Have a general knowledge base for the
Norovirus. Understand the process and steps taken in the
outbreak investigation. Be able to apply information received to
patient education. Correctly answer the quiz questions at the end
of the presentation.
Objectives
In April 2008, a large number of individuals
starting getting sick with severe nausea, vomiting, and diarrhea in Kent, Ohio.
A large majority were Kent State University students.
With a large increase in cases, the local hospital notified the Kent City Health Department.
The Outbreak
Stool samples were collected from individuals
and sent for testing at the Ohio Department of Health laboratory.
Interviews were conducted by Kent health officials of affected individuals.
A common theme from the interviews was haven ate at the Chipotle restaurant just off of Kent State University campus.
The Investigation
Stool samples revealed that the Norovirus
Genotype G2 was the cause.
After further investigation it was determined that food contaminated with the Norovirus served from April 14th though April 18th at the Kent Chipotle was the source of the outbreak.
What was the cause?
The Chipotle restaurant was closed and food
samples were collected from the restaurant for testing.
Leftover Chipotle food samples from affected individuals was also collected and tested.
All employees of the restaurant were also interviewed.
Investigation Continued
Total ill - 509 primary and secondary cases.
Organism – Norovirus
Source – contaminated food from a Chipotle restaurant. No specific source was found.
No patients were hospitalized as a result of the outbreak.
Results
The Chipotle restaurant was closed. All food
was thrown away and the restaurant was sanitized, including all cooking equipment.
The Restaurant was reopened with new employees from other Chipotle locations.
The cost of the outbreak to the Kent community was estimated to be between $130,000 and $305,000.
Results Cont.
The Norovirus
The most common cause of acute gastroenteritis in the United States.
Accounts for approximately 70,000 hospitalizations and 800 deaths per year.
Agent
Contaminated food and
infected individuals
The norovirus is spread by infected humans, contaminated food or fluids, and inanimate objects contaminated the virus on them.
The most contagious time for the norovirus is when a person has the illness and up to three days after recovery.
Host
Unsanitary food preparation
and/or uncleanly environment
Washing your hands before food preparation must be done, especially after using the restroom.
Proper washing of fruits and vegetables
Sanitizing cooking areas
Instructing employees not to work when they are sick.
Environment
A person can be contagious the same day
they contract the norovirus and are highly contagious from onset of symptoms to three days after recovery.
The virus can remain in your stool for two weeks or more after recovery.
Time
Education, Education, Education!!! Hand washing Washing fruits and vegetables thoroughly Cooking seafood thoroughly Do not prepare food or take care of others
when you are sick. Do not eat or drink after another person Keep sick children and adults away from food
preparation areas.
How can we stop the spread of the
Norovirus
No know treatment for the viral infection.
Treat dehydration with IV and oral fluids. The symptoms are treated with medications (ex. nausea and fever).
The Norovirus can be serious especially in young children, the elderly, and the immunocompromised.
Norovirus
How long is a person contagious with the
norovirus?a. one yearb. two weeksc. twenty four to forty eight hoursd. for life
It’s quiz time
The norovirus is
a. only contagious by human to human contact
b. contracted from animals that live in close quarters with other animals
c. the most common cause of acute gastroenteritisd. all of the above
Question
The norovirus is responsible for approximately
how many hospitalizations each year?a. 800b. 8,000c. 700,000d. 70,000
Question
What was the host in the Kent Norovirus
outbreak of 2008?a. A birdb. Contaminated foodc. The door handles of the entrance to the
restaurantd. None of the above
Question
Action News 19, (2008). Test results are back for Norovirus at Kent Chipotle.
Retrieved from http://www.woio.com/global/story.asp?s8236821
Centers for Disease Control and Prevention, (2012). Norovirus. Retrieved from http://www.cdc.gov/norovirus/about/overview.html
Foodborne Illness Database, (2012). Chipotle grill restaurant burritos 2008. Retrieved from http://www.outbreakdatabase.com/details/chipotle-grill-restaurant-burritos-2008/?organism=Norovirus&year=2008&state=18&month=4
Payne, J. W., 2008. Ohio disease outbreak linked to Chipotle restaurant. Retrieved from http://health.usnews.com/health-news/family-health/articles/2008/04/21/ohio-disease-outbreak-linked-to-chipotle-restaurant
References