Abstract
A food-borne outbreak of gastroenteritis with more than 650 suspected cases occurred in April 2016 in Sollentuna, Sweden. It originated in a school kitchen serving a total of 2,700 meals daily. Initial microbiological testing (for Campylobacter, Salmonella, Shigella, Yersinia, Giardia, Cryptosporidium, Entamoeba histolytica, adeno-, astro-, noro-, rota- and sapovirus) of stool samples from 15 symptomatic cases was negative, despite a clinical presentation suggestive of calicivirus. Analyses of the findings from both the Sollentuna municipality environmental team and a web-based questionnaire suggested that the source of the outbreak was the salad buffet served on 20 April, although no specific food item could be identified. Subsequent electron microscopic examination of stool samples followed by whole genome sequencing revealed a variant of sapovirus genogroup V. The virus was not detected using standard PCR screening. This paper describes the epidemiological outbreak investigation and findings leading to the discovery.
Highlights
Sapovirus causes acute gastroenteritis in humans and belongs to the Caliciviridae family, along with norovirus and three other genera [1]
A recent summary and analysis of reported food-borne outbreaks in the European Union in 2011 estimated that viruses were the cause in 13% of those outbreaks in which a causative agent was verified or where such outbreaks were associated with sufficient solid data to be categorised as viral outbreaks supported by strong evidence; a majority of these (98%) were caused by the Caliciviridae family, noroviruses [9]
Of the 682 people (59%) who responded to the question regarding symptoms of gastroenteritis after 20 April, 674 answered the question concerning sex (363 female and 311 male) and of these, 265 people (39%) reported symptoms of gastroenteritis
Summary
Sapovirus causes acute gastroenteritis in humans and belongs to the Caliciviridae family, along with norovirus and three other genera [1]. Sapovirus has a worldwide distribution and is a common cause of sporadic gastroenteritis [2,3,4]. Prevalence and genotype distribution have shifted over time [5]. A recent summary and analysis of reported food-borne outbreaks in the European Union in 2011 estimated that viruses were the cause in 13% of those outbreaks in which a causative agent was verified or where such outbreaks were associated with sufficient solid data to be categorised as viral outbreaks supported by strong evidence; a majority of these (98%) were caused by the Caliciviridae family, noroviruses [9]
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