Epidemiology and Infection

A large hotel outbreak of Norwalk-like virus gastroenteritis among three groups of guests and hotel employees in Virginia

S. S.  LOVE  a1 c1, X.  JIANG  a2, E.  BARRETT  a1, T.  FARKAS  a2 and S.  KELLY  a3
a1 Virginia Department of Health, Richmond, VA
a2 Center for Pediatric Research, Eastern Virginia Medical School, Norfolk, VA
a3 Division of Consolidated Laboratory Services, Richmond, VA


A large outbreak of acute gastroenteritis occurred among three different groups of guests and the employees of a Virginia hotel within a 2-week period in November 2000. At least 76 of the hotel's guests and 40 hotel employees had acute gastroenteritis during this period. All tested ill persons were infected with the same strain of Norwalk-like virus, as shown by cloning and sequencing of virus detected in stool specimens from the three guest groups and the employees. Epidemiologic investigation suggested food as the probable source for the guests. Most of the employees, including those sick, did not eat in the hotel, suggesting that environmental contamination and person-to-person transmission could have contributed to the outbreak. The disease continued to spread in the hotel, passing from one guest group to another, by food, environmental contamination, and/or by person-to-person transmission through infected employees and guests. The study describes procedures implemented to control the outbreak and makes recommendations for future outbreak control.

(Accepted March 1 2002)

c1 Author for correspondence: Virginia Department of Health, 830 Southampton Avenue, Norfolk, Virginia 23510.