Yesterday, along with Gary Newland, a Chicago-area personal injury lawyer, we filed suit on behalf of Anita Fowler for a foodpoisoning illness that she developed after eating at a wedding reception held at Di Nolfo’s banquet hall in Mokena, Illinois. Will County health officials are investigating a number of illnesses (reports of more than 50 people sickened) that are apparently linked to the outbreak. At least one person has tested positive for norovirus, which would seem to fit under the circumstances of this large outbreak. Multiple people required hospitalization for treatment of their illnesses.
The Centers for Disease Control and Prevention (CDC) estimates that noroviruses cause 23 million cases of acute gastroenteritis annually, making noroviruses the leading cause of gastroenteritis in the United States (CDC, 2006; Fankhauser, et al., 2002; Mead, et al., 1999). Of viruses, only the common cold is reported more often than viral gastroenteritis (norovirus) (Benson & Merano, 1998).
Nature has created an ingenious bug in norovirus. The round blue ball structure of norovirus is actually 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.
Transmission of Norovirus:
Noroviruses are transmitted primarily through the fecal-oral route, and fewer than 100 norovirus particles are said to be needed to cause infection (MMWR, 2001, June 1).
Transmission occurs either person-to-person or through contamination of food or water. Foodborne norovirus transmission can occur when food is contaminated by an infected food handler (Caceres, et al., 1998; MMWR, 2001, June 1).
Noroviruses are recognized as causing over half of all foodborne illness outbreaks. 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 (CDC, 2006, August 3).
The virus is shed in large numbers in the vomit and stool of infected individuals, most commonly while they are ill. Some individuals may, however, continue to shed norovirus long after they have recovered from the illness (Patterson, 1993). Aerosolized vomit has also been implicated as a mode of norovirus transmission (Marks, et al., 2000).
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” (MMWR, 2001, June 1).
Symptoms of Norovirus Infection:
Usual symptoms of norovirus infection include nausea, vomiting, diarrhea, and abdominal pain. Headache and low-grade fever may also accompany this illness.
The illness caused by norovirus is usually brief. It develops 24 to 48 hours after contaminated food or water is ingested and lasts for 24 to 60 hours (CDC, 2006, August 3). People infected with norovirus usually recover in two to three days without serious or long-term health effects.
In some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children and among older and immunocompromised adults in hospitals and nursing homes (Mayo Clinic, 2007, April 5).