An outbreak of Norwalk virus gastroenteritis associated with eating raw oysters. Implications for maintaining safe oyster beds. 1995

M A Kohn, and T A Farley, and T Ando, and M Curtis, and S A Wilson, and Q Jin, and S S Monroe, and R C Baron, and L M McFarland, and R I Glass
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.

OBJECTIVE To determine the characteristics and the cause of an outbreak of gastroenteritis associated with eating raw oysters. METHODS Survey of groups of persons reporting illness to the health department after eating oysters; survey of convenience sample of oyster harvesters; and tracing of implicated oysters. METHODS General community. METHODS Relative risk for illness after oyster consumption, source bed of contaminated oysters, presence of antibodies to Norwalk virus in serum, presence of a Norwalk virus in stool by direct electron microscopy and reverse transcription-polymerase chain reaction (RT-PCR), and DNA sequences of RT-PCR products. RESULTS Seventy (83%) of 84 persons who ate raw oysters became ill vs three (7%) of 43 people who did not eat raw oysters (relative risk, 11.9; 95% confidence interval, 4.0 to 34.2). Eleven (79%) of 14 serum pairs had at least a fourfold increase in antibody to Norwalk virus. All 12 stool samples tested were positive by electron microscopy and/or RT-PCR for Norwalk virus. The RT-PCR products from all seven stool samples tested had identical DNA sequences. Implicated oysters were harvested November 9 through 13, 1993, from a remote oyster bed. Crews from 22 (85%) of 26 oyster harvesting boats working in this area reported routine overboard disposal of sewage. One harvester with a high level of antibodies to Norwalk virus reported having gastroenteritis November 7 through 10 and overboard disposal of feces into the oyster bed. CONCLUSIONS This outbreak was caused by contamination of oysters in the oyster bed, probably by stool from one or more ill harvesters. Education of oyster harvesters and enforcement of regulations governing waste disposal by oyster harvesting boats might prevent similar outbreaks.

UI MeSH Term Description Entries
D008145 Louisiana State bounded by Arkansas on the north, by Mississippi on the east, the Gulf of Mexico on the south and Texas on the west.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009663 Norwalk virus The type species in the genus NOROVIRUS, first isolated in 1968 from the stools of school children in Norwalk, Ohio, who were suffering from GASTROENTERITIS. The virions are non-enveloped spherical particles containing a single protein. Multiple strains are named after the places where outbreaks have occurred. Norwalk Agent
D010125 Ostreidae A family of marine mollusks in the class BIVALVIA, commonly known as oysters. They have a rough irregular shell closed by a single adductor muscle. Oysters,Oyster
D012037 Refuse Disposal The discarding or destroying of garbage, sewage, or other waste matter or its transformation into something useful or innocuous. Waste Disposal, Solid,Disposal, Refuse,Disposal, Solid Waste,Disposals, Refuse,Disposals, Solid Waste,Refuse Disposals,Solid Waste Disposal,Solid Waste Disposals,Waste Disposals, Solid
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004196 Disease Outbreaks Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS. Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease
D004812 Epidemiologic Methods Research techniques that focus on study designs and data gathering methods in human and animal populations. Epidemiologic Method,Epidemiological Methods,Methods, Epidemiologic,Epidemiological Method,Method, Epidemiologic,Method, Epidemiological,Methods, Epidemiological
D005243 Feces Excrement from the INTESTINES, containing unabsorbed solids, waste products, secretions, and BACTERIA of the DIGESTIVE SYSTEM.
D005398 Fisheries Places for cultivation and harvesting of fish, particularly in sea waters. (from McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Fish Farms,Fish Hatcheries,Farm, Fish,Farms, Fish,Fish Farm,Fish Hatchery,Fishery,Hatcheries, Fish,Hatchery, Fish

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