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An Outbreak of Norovirus Gastroenteritis Associated with Wedding Cakes
D. S. Friedman, D. Heisey-Grove, F. Argyros, E. Berl, J. Nsubuga, T. Stiles, J. Fontana, R. S. Beard, S. Monroe, M. E. McGrath, H. Sutherby, R. C. Dicker, A. DeMaria, Jr. and B. T. Matyas
Epidemiology and Infection
Vol. 133, No. 6 (Dec., 2005), pp. 1057-1063
Published by: Cambridge University Press
Stable URL: http://www.jstor.org/stable/3865791
Page Count: 7
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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.
Epidemiology and Infection © 2005 Cambridge University Press