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Evidence for airborne transmission of Norwalk-like virus (NLV) in a hotel restaurant

Published online by Cambridge University Press:  01 June 2000

P. J. MARKS ,
I. B. VIPOND ,
D. CARLISLE ,
D. DEAKIN ,
R. E. FEY  and
E. O. CAUL
P. J. MARKS
Affiliation:
Southern Derbyshire Health Authority, Derwent Court, Stuart Street, Derby DE1 2FZ, UK
I. B. VIPOND
Affiliation:
Bristol Public Health Laboratory, Myrtle Road, Kingsdown, Bristol BS2 8EL, UK
D. CARLISLE
Affiliation:
Derby City Council, Celtic House, Heritage Gate, Friary Street, Derby DE1 1QX, UK
D. DEAKIN
Affiliation:
Derby City Council, Celtic House, Heritage Gate, Friary Street, Derby DE1 1QX, UK
R. E. FEY
Affiliation:
Southern Derbyshire Health Authority, Derwent Court, Stuart Street, Derby DE1 2FZ, UK
E. O. CAUL
Affiliation:
Bristol Public Health Laboratory, Myrtle Road, Kingsdown, Bristol BS2 8EL, UK
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Abstract

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An outbreak of gastroenteritis followed a meal in a large hotel during which one of the diners vomited. The clinical features of the illness suggested Norwalk-like virus (NLV, small round structured virus) infection, and this was confirmed by electron microscopy and reverse transcriptase polymerase chain reaction (RT–PCR) of stool samples. Further characterization of the virus by nucleotide sequence analysis of the PCR amplicons revealed identical strains in all the affected individuals. The foods served at the meal could not be demonstrated to be the cause of the outbreak. Analysis of attack rates by dining table showed an inverse relationship with the distance from the person who vomited. No one eating in a separate restaurant reported illness. Transmission from person-to-person or direct contamination of food seems unlikely in this outbreak. However, the findings are consistent with airborne spread of NLV with infection by inhalation with subsequent ingestion of virus particles.

Type
Research Article
Information
Epidemiology & Infection , Volume 124 , Issue 3 , June 2000 , pp. 481 - 487
Copyright
© 2000 Cambridge University Press