was highly stable and resistant against disinfectants.

Findings from this study indicated that appropriate procedures should be developed by airline companies with the help of public health authorities to decrease passengers’ exposure risk to HuNoV.

Survival and inactivation of human norovirus GII.4 Sydney on commonly touched airplane cabin surfaces

Public Health 29 July 2020

Dorra Djebbi-Simmons, Mohammed Alhejaili, Marlene Janes, Joan King and Wenqing Xu*

DOI: 10.3934/publichealth.2020046

https://www.aimspress.com/fileOther/PDF/aimsph/publichealth-07-03-046.pdf

Chipotle: Another gift that keeps on giving, $25 million criminal fine for food poisoning

Chipotle Mexican Grill Inc. will, according to Edvard Pettersson of Bloomberg, pay a $25 million criminal fine to resolve allegations by federal prosecutors that its food sickened more than 1,100 people across the U.S. from 2015 to 2018.

It’s the largest fine ever imposed in a food-safety case, according to a statement by the U.S. attorney’s office in Los Angeles.

The criminal charges pertain in part to norovirus outbreaks at Chipotle restaurants. The highly contagious virus can be transmitted by infected food workers handling ready-to-eat foods and their ingredients, according to the statement. It can cause severe symptoms, including diarrhea, vomiting and abdominal cramping.

“Chipotle failed to ensure that its employees both understood and complied with its food safety protocols, resulting in hundreds of customers across the country getting sick,” U.S. Attorney Nick Hanna said in the statement announcing the deferred-prosecution agreement.

The Newport Beach, California-based company said that, as part of the agreement, it will its strengthen its food-safety polices and practices.

“This settlement represents an acknowledgment of how seriously Chipotle takes food safety every day and is an opportunity to definitively turn the page on past events and focus on serving our customers real food made with real ingredients that they can enjoy with confidence,” Brian Niccol, chairman and chief executive officer of the company, said in a statement.

Prosecutors alleged that four norovirus outbreaks were caused by employees showing up to work sick, in violation of company policy, and by food products being stored at the wrong temperatures.

A fifth outbreak — which sickened about 647 people in July 2018 who dined at a Chipotle in Ohio — was from Clostridium perfringens, a bacterium found in raw meat and poultry that is one of the most common types of foodborne illness in the U.S. People who get ill from it usually recover in 24 hours and it’s not contagious.

Managers at the company’s restaurants failed on a number of occasions to notify Chipotle’s safety group at its headquarters when an employee had been vomiting at work, according to prosecutors. Instead, the safety analysts would find out only after contacting the restaurant because it had received a complaint from a sick customer. As a result, there were days of delay before the restaurants were sanitized.