Epidemiology and Infection

Table of Contents - 2005 - Volume 133, Issue 06  


An outbreak of norovirus gastroenteritis associated with wedding cakes

D. S. FRIEDMAN a1c1, D. HEISEY-GROVE a2, F. ARGYROS a3, E. BERL a3, J. NSUBUGA a2, T. STILES a2, J. FONTANA a2, R. S. BEARD a4, S. MONROE a4, M. E. McGRATH a5, H. SUTHERBY a5, R. C. DICKER a1, A. DeMARIA Jr a2 and B. T. MATYAS a2
a1 Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
a2 Bureau of Communicable Disease Control, Massachusetts Department of Public Health, MA, USA
a3 Division of Food and Drugs, Massachusetts Department of Public Health, MA, USA
a4 Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
a5 Braintree, Massachusetts Board of Health, MA, USA

Article author query
friedman ds   [PubMed][Google Scholar] 
heisey-grove d   [PubMed][Google Scholar] 
argyros f   [PubMed][Google Scholar] 
berl e   [PubMed][Google Scholar] 
nsubuga j   [PubMed][Google Scholar] 
stiles t   [PubMed][Google Scholar] 
fontana j   [PubMed][Google Scholar] 
beard rs   [PubMed][Google Scholar] 
monroe s   [PubMed][Google Scholar] 
mcgrath me   [PubMed][Google Scholar] 
sutherby h   [PubMed][Google Scholar] 
dicker rc   [PubMed][Google Scholar] 
demaria a   [PubMed][Google Scholar] 
matyas bt   [PubMed][Google Scholar] 

Abstract

We sought to determine the source of a norovirus outbreak among attendees of 46 weddings taking place during a single weekend. Norovirus-compatible illness was experienced by 332 (39%) of wedding guests surveyed; the outbreak affected up to 2700 persons. Illness was associated with eating wedding cake provided by a bakery common to the weddings (adjusted RR 4·5, P<0·001). A cake requiring direct hand contact during its preparation accounted for the majority of illness. At least two bakery employees experienced norovirus-compatible illness during the week preceding the weddings. Identical sequence types of norovirus were detected in stool specimens submitted by two wedding guests, a wedding hall employee, and one of the ill bakery employees. It is likely that one or more food workers at the bakery contaminated the wedding cakes through direct and indirect contact. These findings reinforce the necessity of proper food-handling practices and of policies that discourage food handlers from working while ill.

(Published Online June 30 2005)
(Accepted April 22 2005)


Correspondence:
c1 Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130, USA. (Email: dif8@cdc.gov)

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