Abstract
Norovirus (NoV) is the greatest cause of infectious intestinal disease in the UK. The burden associated with foodborne outbreaks is underestimated in part because data are dispersed across different organisations. Each looks at outbreaks through a different lens. To estimate the burden of NoV from seafood including shellfish we used a capture-recapture technique using datasets from three different organisations currently involved in collecting information on outbreaks. The number of outbreaks of NoV related to seafood including shellfish in England was estimated for the period of 2004-2011. The combined estimates were more than three times as high (N = 360 using Chao's sample coverage approach) as the individual count from organisation three (N = 115), which captured more outbreaks than the other two organisations. The estimates were calculated for both independence and dependence between the datasets. There was evidence of under-reporting of NoV outbreaks and inconsistency of reporting between organisations, which means that, currently, more than one data source needs to be used to estimate as accurately as possible the total number of NoV outbreaks and associated cases. Furthermore, either the integration of reporting mechanisms or simplifying the process of reporting outbreaks to organisations is essential for understanding and, hence, controlling disease burden.
Highlights
Norovirus (NoV) infection is the commonest cause of diarrhoea and vomiting worldwide [1]
149 outbreaks occurred in winter and 43 outbreaks occurred in summer
This is the first time that an estimate of the burden of outbreaks associated with seafood in England has been made
Summary
Norovirus (NoV) infection is the commonest cause of diarrhoea and vomiting worldwide [1]. The virus has a low infectious dose and frequently leads to outbreaks [2]. The reservoir for human NoV is the gastrointestinal tract of humans. Consumption of bivalve shellfish, most often raw oysters, is commonly associated with NoV infections [5]. This is usually as a result of contamination of the water in which the oysters are grown and harvested [6]. The virus adheres to the intestinal tract of the oysters and depuration is not effective at removing NoV [7]. Contamination of shellfish by infectious food handlers, as is commonly reported for other food commodities [8], may contribute to the burden of shellfish-related outbreaks
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