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An outbreak of norovirus gastroenteritis associated with wedding cakes

Published online by Cambridge University Press:  30 June 2005

D. S. FRIEDMAN ,
D. HEISEY-GROVE ,
F. ARGYROS ,
E. BERL ,
J. NSUBUGA ,
T. STILES ,
J. FONTANA ,
R. S. BEARD ,
S. MONROE  and
M. E. McGRATH
...Show all authors
D. S. FRIEDMAN
Affiliation:
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
D. HEISEY-GROVE
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
F. ARGYROS
Affiliation:
Division of Food and Drugs, Massachusetts Department of Public Health, MA, USA
E. BERL
Affiliation:
Division of Food and Drugs, Massachusetts Department of Public Health, MA, USA
J. NSUBUGA
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
T. STILES
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
J. FONTANA
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
R. S. BEARD
Affiliation:
Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
S. MONROE
Affiliation:
Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
M. E. McGRATH
Affiliation:
Braintree, Massachusetts Board of Health, MA, USA
H. SUTHERBY
Affiliation:
Braintree, Massachusetts Board of Health, MA, USA
R. C. DICKER
Affiliation:
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
A. DeMARIA
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
B. T. MATYAS
Affiliation:
Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
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Abstract

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We sought to determine the source of a norovirus outbreak among attendees of 46 weddings taking place during a single weekend. Norovirus-compatible illness was experienced by 332 (39%) of wedding guests surveyed; the outbreak affected up to 2700 persons. Illness was associated with eating wedding cake provided by a bakery common to the weddings (adjusted RR 4·5, P<0·001). A cake requiring direct hand contact during its preparation accounted for the majority of illness. At least two bakery employees experienced norovirus-compatible illness during the week preceding the weddings. Identical sequence types of norovirus were detected in stool specimens submitted by two wedding guests, a wedding hall employee, and one of the ill bakery employees. It is likely that one or more food workers at the bakery contaminated the wedding cakes through direct and indirect contact. These findings reinforce the necessity of proper food-handling practices and of policies that discourage food handlers from working while ill.

Type
Research Article
Information
Epidemiology & Infection , Volume 133 , Issue 6 , December 2005 , pp. 1057 - 1063
Copyright
2005 Cambridge University Press