Abstract

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Highlights

  • Norovirus causes self-limiting gastroenteritis that is usually characterised by sudden and abrupt vomiting followed by more prolonged diarrhoea [1]

  • The epidemic curve of this outbreak suggested a single, common, point source and the cohort study identified several types of sandwiches served during the family lunch as possible vehicles of contamination, with egg mayonnaise, turkey with stuffing and chicken sandwiches being the most likely vehicles of the outbreak

  • The results of our study are consistent with previous reports where multi-ingredient foods were implicated in norovirus outbreaks [14,15]

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Summary

Introduction

Norovirus causes self-limiting gastroenteritis that is usually characterised by sudden and abrupt vomiting followed by more prolonged diarrhoea [1]. Transmission primarily occurs through environmental contamination following direct soiling and indirect aerosolisation resulting from projectile vomiting. It can be introduced into a particular setting by contaminated drinking water or food [3]. Subsequent person-to-person transmission will lead to onward propagation in the original setting or in other linked settings, often making the original contamination event difficult to identify [4]. It is important to investigate outbreaks due to norovirus in order to ascertain the source of the infection and mode of transmission. Finding the initial event that allows the linkage of cases is often problematic, making the epidemiological investigation challenging [5]. Immunity against norovirus occurs post infection but may be short lived. This, plus the existence of several viral antigenic types, means later re-infection is possible [2]

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