Search results for: norovirus

Norovirus is one of the most common causes of foodborne illness worldwide, and several factors contribute to its prevalence:

Only a small number of virus particles (as few as 18) are needed to cause infection, making it extremely easy to contract.

Norovirus spreads quickly through contaminated food, water, surfaces, and direct person-to-person contact. It can remain viable on surfaces for extended periods, allowing it to infect others.

Consuming foods or beverages contaminated with Norovirus is a common way of transmission, especially if food handlers are infected and practice poor hygiene.

Close contact, especially in crowded environments such as schools, cruise ships, hospitals, and nursing homes, facilitates transmission.

Vomiting caused by Norovirus can aerosolize the virus, which can then settle on surfaces or be inhaled, further spreading the illness.

Norovirus is resistant to common disinfectants and can survive on surfaces for prolonged periods. This makes it difficult to eradicate from contaminated environments.

It can remain infective in a wide range of temperatures and conditions, from refrigerated foods to hot and humid climates.

After infection, immunity to Norovirus is not long-lasting and varies among individuals, meaning people can be reinfected multiple times during their lifetime.

There are many genetically different strains of Norovirus, which complicates the development of long-term immunity and effective vaccines.

Symptoms typically develop 12 to 48 hours after exposure, allowing the virus to spread quickly before people even realize they are infected.

While symptoms typically last 1 to 3 days, individuals can still shed the virus and potentially infect others for several days after recovery.

Regular and thorough handwashing with soap and water is one of the most effective ways to prevent infection.

Ensuring food is cooked properly and handled with appropriate hygiene can minimize the risk of contamination.

Regular cleaning and disinfecting of surfaces, especially in high-risk environments, can help reduce virus spread.

Given these factors, Norovirus continues to be a ubiquitous and challenging pathogen to control, leading to its widespread and common occurrence as a foodborne illness.

The Pierce County Department of Health announced that it was working with Harvest Buffet, 3121 S. 38th St., Tacoma, following a suspected norovirus outbreak. We closed the restaurant around 10 a.m. Thursday, Oct. 10, and will reopen it after at least 24 hours. Staff will clean and sanitize the restaurant and take all steps necessary to ensure the public is no longer at risk.

Multiple people in the same group but from different households reported norovirus-like symptoms on Wednesday after they ate at the restaurant Sunday, Oct. 6. The meal was their only common source of food.

If you ate at Harvest Buffet recently and became ill, contact us at food@tpchd.org, report online, or (253) 649-1696. 

Norovirus is highly contagious. It can cause diarrhea and vomiting, often at the same time. Symptoms typically last a day or two. It is the same virus often related to cruise ship outbreaks.

In addition to cleaning and sanitizing the restaurant, staff will throw out all ready-to-eat foods like vegetables, bread, and cheese.

Cleaning for norovirus

Clean vomit or diarrhea accidents immediately.

Step 1. Remove vomit or poop.

  • Pick up the chunks with paper towels or other disposable material. Wear disposable gloves if available. 
  • Soak up liquids with absorbent materials. Use kitty litter or dry oatmeal for carpeted areas.
  • Double bag and discard.
  • Do not use a vacuum cleaner.

Step 2. Sanitize areas where vomit or poop was present, as well as bathroom surfaces and other things you frequently touch. 

  • Disinfect hard surfaces using 1 2/3 cups of household bleach per gallon of water. Allow for 1 minute of contact time.
  • Sanitize all handles and knobs in your house with the bleach solution.
  • Linens (including clothing, towels, napkins): Wash separately in hot water and dry on high.
  • Steam clean carpets using the highest setting for heat.
  • Avoid cross-contamination (use separate sanitation cloths for bathroom and other surfaces).
  • Clean and disinfect all containers used (e.g., buckets).

Handwashing

Wash hands often with soap and warm water for at least 20 seconds. Especially after cleaning, restroom use, and before eating.

If you ate at Harvest Buffet and became ill, contact the Health Department at food@tpchd.org, report online, or call (253) 649-1696.

Stoneburner_FlameLogo_RGB

Summary, posted September 12, 2024

Public Health is investigating an outbreak of norovirus-like sickness associated with Stoneburner restaurant in Seattle. We identified multiple people who reported symptoms consistent with norovirus after eating food and drinks at the restaurant. Norovirus is a very common cause of gastrointestinal (stomach) sickness. Symptoms include vomiting, diarrhea, abdominal pain, and chills. Norovirus can spread very easily through contaminated food, surfaces, and from person to person.

This investigation is ongoing.

llnesses

On August 20, 2024, we learned of seven customers who became sick after eating food and drinks from Stoneburner restaurant on August 11 and August 14. We later found that at least two restaurant staff were sick with symptoms consistent with norovirus around this time. No restaurant staff worked while having vomiting or diarrhea, but it’s possible someone was contagious without knowing it. People can be contagious but have very mild or no symptoms at all.

Public Health actions

On August 21, 2024, we closed Stoneburner restaurant so they could do a thorough cleaning and disinfection. We then visited the restaurant on August 22 to make sure they did that cleaning. During this visit, we also learned that restaurant staff had symptoms of norovirus on or before the sick customers’ meal dates. We told restaurant management that staff who are sick with norovirus cannot work until they have no symptoms for at least 48 hours. We also gave them information about how to stop the spread of norovirus in their restaurant — including correct handwashing and using gloves (no bare hand contact) with ready-to-eat foods.

We will revisit the restaurant in mid-September to make sure they continue to follow food safety practices that include correct cleaning and disinfection.

Laboratory testing

We do not have laboratory testing for the people who got sick, which is not unusual for illnesses like this that don’t last very long. Symptoms among those who got sick are like norovirus, but other causes could not be ruled out.

norovirus

Summary
Public Health investigated an outbreak of norovirus associated with Sammamish Cafe & Spirits. We identified multiple sick restaurant staff who reported symptoms consistent with norovirus. Norovirus can spread through multiple contaminated food items, environmental surfaces, and from person to person. This outbreak appears to be over.

Illnesses
Since July 6, 2024, five people have reported becoming sick after eating food and drinks at Sammamish Cafe & Spirits on July 2nd and July 3rd, 2024. One additional person, who lives in the same home as someone who became sick, developed symptoms but did not eat food or drinks from the restaurant. This person likely became sick from the sick person they live with. Everyone had one or more symptoms consistent with norovirus illness, including vomiting, diarrhea, abdominal pain, and chills. We found multiple sick restaurant staff who reported symptoms consistent with norovirus dating back to July 4, 2024.

Public Health actions

After the initial reports of illness, Environmental Health Investigators closed the restaurant on July 12, 2024. The restaurant was directed to do a thorough cleaning and disinfection because we suspected norovirus, a very common cause of gastrointestinal illness.

We visited the restaurant on July 15, 2024, to assess the cleaning and disinfection performed by the restaurant. We also reviewed restaurant staff health histories and found several restaurant staff who reported symptoms consistent with norovirus from July 4 through July 12, 2024. None of these restaurant staff worked while sick. No restaurant staff reported being sick with vomiting or diarrhea in the two weeks before the sick customers ate at the restaurant. We reviewed with restaurant management the requirement that sick 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.

After we confirmed the restaurant had conducted a thorough cleaning and disinfection, they were allowed to reopen on July 15, 2024. Environmental Health Investigators will revisit the restaurant within two weeks to ensure proper compliance with food handling practices and confirm proper cleaning and disinfection is in place.

Laboratory testing

Three of the six people who became sick underwent testing. Two of the people tested positive for norovirus.

oysteralert-june2024-1-redacted

Restaurants and food retailers in Hawaii (HI) and California (CA) that have recently purchased individually quick frozen (IQF) oysters, product of Central Fisheries Co., LTD, Republic of Korea (ROK) (KR 6 SP), harvested on 2/28/2023, from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C-20230228.

Consumers in HI and CA who have recently purchased IQF oysters, product of Central Fisheries Co., LTD, ROK (KR 6 SP), harvested on 2/28/2023, from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C-20230228.

The implicated products include certain IQF oysters, product of Central Fisheries Co., LTD, ROK (KR 6 SP), harvested on 2/28/2023 from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C-20230228. The oysters were distributed to restaurants and retailers in HI and CA. The oysters may have been distributed to other states as well.

The photos below are included as an example of product labeling from IQF oysters, product of Central Fisheries Co., LTD, ROK (KR 6 SP), harvested on 2/28/2023, from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C-20230228:

The FDA is advising restaurants and food retailers not to serve or sell and to dispose of, and consumers not to consume IQF oysters, product of Central Fisheries Co., LTD, ROK (KR 6 SP), harvested on 2/28/2023 from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C- 20230228, and shipped to distributors in HI and CA because they may be contaminated with norovirus.

Oysters contaminated with norovirus can cause illness if eaten, and potentially severe illness in people with compromised immune systems. Food containing norovirus may look, smell, and taste normal. Consumers of these products who are experiencing symptoms of illness should contact their healthcare provider and report their symptoms to their local Health Department. Diarrhea, abdominal cramps, nausea, vomiting, and fever may be associated with gastroenteritis infections caused by this organism.

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.

On 6/13/2024, the Hawaii Department of Health advised the FDA of an outbreak of norovirus illnesses associated with the consumption of certain IQF oysters from Central Fisheries Co., LTD (KR-6-SP), ROK, harvested on 2/28/2023 from Designated Area No. 2, with use by date of 2/28/2025 and Lot Code # C-20230228.

On 6/19/2024, the ROK advised the FDA that Central Fisheries Co., LTD is voluntarily recalling certain oysters due to possible norovirus contamination. The recall includes IQF oysters, product of Central Fisheries Co., LTD, ROK (KR-6-SP), harvested on 2/28/2023 from Designated Area No. 2, with a use by date of 2/28/2025, and Lot Code # C-20230228.

The Central Fisheries Co., LTD oysters were distributed to restaurants and retailers in HI and CA. The oysters may have been distributed to other states as well.

The FDA is issuing this alert advising restaurants and food retailers not to serve or sell and to dispose of, and consumers not to eat IQF oysters, product of Central Fisheries Co., LTD, ROK (KR 6 SP), harvested on 2/28/2023 from Designated Area No. 2, with a use by date of 2/28/2025 and Lot Code # C-20230228 due to possible norovirus contamination.

FDA is awaiting further information on distribution of the implicated oysters and will continue to monitor the investigation and aid state authorities as needed. As new information becomes available, the FDA will update the safety alert.

Restaurants and retailers should not serve or sell the potentially contaminated oysters. Restaurants and retailers should dispose of any products by throwing them in the garbage or returning them 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.

San Diego County health officials have linked 11 confirmed and probable cases of norovirus illness to frozen oysters imported from South Korea. 

Customers who ate the oysters at 100s Seafood Grill Buffet in Mission Valley between March 31 and April 1 became sick, one person went to the emergency department.  

The U.S. Food & Drug Administration (FDA) is now linking the San Diego illnesses to quick-frozen oysters.  

The FDA is cautioning all restaurants and stores that sell frozen, raw half-shell oysters to check their freezers and verify the origin of their oysters.  To identify their origin, look for shellfish tag or label information. Oysters processed by JBR (KR 15 SP) in Tongyeongsi, Republic of Korea on 11/27/2023, 1/4/2024 and 2/15/2024 with lot numbers B231126, B240103 and B240214 should not be consumed. The County of San Diego is working with the California Department of Public Health to identify other potential retailers in our region. 

These items may be labeled “Amazing Sea Brand.” 

If you have consumed these oysters and feel ill, it is important to see your doctor for evaluation,” said Wilma Wooten, M.D., M.P.H., County Public Health Officer. “If you or someone you live with is sick with norovirus, it is important to wash your hands often and clean common areas to prevent spreading the infection.” 

This comes four months after County of San Diego health officials linked 41 confirmed and probable cases of norovirus to raw oysters imported from a specific harvest location in Northwest Mexico. 

People infected with norovirus generally develop nausea, vomiting, diarrhea, stomach cramps, fever and body aches approximately 12 to 48 hours after consuming contaminated foods. The illness typically lasts for one to three days. The vomiting and diarrhea can lead to dehydration requiring medical attention, especially in young children, older adults and people with other illnesses.   

The County’s Epidemiology Program and Department of Environmental Health and Quality are working closely with California Department of Public Health, including the Shellfish Program, to continue investigating illnesses associated with oysters.   

To report illness to the County after dining out or purchasing from wholesale food locations call (858) 505-6814, or email fhdepi@sdcounty.ca.gov.

Key Findings:

• A confirmed case for this outbreak was an individual who ate at Sushi Nine between 11/28/23 and the restaurant closing on 12/5/23, reported having symptoms of norovirus (nausea, vomiting, diarrhea, abdominal pain, fever, headaches, body aches) within 3 days of eating at Sushi Nine, and had a laboratory test result that was positive for norovirus.

• A probable case for this outbreak was an individual who ate at Sushi Nine between 11/28/23 and the restaurant closing on 12/5/23, reported having symptoms of norovirus (nausea, vomiting, diarrhea, abdominal pain, fever, headaches, body aches) within 3 days of eating at Sushi Nine but did not have a laboratory test positive for norovirus.

• 263 individuals were investigated during this outbreak. Out of 263:

– 57 were not included in the case counts because their date for eating at Sushi Nine and/or illness onset date were unknown, or their dates were outside of the appropriate range.

– 203 were probable cases.

– 3 were confirmed cases.

• Three days was chosen because the typical incubation period for norovirus is 12 to 48 hours after consumption. Allowing for a third day accounted for anyone who ate or got sick late in the evening, shortly before or after midnight.

• Most commonly occurring symptoms among cases were nausea, vomiting, diarrhea, fever, abdominal pain, headaches, and body aches.

Initial Stages of Investigation

• Around 4 PM on Friday, December 1, 2023, Wake County Environmental Health Services (EHS) received a complaint from a parent regarding their adult child and child’s friend going to Sushi Nine the evening prior (November 30, 2023) and becoming sick overnight with nausea, vomiting, and diarrhea.

• When EHS staff talked to a manager at Sushi Nine shortly after receiving the complaint, the manager reported two other customers had called the restaurant on December 1 also reporting illness. At this time, all customers who had reported illness had consumed the spicy tuna salad, and the manager was concerned about the tuna and discarded all tuna; however, the outbreak continued, and later illness reports came from individuals who ate other menu items that did not contain tuna.

• After first talking with the manager, the restaurant manager interviewed all employees to determine if they were potentially sick when working. Two employees reported being sick after working but had not returned to work at that time since developing symptoms. No employees reported being sick while working. The manager also recalled an incident where a woman and a child used the restrooms on the afternoon of November 30 and left quickly afterwards. Evidence of diarrhea was then found on the walls and floors in two of the three restrooms (the women’s and family ones). Information on how this was cleaned was provided to Environmental Services. This was initially an incident of interest but later determined that it would not account for individuals who had already reported being sick on November 29 and 30.

• Additional complaints were received in the following days by both EHS and the Wake County Health and Human Services Communicable Disease (CD) staff through the foodborne illness web submit form.

• By Monday, December 4, 2023, the count of complaints was up to 11. Wake County EHS and CD staff were reaching out to each individual and interviewing those they got in contact with.

• The first confirmed case had a lab test positive for norovirus collected on December 3, and the second confirmed case had a lab result positive for norovirus on December 4.

• New complaints continued to be reported and on December 5, the restaurant decided to close early after discussions with EHS.

• The restaurant remained closed December 6 and 7 and re-opened on December 8. During this time, they performed deep-cleaning and disinfecting of all areas of the restaurant.

• New complaints continued to be reported during this time from those who ate at Sushi Nine on 11/28 through the closure on 12/5 and developed symptoms of norovirus shortly after.

• The third confirmed case had a positive lab result for norovirus that was collected on December 6.

• The number of complaints grew quickly after WRAL published an initial news story on Thursday, December 7 and when additional articles and news stories were published by other news outlets after that.

• From the start of the outbreak until it was declared over, Wake County staff recorded and interviewed, or attempted to interview, 263 complainants.

Laboratory

Norovirus (GI/GII) was detected in three stool samples through PCR testing. These samples were collected from individuals seeking healthcare at emergency departments, and the labs were processed by those hospital systems.

Investigation Findings

Following the identification or notification of potential cases, Wake County CD nurses conducted inquiries with those individuals regarding when they visited Sushi Nine, when they developed symptoms, what they ate during their visit, other aspects of their visit to Sushi Nine, their symptoms, and if they have sought healthcare. Copies of the three lab results were uploaded into the outbreak’s event ID in the North Carolina Electronic Disease Surveillance System (NCEDSS) but no IDs were created for the cases (norovirus, by law, is not a reportable disease in North Carolina).

The Wake County epidemiology team examined the potential cases linked to the outbreak and analyzed the menu items reported to have been consumed at Sushi Nine by the individuals affected. A list of the most frequently reported menu items is included at the end of this report in Appendix A. Most of the items on the restaurant’s menu were reported as consumed by an affected individual at least once. Additionally, no common ingredient was found. A large portion of the most frequently reported menu items consumed contained tuna and/or avocado but many didn’t include either of those items. Wake County investigated all potential sources of exposure. The investigation did not point to a specific source of contamination, which is common in norovirus investigations. The epidemiology team periodically analyzed the available data while the outbreak was still on-going to provide summaries for those involved from Wake County, in addition to providing this final analysis.

Food Safety Investigation

Wake County Environmental Health Services (EHS) received the first complaint related to this outbreak shortly after 4 PM on Friday 12/1/2023. The following is a summary of EHS’ investigation and visits to the restaurant.

Friday, December 1, 2023 (after receiving initial complaint):

• EHS spoke with a manager of the restaurant regarding employee health, bare-hand contact, handwashing, other complaints the restaurant had received, details of the complaint (food consumed, symptoms, date and time of consumption).

• The manager thought the trimmings from the spicy tuna salad could be a suspect food, so the manager discarded all opened tuna and began using new packages of tuna for the sashimi and spicy tuna salad.

• EHS and the manager also discussed employee illness reporting requirements, handwashing, glove use, and more.

Monday, December 4, 2023:

• Complaints that were received by EHS over the weekend were processed and EHS contacted complainants to determine information such as when they ate at Sushi Nine, what foods were consumed, when their symptoms began, and other relevant information.

• EHS informed Wake County Communicable Disease (CD) staff of the complaints received by EHS and sent information from complainant interviews to the restaurant manager and CD staff.

• Sushi Nine management implemented a temporary policy to discard all leftovers at the end of each day’s operation as an extra precaution.

Tuesday, December 5, 2023:

• Complaints continued to be received by Wake County EHS and CD staff.

• An EHS staff member visited the restaurant reviewed the norovirus sections of employee health policy and norovirus event clean-up guidance with staff.

• The manager interviewed employees per employee health policy, and two employees reported feeling ill with similar symptoms as the complainants after working shifts at Sushi Nine (but as of 12/5/2023 had not worked since becoming ill on 11/30 and either 12/2 or 12/3)

• The manager informed EHS that there was a customer diarrhea event on 11/30/23 at 2:30pm in 2 customer restrooms (described in more detail in Initial Stages of the Investigation section).

• A letter from Wake County’s Environmental Health and Safety manager was emailed to the restaurant manager to discuss closure of the restaurant. The restaurant voluntarily closed early at 8:20 PM on 12/5/2023 to perform detailed cleaning and disinfecting.

Wednesday, December 6, 2023:

• EHS informed the restaurant manager that complaints of customers who ate on 12/4/2023 (Monday) were being received.

• The manager sent videos of major facility cleaning taking place, including moving the cookline equipment, clearing the serving areas, disinfection with chlorine, and more. EHS staff communicated with the manager about where and how to clean and disinfect.

Thursday, December 7, 2023:

• EHS staff visited the restaurant to verify cleaning and disinfection was performed per the guidance provided by EHS, as well as meet with the restaurant manager.

• Additional guidance and instruction was given on employee health and handwashing to the employees through materials translated from English to Spanish. However, four languages are spoken by employees- Thai, Spanish, Korean, and English.

Friday, December 8, 2023:

• The restaurant re-opened on 12/8/2023. 

Monday, December 11 to Friday, December 15, 2023:

• EHS staff visited the restaurant again on Monday 12/11; this visit entailed meeting with the restaurant operators and providing instruction on handwashing, norovirus transfer, and diarrhea and vomit cleanup procedures. It was noted that chlorine disinfectant is being used on dining room surfaces each night.

• On 12/12, EHS staff updated the restaurant manager on the actions CD and EHS staff had taken, including the continuing investigation of complaints that had eaten at the restaurant before the closure on 12/5.

• On 12/14, EHS staff visits the restaurant; during this visit, the staff member communicated with the manager on approved disinfectants, observed proper handwashing practices and disinfectant use, and discussed relocating the handwash soap dispensers to facilitate handwashing in approved locations.

• On 12/15, EHS staff informed the restaurant manager that the outbreak was declared over on 12/11 due to 2 incubation periods passing without new cases. Additionally, EHS staff continued discussion with the manager on the importance of handwashing and adherence to the employee health policy took place as well.

Conclusion

The last reported case in this outbreak had a symptom onset date of 12/7/2023. The outbreak was declared over as of 12/11/2023 because twice the incubation period for norovirus is 96 hours (4 days). There have been no additional cases identified since that time. Norovirus is a highly contagious virus usually transmitted from having direct contact with someone infected, consuming contaminated food or water, or touching contaminated surfaces and then putting your unwashed hands in your mouth. While many potential sources were identified during the investigation of this outbreak, no definitive source was determined.

What worked well?

• Collaboration between Wake County’s CD, Epidemiology, and EHS programs, as well as NCDHHS.

• Thoroughly investigating the implicated facility promptly to inform and educate them and prevent future infections.

• The facility voluntarily closing early on 12/5/2023 and remaining closed to perform thorough cleaning and disinfection until 12/8/2023. No cases reported eating at Sushi Nine since the re-opening on 12/8/2023.

Challenges

• Difficulty identifying an exact cause (either ill staff or food source).

• Lack of complete information for possible cases; this was due to several reasons, but some included one person reporting for a group and not having contact information for the additional individuals and/or the additional individuals not answering or returning calls.

• Individuals having difficulty recalling what they ate; some individuals could not recall the menu item names and listed one of the ingredients in it but not enough to narrow down to the specific item (an example would be saying they had one of the sushi rolls that has salmon and multiple rolls on the menu contain salmon).

Recommendations

• Wash hands often with soap and water for at least 20 seconds. Hand sanitizer does not work well against norovirus.

• Handle and prepare food safely by washing fruits and vegetables well, cooking oysters or shellfish thoroughly and routinely cleaning and sanitizing kitchen utensils, counters, and surfaces.

• Avoid preparing or handling food when sick; wait at least two days after symptoms subside before preparing food or providing healthcare to others.

• Clean and disinfect surfaces often, especially when someone has been sick; wash clothes or linens immediately if someone has been sick on them.

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Audience

Restaurants and food retailers in Connecticut (CT), Florida (FL), Georgia (GA), Maine (ME), Maryland (MD), Massachusetts (MA), Minnesota (MN), New Jersey (NJ), Ohio (OH), Rhode Island (RI), South Carolina (SC) and Texas (TX) that have recently purchased oysters from Norm Bloom and Son (CT-069-SS, AQ), harvested from Westport, CT, lot 207, with the harvest date 2/20/2024.

Consumers in CT, FL, GA, MA, MD, ME, MN, NJ, OH, RI, SC, and TX who have recently purchased oysters from Norm Bloom and Son (CT-069-SS, AQ), harvested from Westport, CT, lot 207, with the harvest date 2/20/2024.

Product

Recalled oysters are from Norm Bloom and Son (CT-069-SS, AQ), harvested from Westport, CT, lot 207, with the harvest date 2/20/2024. The oysters were distributed to restaurants and retailers in CT, FL, GA, MA, MD, ME, MN, NJ, OH, RI, SC, and TX, and may have been distributed to other states as well.

Purpose

The FDA is notifying restaurants, food retailers, and consumers that the Connecticut Department of Agriculture, Bureau of Aquaculture is conducting a recall of oysters harvested by Norm Bloom and Son (CT-069-SS, AQ) from Westport, CT, lot 207, with the harvest date 2/20/2024, because they are associated with a norovirus outbreak in Minnesota and may be contaminated with norovirus. The FDA is advising restaurants and food retailers not to serve or sell and consumers not to eat the recalled oysters.

Shellfish contaminated with norovirus can cause illness if eaten, and potentially severe illness in people with compromised immune systems. Food containing norovirus may look, smell, and taste normal. Consumers of these products who are experiencing symptoms of illness should contact their healthcare provider and report their symptoms to their local Health Department. Diarrhea, abdominal cramps, nausea, vomiting, and fever may be associated with gastroenteritis infections caused by this organism.

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

Summary of Problem and Scope

The Connecticut Department of Agriculture, Bureau of Aquaculture is conducting a recall of oysters from Norm Bloom and Son (CT-069-SS, AQ), harvested from Westport, CT, lot 207, with the harvest date 2/20/2024, because they are associated with a norovirus outbreak in Minnesota and may be contaminated with norovirus. The oysters were distributed to restaurants and retailers in CT, FL, GA, MA, MD, ME, MN, NJ, OH, RI, SC, and TX, and may have been distributed to other states as well. The FDA is advising consumers not to eat, and restaurants and food retailers not to sell, and to dispose of these oysters.

Contaminated oysters 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.

FDA Actions

The FDA is sharing the notice of the CT oyster recallExternal Link Disclaimer and advising consumers not to eat, and restaurants and food retailers not to sell, oysters from Norm Bloom and Son (CT-069-SS, AQ), harvested from Westport, CT, lot 207, with the harvest date 2/20/2024, and distributed to restaurants and retailers in  CT, FL, GA, MA, MD, ME, MN, NJ, OH, RI, SC, and TX. The FDA is awaiting information on further interstate distribution of the oysters and will continue to monitor the investigation and provide assistance to state authorities as needed.

Recommendations for Restaurants and Retailers

Restaurants and retailers should not serve or sell the potentially contaminated oysters. Restaurants and retailers should dispose of any products by throwing them in the garbage or returning them 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.
Screenshot 2024-02-24 at 12.20.49 PM

Norovirus, the extremely contagious illness that causes vomiting and diarrhea, has surged in the Northeast region of the United States in the past few weeks, according to recent data from the Centers for Disease Control and Prevention (CDC).1

Centers for Disease Control and Prevention. Norovirus regional trends.

While surveillance data show an increase in positive test results nationwide—as is typical for norovirus during the winter months—northeastern states have been hit especially hard, with a three-week average of 13.7% for positive norovirus tests. Those tests have held above a 10% positive rate since December 2023.

Other U.S. regions have also seen an uptick in norovirus illnesses, just at lower rates. For the past three weeks, southern states have seen positive test rate of about 9.4%, the Midwest is at 10%, and western states have seen a 12.6% positive rate.

What is 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. 

Nature has created an ingenious bug in norovirus. The round blue ball structure of norovirus is a protein surrounding the virus’s genetic material. The virus attaches to the outside of cells lining the intestine, and then transfers its genetic material into those cells. 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.

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. 

How is Norovirus transmitted?

Norovirus causes nearly 60% of all foodborne illness outbreaks. 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.

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.

What are the Symptoms & Risks of a Norovirus Infection?

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.

How do you Diagnose 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.  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. 

How do you Treat a Norovirus Infection?

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.

How do you Prevent a 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%). Proper hand washing is the best way to prevent the spread of norovirus. 

Shellfish (oysters, clams, mussels) pose the greatest risk and any serving may be contaminated with norovirus; there is no way to detect a contaminated oyster, clam, or mussel from a safe one.  Shellfish become contaminated when their waters become contaminated—e.g., when raw sewage is dumped overboard by recreational or commercial boaters). 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. 

References

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Audience

  • Restaurants and food retailers in California that have recently purchased oysters harvested in Baja California, Mexico from Acuacultura Integral De Baja California SA de CV – MX 4 SS harvested on 12/15/2023, 12/16/2023, 12/19/2023, 12/23/2023, or 12/29/2023.
  • Consumers in California who have recently purchased oysters harvested in Baja California, Mexico from Acuacultura Integral De Baja California SA de CV – MX 4 SS harvested on 12/15/2023, 12/16/2023, 12/19/2023, 12/23/2023, or 12/29/2023.  

Product

  • Certain oysters from Baja California, Mexico from Acuacultura Integral De Baja California SA de CV – MX 4 SS from harvest area Laguna Manuela, B.C., Mexico harvested on 12/15/2023, 12/16/2023, or 12/23/2023 or Laguna De Guerrero Negro, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, 12/19/2023, or 12/29/2023. The oysters were distributed to restaurants and retailers in California and may have been distributed to other states as well. 

The following product tags are provided to be representative of labeling that would accompany the implicated oysters and could include the various harvest dates as identified in this safety alert.

Purpose

The FDA is advising restaurants and food retailers not to serve or sell and to dispose of and consumers not to eat oysters from Baja California, Mexico from Acuacultura Integral De Baja California SA de CV  – MX 4 SS from harvest area Laguna Manuela, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, or 12/23/2023 or Laguna De Guerrero Negro, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, 12/19/2023 or 12/29/2023 and shipped to distributors in California because they may be contaminated with norovirus.

Oysters contaminated with norovirus can cause illness if eaten, and potentially severe illness in people with compromised immune systems. Food containing norovirus may look, smell, and taste normal. Consumers of these products who are experiencing symptoms of illness should contact their healthcare provider and report their symptoms to their local Health Department. Diarrhea, abdominal cramps, nausea, vomiting, and fever may be associated with gastroenteritis infections caused by this organism.

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.

Summary of Problem and Scope

On 1/16/2024, the California Department of Public Health (CDPH) notified the FDA of an outbreak of norovirus that has been linked to consumption of oysters harvested in Baja California, Mexico from Acuacultura Integral De Baja California SA de CV – MX 4 SS from harvest area Laguna Manuela, B.C., Mexico on 12/15/2023, 12/16/2023, or 12/23/2023 or Laguna De Guerrero Negro, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, 12/19/2023 or 12/29/2023. 

As of 1/17/2024, CDPH has reported cases of norovirus illness in Los Angeles County and other counties that have been linked to consumption of oysters tracing back to specific harvest areas in Mexico. An investigation is ongoing and the number of illnesses is being tracked.

FDA Actions

The FDA is issuing this alert advising restaurants and food retailers not to serve or sell and consumers not to eat oysters from Acuacultura Integral De Baja California SA de CV  – MX 4 SS from harvest area Laguna Manuela, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, or 12/23/2023, or Laguna De Guerrero Negro, B.C., Mexico, harvested on 12/15/2023, 12/16/2023, 12/19/2023, or 12/29/2023 due to potential norovirus contamination. The FDA is awaiting further information on distribution of the oysters harvested and will continue to monitor the investigation and provide assistance to state authorities as needed. As new information becomes available, the FDA will update the safety alert.

Recommendations for Restaurants and Retailers

Restaurants and retailers should not serve or sell the potentially contaminated oysters. Restaurants and retailers should dispose of any products by throwing them in the garbage or contacting their distributor to coordinate return or 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.

Recommendations for Consumers

Consumers should not eat the potentially contaminated oysters. Consumers who have symptoms should contact their health care provider to report their symptoms and receive care.