Although cruise ships get most of the attention when it comes to norovirus outbreaks, a Centers for Disease Control (CDC) study, released yesterday, found that the majority of cases are linked to food service settings. Food service workers who handle food with bare hands are blamed for the food contamination that is responsible for 64 percent of the country’s norovirus cases. Catering and banquet facilities accounted for 17 percent of outbreaks. Only 1 percent of cases are attributed to cruise ships.
The CDC study looked at data from state, territory and local health departments between 2009 and 2012 on norovirus outbreaks reported through the National Outbreak Reporting System. Over the four-year period, health departments reported 1,008 norovirus outbreaks. Contamination in private residences, healthcare facilities, schools and daycare were linked to 6 percent of outbreak reports.
Norovirus is highly contagious, and can be spread wherever groups of people gather and food is served. Approximately 20 million people contract the virus each year through direct contact with infected people or through contaminated food. While infection is generally not life threatening — most people experience a few uncomfortable days of diarrhea and vomiting — the very young and the elderly can develop serious complications. Severe dehydration and malnutrition, which can be fatal, threatens those with compromised immune systems.
To reduce incidents of contamination, The CDC is recommending that food service managers provide training for employees in proper hygiene, regular hand washing and proper food handling. Kitchen managers and food service workers should obtain certification in food safety. Because 90 percent of contamination comes from handling ready-to-eat foods, such as fruit and sandwiches, with bare hands, use of disposable gloves and utensils are recommended rather than directly touching food.
CDC Director Dr. Tom Frieden urges food service businesses to implement policies that encourage sick employees to stay home. In a CDC telebriefing, Frieden notes that employees understandably fear losing their jobs if they must call in sick, therefore the burden of keeping ill workers away from food meant for public consumption falls on management. Dr. Frieden recommends offering paid sick leave and having in place a system to call in substitute workers.
“It is vital that food service workers stay home if they are sick; otherwise, they risk contaminating food that many people will eat.” — Dr. Aron Hall, CDC Division of Viral Diseases
This study does clear up the misconception that norovirus outbreaks are primarily a hazard of cruise travel. Incidents of outbreaks onboard cruise ships do regularly make the news. Ships are required to report illnesses to health officials, unlike restaurants, and therefore norovirus outbreaks at sea do receive more media attention.