An outbreak of norovirus infection caused by ice cubes and a leaking air ventilation valve

Abstract

A gastrointestinal outbreak was reported among 154 diners who attended a Christmas buffet on the 9 and 10 December 2016. A retrospective cohort study was undertaken. Faecal samples, water, ice and an air ventilation device were tested for indicators and routine pathogens. Altogether 26% (24/91) fulfilled the case definition of having typical viral gastrointestinal symptoms. Norovirus genogroup I was detected in faecal samples from three cases. One of these cases tested positive also for sapovirus and had a family member testing positive for both norovirus and sapovirus. A diner who drank water or drinks with ice cubes (risk ratios (RR) 6.5, 95% confidence intervals (CI) 1.5–113.0) or both (RR 8.2, 95% CI 1.7–145.5) had an increased risk in a dose-response manner. Ice cubes from three vending machines had high levels of heterotrophic bacteria. A faulty air ventilation valve in the space where the ice cube machine was located was considered a likely cause of this outbreak. Leaking air ventilation valves may represent a neglected route of transmission in viral gastrointestinal outbreaks.

First respiratory transmitted food borne outbreak?

“…To target the actions, similar basic epidemiological actions to human cases need to be taken with animal or food exposures. The data needs to be carefully described in terms of time-place-person (animal/food) (Jalava et al, 2018;Morgan, 2019). To resolve the outbreak, environmental epidemiologists interview the human case patients carefully and possibly other seafood market visitors about their activities in the market and exceptional events they may have observed or taken part in.…”

“…Nice thing about food trace back is that it is almost always possible, yet laborious, to reconstruct afterwards (in comparison to human movements) as money follows the lots of animals, documentation, taxation and selling spots in the market (Keto-Timonen et al, 2019;Self et al, 2019). Finding out the route of transmission is of uttermost importance to implement effective prevention methods (Jalava et al, 2018). Assuming that this outbreak is indeed due to contaminated food, then it represents a clear example as to why food control is important.…”

Covid-19 pandemic and food: Present knowledge, risks, consumers fears and safety

“…Outbreaks of infectious diseases are common, and usually happen through one of several means of transmission: food, water, person-to-person or environmental. Regardless of the initial means of transmission, outbreaks are followed by spreading through direct human contacts ( Jalava, Kauppinen, Al-Hello, & Räsänen, 2019 ). Initial human-to-human transmission was limited, and cases clustered around the Huanan market, mainly among elderly men.…”

Hygienic Practices and Structural Conditions of the Food Processing Premises Were the Main Drivers of Microbiological Quality of Edible Ice Products in Binh Phuoc Province, Vietnam 2019

“…Outbreaks of gastroenteritis due to contaminated ice have been reported in other parts of the world. [1][2][3] For example, a major outbreak of hepatitis A in Lampang and Chiang Rai, Thailand, affecting 906 people, was reportedly due to contaminated ice cubes. 4 Initial investigations pointed to an ice factory in Chiang Rai Province where water is drawn from artesian wells that were contaminated with coliforms.…”

“…The outbreak was also reported to be linked with ice cubes from 3 vending machines with high levels of heterotrophic bacteria. 3 Studies from various countries have shown that the microbiological quality of ice manufactured for use in foods and drinks could be a cause for concern. 1,[5][6][7] These studies showed that Escherichia coli, coliforms, and a variety of microorganisms could be present in ice products demonstrating either the poor quality of source water used or a lack of hygiene in the production process or handling or both.…”