Norovirus outbreaks at restaurants: employees may have spread illness
The LA Daily News reported that at least two LA-area restaurants have been identified as the source of norovirus outbreaks recently. The Buca di Beppo restaurant located in the Valencia Town Center and the Marie Callender's restaurant located near Magic Mountain - both in Los Angeles County - were the source of food poisoning outbreaks that caused symptoms of vomiting, diarrhea, nausea, fever, and dehydration. According to the Daily News, one employee who worked at both restaurants could have been the source of disease transmission.
Ironically, this week's MMWR, published by the Centers for Disease Control and Prevention, contains a report on norovirus outbreaks at Michigan restaurants in early 2006. An editorial note in the MMWR contains the following:
Norovirus can be transmitted person-to-person (via the fecal-oral route) and spread through contaminated airborne droplets, food, water, environmental surfaces, and fomites (3). In the outbreak described in this report, at least 364 restaurant patrons became ill with gastroenteritis after dining at a restaurant where employees had reported to work while ill. In a norovirus outbreak, a vomiting incident is a major risk factor for norovirus illness and can double the attack rate (4). In this outbreak, vomiting by a line cook at the work station might have contributed to transmission. Because of the open physical layout of the restaurant, no barrier impeded airborne spread of the virus from the kitchen to the main dining area. Attack rates increased after this incident, and among employees who worked on January 28, a higher percentage of line cooks became ill compared with servers. In addition, other environmental contamination probably contributed to transmission. Low-level transmission was occurring in the week before January 28; seven patrons who dined at the restaurant during January 21--27 met the case definition. During January 21--February 3, exposure to virus likely occurred by contact with contaminated surfaces and objects.
Norovirus, as seen here, is particularly easy to spread and is frequently spread through modes of transmission other than food.
