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Volume 11, Number 1—January 2005
Research

Norovirus and Foodborne Disease, United States, 1991–2000

Marc-Alain Widdowson*Comments to Author , Alana Sulka*, Sandra N. Bulens*†, R. Suzanne Beard*, Sandra S. Chaves†‡, Roberta Hammond§, Ellen D.P. Salehi¶, Ellen Swanson#, Jessica Totaro**, Ray Woron††, Paul S. Mead*, Joseph S. Bresee*, Stephan S. Monroe*, and Roger I. Glass*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Atlanta Research and Education Foundation, Atlanta, Georgia, USA; ‡Department of Human Resources, Atlanta, Georgia, USA; §Bureau of Community Environmental Health, Tallahassee, Florida, USA; ¶Ohio Department of Health, Columbus, Ohio, USA; #Department of Health, Minneapolis, Minnesota, USA; **Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USA; ††New York State Department of Health, Troy, New York, USA

Main Article

Table 3

Role of different foods and foodhandlers in outbreaks of gastroenteritis of noroviral, bacterial, and unknown cause, United States, 1998–2000*

Cause of outbreak
 p value†
Norovirus no. (%) Bacteria no. (%) Unknown no. (%)
Total outbreaks with data on implicated food 76 124 408
Implicated food
Salad 20 (26) 20 (16) 73 (18) NS
Sandwich 10 (13) 0 24 (6) < 0.05‡
Produce/fruit 13 (17) 4 (3) 15 (4) < 0.001
Meat dish 8 (11) 50 (40) 139 (34) < 0.001
Fish dish 4 (5) 9 (7) 19 (5) NS
Bakery product 5 (7) 2 (2) 15 (4) NS
Oysters 2 (3) 2 (2) 12 (3) NS
Other various§
 14 (18)
 37 (30)
 111 (27)
 ND
Total outbreaks with data on investigation of foodhandler 94 102 564
Foodhandler implicated
Yes 45 (48) 20 (20) 51 (9) < 0.001
No 49 (52) 82 (80) 513 (91)

* ND, not done; NS, not significant.
†Chi-square test: p value refers to comparison of norovirus (NoV) outbreaks with both bacteria and unknown outbreaks separately.
‡p < 0.001 when comparing NoV outbreaks with bacterial outbreaks.
§No difference noted for dairy products (3%–5%), cold meats (2%–4%), egg dishes (0%–1%), beverages (1%–4%), or ice (0%–1%).

Main Article

1Efforts in 1998 to improve outbreak reporting resulted in more outbreaks being retrospectively attributed to this period. The current figures for 1993 to 1997 are 65 (2%) of 3,257 outbreaks attributable to NoV and 67% of unknown etiology.

Page created: April 14, 2011
Page updated: April 14, 2011
Page reviewed: April 14, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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