Role of infected food handler in hotel outbreak of Norwalk-like viral gastroenteritis: implications for control

Abstract

Investigation of an outbreak of viral (Norwalk-like) gastroenteritis amongst staff (40 cases), resident guests (over 70 cases), and persons attending functions (54 cases) at one hotel over 8 days suggested that the main vehicle of infection was cold foods prepared by a food handler during and after a mild gastrointestinal illness. He was excreting Norwalk-like virus particles 48 hours after the illness. In addition, ill kitchen staff vomited in the kitchen area and may have contaminated surfaces and stored foods. It is recommended that food handlers should be regarded as potentially infectious until at least 48 hours after clinical recovery from viral gastroenteritis. Stored foods that may have been contaminated should be immediately discarded and areas of the work place which may have been affected should be identified and decontaminated.