Epidemiology and Infection

Widespread environmental contamination with Norwalk-like viruses (NLV) detected in a prolonged hotel outbreak of gastroenteritis

J. S. CHEESBROUGH a1c1, J. GREEN a2, C. I. GALLIMORE a2, P. A. WRIGHT a1 and D. W. G. BROWN a2
a1 Preston Public Health Laboratory, Royal Preston Hospital, PO Box 202, Sharoe Green Lane, Fulwood, Preston, Lancashire PR2 9HG, UK
a2 Enteric & Respiratory Virus Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK


A protracted outbreak of Norwalk-like virus (NLV)-associated gastroenteritis occurred in a large hotel in North-West England between January and May 1996. We investigated the pattern of environmental contamination with NLV in the hotel during and after the outbreak. In the ninth week, 144 environmental swabs taken from around the hotel were tested for NLV by nested RT–PCR. The sites were categorized according to the likelihood of direct contamination with vomit/faeces. The highest proportion of positive samples were detected in directly contaminated carpets, but amplicons were detected in sites above 1·5 m which are unlikely to have been contaminated directly. The trend in positivity of different sites paralleled the diminishing likelihood of direct contamination. A second environmental investigation of the same sites 5 months after the outbreak had finished were all negative by RT–PCR. This study demonstrates for the first time the extent of environmental contamination that may occur during a large NLV outbreak.

(Accepted April 26 2000)

c1 Author for correspondence.