Abstract
An outbreak of norovirus (NoV) genotype I and Enterotoxigenic Escherichia coli (ETEC) occurred among US Navy Ship personnel following a visit to Lima, Peru, in June 2008. Visiting a specific area in Lima was significantly associated with illness. While ETEC and NoV are commonly recognized as causative agents of outbreaks, co-circulation of both pathogens has been rarely observed in shipboard outbreaks.
Highlights
The discovery of novel gastrointestinal viruses has prompted the global health community to reevaluate their epidemiological perspective on the common causes of gastroenteritis
This study describes a gastrointestinal outbreak which occurred on a US Navy ship in the port of Callao, Peru
NoV GI and enterotoxigenic Escherichia coli (ETEC) were both identified as etiological agents in the early phase of the outbreak, it is likely that NoV was the source of the outbreak in the secondary wave based upon its mechanism of transmission
Summary
The discovery of novel gastrointestinal viruses has prompted the global health community to reevaluate their epidemiological perspective on the common causes of gastroenteritis. There are five recognized NoV genogroups, of which three (I,II and IV) are known to cause illness in humans [4]. The incubation period ranges from 24–48 hours and is typically transmitted through direct person-to-person contact or through the oral fecal route [4]. For this reason NoV is frequently associated with large outbreaks within military populations and on military and civilian ships, reaching attack rates as high as 60% [2]. On June 30th, 2008 an outbreak of a gastrointestinal illness occurred aboard a US Navy ship in the port of Lima. An investigation was conducted to identify the etiologic agent, to evaluate factors associated with the outbreak and to provide recommendations to the ship’s commander on how to control the current and prevent future outbreaks
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