Audience

Restaurants and food retailers that have received shipments of oysters harvested between January 16, 2023 and February 17, 2023, from Deep Bay subarea 14-8 landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153 and #1411195 in British Columbia, Canada.

Product

  • Oysters harvested between January 16, 2023, and February 17, 2023, from Deep Bay subarea 14-8 landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153 and #1411195 in British Columbia, Canada.
  • Packaged oysters include the harvest area information on their packaging.

Purpose

The FDA is advising consumers not to eat, and restaurants and food retailers not to sell, and to dispose of oysters that were harvested between January 16, 2023 and February 17, 2023, from Deep Bay subarea 14-8 landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153, and #1411195 in British Columbia, Canada. Consumers who purchased oysters after January 16, 2023 should check the packaging to see if they were harvested in Deep Bay from the affected landfiles of subarea 14-8, landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153, and #1411195. Contaminated shellfish can cause illness if eaten raw, particularly in people with compromised immune systems. Food contaminated with norovirus may look, smell, and taste normal. Consumers of these products who are experiencing symptoms of norovirus illness should contact their healthcare provider, who should report their symptoms to their local Health Department.

Summary of Problem and Scope

The U.S. Food and Drug Administration (FDA) is working with federal, state, and local officials, and with Canadian public health authorities on a norovirus outbreakExternal Link Disclaimer linked to raw oysters from British Columbia, Canada. Currently, illnesses have only been reported in Canada with no known cases of norovirus associated with these oysters reported in the U.S. The FDA is alerting restaurants, retailers and consumers because it is possible that states received these oysters through distribution to the U.S.

Retailers should not sell or serve raw oysters harvested from BC 14-8 landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153 and #1411195, with harvest dates starting as early as January 16, 2023, which will be printed on product tags.

Shellfish can cause illness if eaten raw, particularly in people with compromised immune systems. Food contaminated with norovirus may look, smell, and taste normal.

FDA Actions

The FDA is issuing this alert advising consumers to not eat, and restaurants and food retailers to not sell, oysters harvested between January 16, 2023 and February 17, 2023, from BC 14-8 landfiles #0278744, #0278742, #0278741, #0278740, #1414396, #0319716, #1414456, #1414457, #1400483, #1411206, #1407063, #1408485, #0278739, #0278737, #1403139, #0278734, #1411153 and #1411195, British Columbia, Canada due to possible norovirus contamination. The FDA is awaiting information on distribution of the oysters and will continue to monitor the investigation and provide assistance to state authorities as needed.

Symptoms of Norovirus

People of all ages can get infected and sick with norovirus. The most common symptoms of norovirus are diarrhea, vomiting, nausea, and stomach pain. Other symptoms include fever, headache, and body ache.

A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days.

If you have norovirus illness, you can feel extremely ill, and vomit or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses. Symptoms of dehydration include decrease in urination, dry mouth and throat, and feeling dizzy when standing up. Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy. 

If you think you or someone you are caring for is severely dehydrated, call your healthcare provider.

Recommendations for Restaurants and Retailers

Restaurants and retailers should not sell/serve the potentially contaminated oysters. Restaurants and retailers should dispose of any products by throwing them in the garbage or returning to their distributor for destruction.

Restaurants and retailers should also be aware that shellfish may be a source of pathogens and should control the potential for cross-contamination of food processing equipment and the food processing environment. They should follow the steps below:

  • Wash hands with warm water and soap following the cleaning and sanitation process.
  • Retailers, restaurants, and other food service operators who have processed and packaged any potentially contaminated products need to be concerned about cross-contamination of cutting surfaces and utensils through contact with the potentially contaminated products.
  • Retailers that have sold bulk product should clean and sanitize the containers used to hold the product.
  • Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.

Additional Information

An Introduction to Norovirus

The Centers for Disease Control and Prevention (CDC) estimates that noroviruses cause nearly 21 million cases of acute gastroenteritis annually, making noroviruses the leading cause of gastroenteritis in adults in the United States. [5, 9, 13, 31]  According to a relatively recent article in the New England Journal of Medicine, 

The Norwalk agent was the first virus that was identified as causing gastroenteritis in humans, but recognition of its importance as a pathogen has been limited because of the lack of available, sensitive, and routine diagnostic methods. Recent advances in understanding the molecular biology of the noroviruses, coupled with applications of novel diagnostic techniques, have radically altered our appreciation of their impact. Noroviruses are now recognized as being the leading cause of epidemics of gastroenteritis and an important cause of sporadic gastroenteritis in both children and adults. [16]

Of the viruses, only the common cold is reported more often than a norovirus infection—also referred to as viral gastroenteritis. [3]

Nature has created an ingenious bug in norovirus. [21] The round blue ball structure of norovirus is actually a protein surrounding the virus’s genetic material. [16, 33]  The virus attaches to the outside of cells lining the intestine, and then transfers its genetic material into those cells. [33] Once the genetic material has been transferred, norovirus reproduces, finally killing the human cells and releasing new copies of itself that attach to more cells of the intestine’s lining. [12, 15, 33]

Norovirus (previously called “Norwalk-like virus” or NLV) is a member of the family Caliciviridae. [15, 33]  The name derives from the Latin for chalice—calyx—meaning cup-like, and refers to the indentations of the virus surface. [33] The family of Caliciviridae consists of several distinct groups of viruses that were first named after the places where outbreaks occurred. [30] The first of these outbreaks occurred in 1968 among schoolchildren in Norwalk, Ohio. [16] The prototype strain was identified four years later, in 1972, and was the first virus identified that specifically caused gastroenteritis in humans. [16, 33] Other discoveries followed, with each strain name based on the location of its discovery—e.g., Montgomery County, Snow Mountain, Mexico, Hawaii, Parmatta, Taunton, and Toronto viruses. [15, 21] A study published in 1977 found that the Toronto virus was the second most common cause of gastroenteritis in children. [27] Eventually this confusing nomenclature was resolved, first in favor of calling each of the strains a Norwalk-like virus, and then simply, a norovirus – the term used today. [16, 33]

Humans are the only host of norovirus, and norovirus has several mechanisms that allow it to spread quickly and easily. [15] Norovirus infects humans in a pathway similar to the influenza virus’ mode of infection. [5, 15, 33] In addition to their similar infective pathways, norovirus and influenza also evolve to avoid the immune system in a similar way. [21] Both viruses are driven by heavy immune selection pressure and antigenic drift, allowing evasion of the immune system, which results in outbreaks. [21, 30] Norovirus is able to survive a wide range of temperatures and in many different environments. [15, 33] Moreover, the viruses can spread quickly, especially in places where people are in close proximity, such as cruise ships and airline flights, even those of short duration. [14, 15] As noted by the CDC in its Final Trip Report, 

noroviruses can cause extended outbreaks because of their high infectivity, persistence in the environment, resistance to common disinfectants, and difficulty in controlling their transmission through routine sanitary measures. [10]

Norovirus outbreaks can result from the evolution of one strain due to the pressure of population immunity. [12, 32] Typically, norovirus outbreaks are dominated by one strain, but can also involve more than one strain. [9, 11, 15] For example, some outbreaks associated with shellfish have been found to contain up to seven different norovirus strains. [30, 38] Swedish outbreak studies also reveal a high degree of genetic variability, indicating a need for wide detection methods when studying these outbreaks. [23]

By way of further example, in 2006, there was a large increase in the number of norovirus cases on cruise ships. Norovirus cases were increasing throughout Europe and the Pacific at the same time. [36] One issue with cruise ships is the close contact between people as living quarters are so close, and despite education efforts, there still seems to be a lack of public understanding regarding how the illness is spread. [7, 14] On the other hand, reporting occurs much more quickly in these situations because of the close proximity and concentration of illness, allowing for the quicker detection of outbreaks. [8] Cruise ship outbreaks often occur when new strains of norovirus are appearing, providing a good indicator system for new norovirus strains.  [7, 8] In this case, two new variants appeared within the global epidemic genotype, suggesting a strong pressure for evolution against the human immune system. [12] This points to the need for an international system of guidelines in tracing norovirus outbreaks. [36]

How is norovirus transmitted?

Norovirus causes nearly 60% of all foodborne illness outbreaks. [31] Norovirus is transmitted primarily through the fecal-oral route, with fewer than 100 norovirus particles needed to cause infection. [10, 15, 33] Transmission occurs either person-to-person or through contamination of food or water.  [1, 15, 33] CDC statistics show that food is the most common vehicle of transmission for noroviruses; of 232 outbreaks of norovirus between July 1997 and June 2000, 57% were foodborne, 16% were spread from person-to-person, and 3% were waterborne. [6, 31] When food is the vehicle of transmission, contamination occurs most often through a food handler improperly handling a food directly before it is eaten. [4, 9, 10]  

Infected individuals shed the virus in large numbers in their vomit and stool, shedding the highest amount of viral particles while they are ill.  [5, 33] Aerosolized vomit has also been implicated as a mode of norovirus transmission. [24] Previously, it was thought that viral shedding ceased approximately 100 hours after infection; however, some individuals continue to shed norovirus long after they have recovered from it, in some cases up to 28 days after experiencing symptoms. [28, 31, 35] Viral shedding can also precede symptoms, which occurs in approximately 30% of cases. [16] Often, an infected food handler may not even show symptoms. [9] In these cases, people can carry the same viral load as those who do experience symptoms. [5, 9, 33]

A Japanese study examined the ability of asymptomatic food handlers to transfer norovirus. Approximately 12% of asymptomatic food handlers were carriers for one of the norovirus genotypes. [28] This was the first report of norovirus molecular epidemiology relating asymptomatic individuals to outbreaks, suggesting that asymptomatic individuals are an important link in the infectivity pathway. [15, 28] Asymptomatic infection may occur because some people may have acquired immunity, which explains why some show symptoms upon infection and some do not. [16, 28, 33] Such immunity does not last long, though. [16, 21, 28] These discoveries reveal just how complicated the pathway of norovirus infection is, as well as how difficult it is to define the true period of infectivity. [30] Furthermore, it remains unclear why some people do not become sick with norovirus even when they are exposed. [16, 21, 32] Very little is known about the differences in hygiene practices, behaviors, and personal susceptibility between those who become infected and those who do not, which brings up the potential for more research. [17] Discrepancies exist in the published research about infective doses for norovirus, with earlier studies having used a much higher dose to trigger immune responses. [16]

Symptoms & Risks of Norovirus Infection

Norovirus illness usually develops 24 to 48 hours after ingestion of contaminated food or water. [5, 16, 33] Symptoms typically last a relatively short amount of time, approximately 24 to 48 hours. [5, 25] These symptoms include nausea, vomiting, diarrhea, and abdominal pain.  Headache and low-grade fever may also accompany this illness. [5, 25, 33]  People infected with norovirus usually recover in two to three days without serious or long-term health effects. [5, 25]

Although symptoms usually only last one to two days in healthy individuals, norovirus infection can become quite serious in children, the elderly, and immune-compromised individuals. [10, 18, 33] In some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immune-compromised adults in hospitals and nursing homes. [25, 30] In England and Wales, 20% of those over the age of 65 die due to infectious intestinal illness other than Clostridium difficile. [18] Recently, there have been reports of some long-term effects associated with norovirus, including necrotizing entercolitis, chronic diarrhea, and post-infectious irritable bowel syndrome, but more data is needed to support these claims. [37]

Diagnosing a Norovirus Infection

Diagnosis of norovirus illness is based on the combination of symptoms, particularly the prominence of vomiting, little fever, and the short duration of illness. [5, 25, 33] If a known norovirus outbreak is in progress, public health officials may obtain specimens from ill individuals for testing in a lab. [5, 9] These lab tests consist of identifying norovirus under an electron microscope. A reverse transcriptase polymerase chain reaction test (RT-PCR assay) also can detect norovirus in food, water, stool samples, and on surfaces. These tests isolate and replicate the suspected virus’ genetic material for analysis. [25, 33] An ELISA can also be performed, which detects antigens. They are easier to perform than RT-PCR, but less sensitive and can also result in many false negatives. [9, 11]

Treating a Norovirus Infection

There is no specific treatment available for norovirus. [16, 33] In most healthy people, the illness is self-limiting and resolves in a few days; however, outbreaks among infants, children, elderly, and immune-compromised populations may result in severe complications among those affected.  [16, 27, 30, 33] Death may result without prompt measures. [5, 16, 25, 33] The replacement of fluids and minerals such as sodium, potassium and calcium – otherwise known as electrolytes – lost due to persistent diarrhea is vital. This can be done either by drinking large amounts of liquids, or intravenously. [16, 25]

Recent research has looked into the potential for developing a norovirus vaccine. [9, 16, 37] Researchers indicate that coming up with a norovirus vaccine would be similar to vaccinating for influenza, by using screening in order to select for the most prevalent strains. This is a quite challenging process. [37] Other challenges include the fact that cell culture and small-animal models are limited, host pre-exposure histories are complicated, and there is always the potential for the evolution of novel immune escape variants, rendering the vaccine useless. [13, 33] Furthermore, scientists would likely face a lack of funding to develop a vaccine because vaccine development is expensive. [12, 21]

Preventing Norovirus Infection

Common settings for norovirus outbreaks include restaurants and events with catered meals (36%), nursing homes (23%), schools (13%), and vacation settings or cruise ships (10%). [6] Proper hand washing is the best way to prevent the spread of norovirus. [9, 17, 25]

The good news about norovirus is that it does not multiply in foods as many bacteria do. [5, 31, 33] In addition, thorough cooking destroys this virus.  [5, 25] To avoid norovirus, make sure the food you eat is cooked completely. [5, 9, 10] While traveling in in areas that have polluted water sources, raw vegetables should be washed thoroughly before being served, and travelers should drink only boiled drinks or carbonated bottled beverages without ice. [9, 16]

Shellfish (oysters, clams, mussels) pose the greatest risk and any particular serving may be contaminated with norovirus; there is no way to detect a contaminated oyster, clam, or mussel from a safe one. [5, 31] Shellfish become contaminated when their waters become contaminated—e.g., when raw sewage is dumped overboard by recreational or commercial boaters).  [19, 33] Shellfish are filter feeders and will concentrate virus particles present in their environment. With shellfish, only complete cooking offers reliable protection; steaming does not kill the virus or prevent its transmission. [19] Some researchers suggest that norovirus monitoring in shellfish areas could be a good preventive strategy as well. [22] Waterborne norovirus outbreaks are ubiquitous, but difficult to recognize. Improved analysis of environmental samples would have the potential to significantly improve the detection for norovirus in shellfish waters. [20]

Finally, and as briefly mentioned earlier, outbreaks of norovirus infections have become synonymous with cruise ships. [7, 8, 36] Healthcare facilities also experience a high incidence of norovirus outbreaks.  [6, 30, 35]The CDC has published information regarding the prevention of norovirus outbreaks on cruise ships and in healthcare facilities on its website. [6, 7] Once a case has occurred, even more stringent hygienic measures than normal are required in order to prevent an outbreak, particularly on an enclosed space such as a cruise ship. [17]

References

  1. American Public Health Association (APHA), Heymann, David L., editor, “Norovirus Infection,” in CONTROL OF COMMUNICABLE DISEASES MANUAL, pp. 227-29, (18th Ed. 2008).
  2. Antonio, J, et al., “Passenger Behaviors During Norovirus Outbreaks on Cruise Ships,” INTERNATIONAL SOCIETY OF TRAVEL MAGAZINE, Vol. 15, No. 3, pp. 172-176 (May-June 2008). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/18494694
  3. Benson, V. and Merano, M.A., “Current estimates from the National Health Interview Survey 1995,” VITAL HEALTH STATISTICS, SERIES 10 (Nat’l Center for Health Statistics 1998). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/9914773
  4. Cáceres, VM, et al., “A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff,” INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, Vol. 19, No. 3, pp. 162-7 (March 1998). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/9552183
  5. CDC, Norovirus:  Technical Fact Sheet, from Centers for Disease Control and Prevention Web site,http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm (last modified on August 24, 2011) (last checked on Jan. 3, 2012). 
  6. CDC, Norovirus in Healthcare Facilities Fact Sheet, released December 21, 2006, available through Centers for Disease Control and Prevention website, at http://www.cdc.gov/ncidod/dvrd/revb/gastro/downloads/noro-hc-facilities-fs-508.pdf (last checked on January 4, 2012).
  7. CDC, Facts about Norovirus on Cruise Ships, last updated July 20, 2009, available through the Centers for Disease Control and Prevention website, at http://www.cdc.gov/nceh/vsp/pub/Norovirus/Norovirus.htm (last checked on January 4, 2012). 
  8. CDC, “Outbreaks of Gastroenteritis Associated with Noroviruses on Cruise Ships – United States, 2002,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 51, No. 49, pp. 1112-15 (Dec. 13, 2002). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a2.htm
  9. CDC, “Updated Norovirus Outbreak Management and Disease Prevention Guidelines,” MORBIDITY AND MORTALITY WEEKLY REPORT, Vol. 60, Recommendations and Reports No. 3, pp. 1-15 (March 4, 2011). Full text available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6003a1.htm
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  17. Janneke, C, et al., “Enhanced Hygiene Measures and Norovirus Transmission during an Outbreak,” EMERGING INFECTIOUS DISEASES, Vol. 15, No., pp. 24-30 (Jan. 2009). Full text available online at http://wwwnc.cdc.gov/eid/article/15/1/08-0299_article.htm
  18. Harris, JP, et al., “Deaths from Norovirus among the Elderly, England and Wales,” EMERGING INFECTIOUS DISEASES, Vol. 14, No. 10, pp. 1548-1552 (Oct. 2008). Full text available online athttp://wwwnc.cdc.gov/eid/article/14/10/08-0188_article.htm
  19. Kirkland, KB, et al., “Steaming oysters does not prevent Norwalk-like gastroenteritis,” PUBLIC HEALTH REPORTS, Vol. 111, pp. 527-30 (1996). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1381901/pdf/pubhealthrep00045-0057.pdf
  20. Maunula, L, Miettinen, IT, and Bonsdorff, CH, “Norovirus Outbreaks from Drinking Water,” EMERGING INFECTIOUS DISEASES, Vol. 11, No. 11, pp. 1716-1721 (2005).  Full text available online at http://wwwnc.cdc.gov/eid/content/11/11/pdfs/v11-n11.pdf
  21. Lopman, Ben, Zambon, Maria, and Brown, David, “The Evolution of Norovirus, the ‘Gastric Flu,’” Public Library of Science: Medicine, Vol. 5, Issue 2, pp.187-189 (Feb. 2010). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235896/pdf/pmed.0050042.pdf
  22. Lowther, J, Henshilwood, K, and Lees DN, “Determination of Norovirus Contamination in Oysters from Two Commercial Harvesting Areas over an Extended Period, Using Semiquantitative Real-Time Reverse Transcription PCR,” JOURNAL OF FOOD PROTECTION, Vol. 71, No. 7, pp. 1427-1433 (2008). Abstract available online at http://www.ncbi.nlm.nih.gov/pubmed/18680943
  23. Lysen, M, et al., “Genetic Diversity among Food-Borne and Waterborne Norovirus Strains Causing Outbreaks in Sweden,” JOURNAL OF CLINICAL MICROBIOLOGY, Vol. 47, No. 8, pp. 2411-2418 (2009). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725682/?tool=pubmed
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  30. Said, Maria, Perl, Trish, and Sears Cynthia, “Gastrointestinal Flu: Norovirus in Health Care and Long-Term Care Facilities,” HEALTHCARE EPIDEMIOLOGY, vol. 47, pp. 1202-1208 (Nov. 1, 2008). Full text available online at http://cid.oxfordjournals.org/content/47/9/1202.full.pdf+html
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  36. Verhoef, L, et al., “Emergence of New Norovirus Variants on Spring Cruise Ships and Prediction of Winter Epidemics,” EMERGING INFECTIOUS DISEASES, Vol. 14, No. 2, pp. 238-243 (Feb. 2008). Full text available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600213/pdf/06-1567_finalR.pdf
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  38. Westrell T, et al., “Norovirus outbreaks linked to oyster consumption in the United Kingdom, Norway, France, Sweden and Denmark,”  EURO-SURVEILLANCE (European Communicable Disease Bulletin), Vol. 15, No. 12 (Mar. 25 2010). Full text available online at http://www.eurosurveillance.org/images/dynamic/EE/V15N12/art19524.pdf

Norovirus:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Norovirusoutbreaks. The Norovirus lawyers of Marler Clark have represented thousands of victims of Norovirus and other foodborne illness outbreaks and have recovered over $850 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Norovirus lawyers have litigated Norovirus cases stemming from outbreaks traced to a number of food products and restaurants.  

If you or a family member became ill with Norovirus after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Norovirus attorneys for a free case evaluation.

CDC is working with the U.S. Food and Drug Administration (FDA), the Texas Department of State Health Services, along with other state and local officials to investigate a multistate norovirus outbreak linked to raw oysters from harvest area TX 1, Galveston Bay, Texas.

Restaurants and food retailers should not serve raw oysters from harvest area TX 1, Galveston Bay, Texas, harvested between 11/17/2022 and 12/7/2022, which will be printed on product tags.

The FDA has confirmed that raw oysters harvested in area TX 1, Galveston Bay, Texas were potentially contaminated with norovirus and distributed to restaurants and retailers in Alabama (AL), Florida (FL), Georgia (GA), Louisiana (LA), Mississippi (MS) North Carolina (NC), Tennessee (TN) and Texas (TX). It is possible that additional states received these oysters through further distribution within the U.S.

The Texas Department of State Health Services and the Florida Department of Health notified the FDA of illnesses associated with eating raw oysters harvested from TX 1, Galveston Bay, Texas. On December 8, 2022, the Texas Department of State Health Services issued a recall on all oysters harvested between 11/17/2022 and 12/7/2022 from harvest area TX 1, Galveston Bay, Texas. FDA Advises Restaurants, Retailers and Consumers to Avoid Potentially Contaminated Oysters from Harvest Area TX 1, Texas | FDA They also informed the Interstate Shellfish Sanitation Conference who notified other member states. This resulted in other states initiating recall measures consistent with the Interstate Shellfish Sanitation Conference agreement.

As of December 15, 2022, 211 norovirus illnesses have been reported from 8 states. CDC is working with state and local partners to determine a more accurate number of illnesses in this outbreak and will update this number as more information is gathered.

Norovirus is the leading cause of foodborne illness in the United States. However, state, local, and territorial health departments are not required to report individual cases of norovirus illness to a national surveillance system. That’s why we may not know about many cases, especially if people do not go to a doctor’s office or hospital. Each year, there are about 2,500 reported norovirus outbreaks in the United States. Norovirus outbreaks occur throughout the year but are most common from November to April.

State and local public health officials are interviewing people about the foods they ate a day to four days before they got sick. In interviews, many of the sick people reported eating raw oysters.

State and local officials have collected information about the source of oysters from restaurants where sick people ate. FDA has confirmed that potentially contaminated raw oysters were harvested in area TX 1, Galveston Bay, Texas. The FDA and the states are conducting a trace forward investigation to determine where the raw oysters were distributed and to ensure they’re removed from the food supply.

This investigation is ongoing. CDC will update the public as more information is gathered.

Norovirus is transmitted primarily through the fecal-oral route, with fewer than 100 norovirus particles needed to cause infection. Transmission occurs either person-to-person or through contamination of food or water. CDC statistics show that food is the most common vehicle of transmission for noroviruses; of 232 outbreaks of norovirus between July 1997 and June 2000, 57% were foodborne, 16% were spread from person-to-person, and 3% were waterborne. When food is the vehicle of transmission, contamination occurs most often through a food handler improperly handling a food directly before it is eaten.

Humans are the only host of norovirus, and norovirus has several mechanisms that allow it to spread quickly and easily. Norovirus infects humans in a pathway like the influenza virus’ mode of infection. In addition to their similar infective pathways, norovirus and influenza also evolve to avoid the immune system in a similar way. Both viruses are driven by heavy immune selection pressure and antigenic drift, allowing evasion of the immune system, which results in outbreaks. Norovirus can survive a wide range of temperatures and in many different environments. Moreover, the viruses can spread quickly, especially in places where people are in proximity, such as cruise ships and airline flights, even those of short duration.

Infected individuals shed the virus in large numbers in their vomit and stool, shedding the highest number of viral particles while they are ill. Aerosolized vomit has also been implicated as a mode of norovirus transmission. Previously, it was thought that viral shedding ceased approximately 100 hours after infection; however, some individuals continue to shed norovirus long after they have recovered from it, in some cases up to 28 days after experiencing symptoms. Viral shedding can also precede symptoms, which occurs in approximately 30% of cases. Often, an infected food handler may not even show symptoms. In these cases, people can carry the same viral load as those who do experience symptoms.

Norovirus illness usually develops 24 to 48 hours after ingestion of contaminated food or water. Symptoms typically last a relatively short amount of time, approximately 24 to 48 hours. These symptoms include nausea, vomiting, diarrhea, and abdominal pain.  Headache and low-grade fever may also accompany this illness. People infected with norovirus usually recover in two to three days without serious or long-term health effects.

Although symptoms usually only last one to two days in healthy individuals, norovirus infection can become quite serious in children, the elderly, and immune-compromised individuals. In some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immune-compromised adults in hospitals and nursing homes. Recently, there have been reports of some long-term effects associated with norovirus, including necrotizing entercolitis, chronic diarrhea, and post-infectious irritable bowel syndrome, but more data is needed to support these claims.

Diagnosis of norovirus illness is based on the combination of symptoms, particularly the prominence of vomiting, little fever, and the short duration of illness. If a known norovirus outbreak is in progress, public health officials may obtain specimens from ill individuals for testing in a lab. These lab tests consist of identifying norovirus under an electron microscope. 

There is no specific treatment available for norovirus. In most healthy people, the illness is self-limiting and resolves in a few days; however, outbreaks among infants, children, elderly, and immune-compromised populations may result in severe complications among those affected. Death may result without prompt measures. The replacement of fluids and minerals such as sodium, potassium and calcium – otherwise known as electrolytes – lost due to persistent diarrhea is vital. This can be done either by drinking large amounts of liquids, or intravenously.

Norovirus: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Norovirusoutbreaks. The Norovirus lawyers of Marler Clark have represented thousands of victims of Norovirus and other foodborne illness outbreaks and have recovered over $850 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Norovirus lawyers have litigated Norovirus cases stemming from outbreaks traced to several food products and restaurants. 

If you or a family member became ill with Norovirus after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Norovirus attorneys for a free case evaluation.

CDC is working with the U.S. Food and Drug Administration (FDA), the Texas Department of State Health Services, along with other state and local officials to investigate a multistate norovirus outbreak linked to raw oysters from harvest area TX 1, Galveston Bay, Texas.

Restaurants and food retailers should not serve raw oysters from harvest area TX 1, Galveston Bay, Texas, harvested between 11/17/2022 and 12/7/2022, which will be printed on product tags.

The FDA has confirmed that raw oysters harvested in area TX 1, Galveston Bay, Texas were potentially contaminated with norovirus and distributed to restaurants and retailers in Alabama (AL), Florida (FL), Georgia (GA), Louisiana (LA), Mississippi (MS) North Carolina (NC), Tennessee (TN) and Texas (TX). It is possible that additional states received these oysters through further distribution within the U.S.

The Texas Department of State Health Services and the Florida Department of Health notified the FDA of illnesses associated with eating raw oysters harvested from TX 1, Galveston Bay, Texas. On December 8, 2022, the Texas Department of State Health Services issued a recall on all oysters harvested between 11/17/2022 and 12/7/2022 from harvest area TX 1, Galveston Bay, Texas. FDA Advises Restaurants, Retailers and Consumers to Avoid Potentially Contaminated Oysters from Harvest Area TX 1, Texas | FDA They also informed the Interstate Shellfish Sanitation Conference who notified other member states. This resulted in other states initiating recall measures consistent with the Interstate Shellfish Sanitation Conference agreement.

As of December 15, 2022, 211 norovirus illnesses have been reported from 8 states. CDC is working with state and local partners to determine a more accurate number of illnesses in this outbreak and will update this number as more information is gathered.

Norovirus is the leading cause of foodborne illness in the United States. However, state, local, and territorial health departments are not required to report individual cases of norovirus illness to a national surveillance system. That’s why we may not know about many cases, especially if people do not go to a doctor’s office or hospital. Each year, there are about 2,500 reported norovirus outbreaks in the United States. Norovirus outbreaks occur throughout the year but are most common from November to April.

State and local public health officials are interviewing people about the foods they ate a day to four days before they got sick. In interviews, many of the sick people reported eating raw oysters.

State and local officials have collected information about the source of oysters from restaurants where sick people ate. FDA has confirmed that potentially contaminated raw oysters were harvested in area TX 1, Galveston Bay, Texas. The FDA and the states are conducting a trace forward investigation to determine where the raw oysters were distributed and to ensure they’re removed from the food supply.

This investigation is ongoing. CDC will update the public as more information is gathered.

Norovirus:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Norovirus outbreaks. The Norovirus lawyers of Marler Clark have represented thousands of victims of Norovirus and other foodborne illness outbreaks and have recovered over $800 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Norovirus lawyers have litigated Norovirus cases stemming from outbreaks traced to a number of food products and restaurants. 

If you or a family member became ill with Norovirus after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Norovirus attorneys for a free case evaluation.

According to the Tazewell County Health Department (TCHD) Facebook page, in conjunction with state health officials, the TCHD has been monitoring an illness outbreak associated with Monical’s Pizza in Washington. To date, 3 laboratory-confirmed cases of norovirus infection have been identified. Dates of illness onset range from November 21 to November 26, 2022. An epidemiological investigation conducted by TCHD has implicated high-touch surfaces as the vehicle of transmission. TCHD is continuing to interview restaurant patrons who are reporting illness.The Centers for Disease Control and Prevention (CDC) estimates that noroviruses cause nearly 21 million cases of acute gastroenteritis annually, making noroviruses the leading cause of gastroenteritis in adults in the United States. Of the viruses, only the common cold, and now COVID-19, is reported more often than a norovirus infection—also referred to as viral gastroenteritis.

Norovirus is transmitted primarily through the fecal-oral route, with fewer than 100 norovirus particles needed to cause infection. Transmission occurs either person-to-person or through contamination of food or water. CDC statistics show that food is the most common vehicle of transmission for noroviruses; of 232 outbreaks of norovirus between July 1997 and June 2000, 57% were foodborne, 16% were spread from person-to-person, and 3% were waterborne. When food is the vehicle of transmission, contamination occurs most often through a food handler improperly handling a food directly before it is eaten.

Humans are the only host of norovirus, and norovirus has several mechanisms that allow it to spread quickly and easily. Norovirus infects humans in a pathway like the influenza virus’ mode of infection. In addition to their similar infective pathways, norovirus and influenza also evolve to avoid the immune system in a similar way. Both viruses are driven by heavy immune selection pressure and antigenic drift, allowing evasion of the immune system, which results in outbreaks. Norovirus can survive a wide range of temperatures and in many different environments. Moreover, the viruses can spread quickly, especially in places where people are in proximity, such as cruise ships and airline flights, even those of short duration.

Infected individuals shed the virus in large numbers in their vomit and stool, shedding the highest number of viral particles while they are ill. Aerosolized vomit has also been implicated as a mode of norovirus transmission. Previously, it was thought that viral shedding ceased approximately 100 hours after infection; however, some individuals continue to shed norovirus long after they have recovered from it, in some cases up to 28 days after experiencing symptoms. Viral shedding can also precede symptoms, which occurs in approximately 30% of cases. Often, an infected food handler may not even show symptoms. In these cases, people can carry the same viral load as those who do experience symptoms.

Norovirus illness usually develops 24 to 48 hours after ingestion of contaminated food or water. Symptoms typically last a relatively short amount of time, approximately 24 to 48 hours. These symptoms include nausea, vomiting, diarrhea, and abdominal pain.  Headache and low-grade fever may also accompany this illness. People infected with norovirus usually recover in two to three days without serious or long-term health effects.

Although symptoms usually only last one to two days in healthy individuals, norovirus infection can become quite serious in children, the elderly, and immune-compromised individuals. In some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immune-compromised adults in hospitals and nursing homes. Recently, there have been reports of some long-term effects associated with norovirus, including necrotizing entercolitis, chronic diarrhea, and post-infectious irritable bowel syndrome, but more data is needed to support these claims.

Diagnosis of norovirus illness is based on the combination of symptoms, particularly the prominence of vomiting, little fever, and the short duration of illness. If a known norovirus outbreak is in progress, public health officials may obtain specimens from ill individuals for testing in a lab. These lab tests consist of identifying norovirus under an electron microscope. 

There is no specific treatment available for norovirus. In most healthy people, the illness is self-limiting and resolves in a few days; however, outbreaks among infants, children, elderly, and immune-compromised populations may result in severe complications among those affected. Death may result without prompt measures. The replacement of fluids and minerals such as sodium, potassium and calcium – otherwise known as electrolytes – lost due to persistent diarrhea is vital. This can be done either by drinking large amounts of liquids, or intravenously.

Norovirus: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Norovirusoutbreaks. The Norovirus lawyers of Marler Clark have represented thousands of victims of Norovirus and other foodborne illness outbreaks and have recovered over $850 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Norovirus lawyers have litigated Norovirus cases stemming from outbreaks traced to several food products and restaurants. 

If you or a family member became ill with Norovirus after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Norovirus attorneys for a free case evaluation.

Monical’s Pizza at 6 Cherry Tree Shopping center in Washington, Illinois is currently closed due to an outbreak of an illness.

According to the Tazewell County Health Department, Monical’s was temporarily closed by the Illinois Department of Public Health (IDPH) due to an outbreak of a currently unknown foodborne illness. IDPH is currently working with the Tazewell County Health Department to identify the source.

155 people have currently reached out to the Tazewell County Health Department and reported symptoms of diarrhea and vomiting lasting 12 to 24 hours.

The health department is encouraging everyone to wash their hands and use hand sanitizer currently.

Anyone who ate at Monical’s since November 21st, and is experiencing symptoms, is encouraged to complete an online form.

The Tazewell County Health Department stated that Lab results related to this incident are expected Wednesday.

The McHenry County Department of Health is reporting its investigation into the recent gastrointestinal illness outbreak linked to D.C. Cobb’s, 1204 N. Green Street in McHenry, is closed.  
The outbreak investigation was launched after a cluster of illnesses was linked to the food establishment at the end of August. MCDH conducted a case-control study that identified 173 individuals who became ill after eating food from the restaurant. Norovirus was identified as the pathogen, but the investigation could not determine exactly how it was introduced into the facility. A complete report of the investigation is available at Communicable Diseases Data and Reports under Foodborne and Waterborne Illness Reports.

“Foodborne illness investigations are a top priority to protect the public’s health. The MCDH investigation team appreciates the cooperation from the public to bring this complex investigation to a close,” said Susan Karras, MCDH’s Director of Public Health Nursing. “The final report demonstrates the dedication and high level of work the MCDH team does every day to protect the public’s health in McHenry County.”

After MCDH staff conducted an inspection and provided corrective action, D.C. Cobb’s employees and management responded quickly, dramatically reducing the transmission of illness associated with the outbreak.

“The management of D.C. Cobb’s fully cooperated with the illness investigation team and continues to work with Division of Environmental Health staff to implement additional strategies to prevent future public health concerns,” said Patti Nomm, MCDH’s Director of Environmental Health.

Norovirus is a highly contagious virus that spreads quickly from person to person or through contaminated items, and it cannot be treated with antibiotics. Symptoms of norovirus include diarrhea, vomiting, nausea and stomach pain that usually last between 24 hours and 48 hours. Anyone with norovirus illness should stay home when sick and for 24 hours after experiencing vomiting or diarrhea.

Routinely cleaning and sanitizing kitchen utensils, counters and surfaces before preparing food can reduce the risk of norovirus. Good hygiene practices are equally important whether or not food is being prepared.

The McHenry County Department of Health is reporting its investigation into the recent gastrointestinal illness outbreak linked to D.C. Cobb’s, 1204 N. Green Street in McHenry, is closed.  

The outbreak investigation was launched after a cluster of illnesses was linked to the food establishment at the end of August. MCDH conducted a case-control study that identified 173 individuals who became ill after eating food from the restaurant. Norovirus was identified as the pathogen, but the investigation could not determine exactly how it was introduced into the facility. A complete report of the investigation is available at Communicable Diseases Data and Reports under Foodborne and Waterborne Illness Reports.

“Foodborne illness investigations are a top priority to protect the public’s health. The MCDH investigation team appreciates the cooperation from the public to bring this complex investigation to a close,” said Susan Karras, MCDH’s Director of Public Health Nursing. “The final report demonstrates the dedication and high level of work the MCDH team does every day to protect the public’s health in McHenry County.”

After MCDH staff conducted an inspection and provided corrective action, D.C. Cobb’s employees and management responded quickly, dramatically reducing the transmission of illness associated with the outbreak.

“The management of D.C. Cobb’s fully cooperated with the illness investigation team and continues to work with Division of Environmental Health staff to implement additional strategies to prevent future public health concerns,” said Patti Nomm, MCDH’s Director of Environmental Health.

Norovirus is a highly contagious virus that spreads quickly from person to person or through contaminated items, and it cannot be treated with antibiotics. Symptoms of norovirus include diarrhea, vomiting, nausea and stomach pain that usually last between 24 hours and 48 hours. Anyone with norovirus illness should stay home when sick and for 24 hours after experiencing vomiting or diarrhea.

Routinely cleaning and sanitizing kitchen utensils, counters and surfaces before preparing food can reduce the risk of norovirus. Good hygiene practices are equally important whether or not food is being prepared.

As of June 10, 2022, there have been 60 cases of norovirus and gastrointestinal illness reported in the following provinces: British Columbia (18), Alberta (12), Manitoba (19), and Ontario (11). Individuals became sick between mid-May and late-May 2022, and no deaths have been reported. Although not all cases of illness have been tested, laboratory testing has confirmed the presence of norovirus infection.

The CFIA is continuing its food safety investigation into the spot prawns associated with the illnesses under investigation. The CFIA has issued food recall warnings for several lot codes of spot prawns that are associated with the illnesses under investigation. Links to each food recall associated with this investigation can be found at the end of this public health.”

Norovirus:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Norovirus outbreaks. The Norovirus lawyers of Marler Clark have represented thousands of victims of Norovirus and other foodborne illness outbreaks and have recovered over $800 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Norovirus lawyers have litigated Norovirus cases stemming from outbreaks traced to a number of food products and restaurants.  

If you or a family member became ill with Norovirus after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Norovirus attorneys for a free case evaluation.

Summary

Public Health is investigating an outbreak of norovirus-like illness associated with vomiting, diarrhea, abdominal pain, and chills at IHOP #1755 in Seattle.

Illnesses

Since April 29, 2022, 5 people from 1 meal party reported becoming ill after eating food from IHOP on April 28, 2022. We have not identified any ill employees.

Public Health actions

Environmental Health Investigators visited the restaurant on May 4th, 2022. Investigators identified improper handwashing which is a risk factor known to contribute to the spread of norovirus-like illness. The restaurant closed on May 4, 2022, to complete a thorough cleaning and disinfection.

Environmental Health Investigators revisited the restaurant on May 5th and confirmed proper cleaning and disinfection was completed. The restaurant was reopened on May 5, 2022.

Investigators reviewed with restaurant management the requirement that ill staff are not allowed to work until they are symptom-free for at least 48 hours and provided education about preventing the spread of norovirus — including proper handwashing and preventing bare hand contact with ready-to-eat foods.

Laboratory testing

We do not have laboratory testing for the people who got sick. Often in norovirus outbreaks, no laboratory testing is done because people tend to get better within a day or two. Symptoms among those who got sick are suggestive of norovirus-like illness.