Kent, Ohio Norovirus

Outbreak 2008

Shawn Kise BSN, RN, MS Student

Have a general knowledge base for the

Norovirus. Understand the process and steps taken in the

outbreak investigation. Be able to apply information received to

patient education. Correctly answer the quiz questions at the end

of the presentation.

Objectives

In April 2008, a large number of individuals

starting getting sick with severe nausea, vomiting, and diarrhea in Kent, Ohio.

A large majority were Kent State University students.

With a large increase in cases, the local hospital notified the Kent City Health Department.

The Outbreak

Stool samples were collected from individuals

and sent for testing at the Ohio Department of Health laboratory.

Interviews were conducted by Kent health officials of affected individuals.

A common theme from the interviews was haven ate at the Chipotle restaurant just off of Kent State University campus.

The Investigation

Stool samples revealed that the Norovirus

Genotype G2 was the cause.

After further investigation it was determined that food contaminated with the Norovirus served from April 14th though April 18th at the Kent Chipotle was the source of the outbreak.

What was the cause?

The Chipotle restaurant was closed and food

samples were collected from the restaurant for testing.

Leftover Chipotle food samples from affected individuals was also collected and tested.

All employees of the restaurant were also interviewed.

Investigation Continued

Total ill - 509 primary and secondary cases.

Organism – Norovirus

Source – contaminated food from a Chipotle restaurant. No specific source was found.

No patients were hospitalized as a result of the outbreak.

Results

The Chipotle restaurant was closed. All food

was thrown away and the restaurant was sanitized, including all cooking equipment.

The Restaurant was reopened with new employees from other Chipotle locations.

The cost of the outbreak to the Kent community was estimated to be between $130,000 and $305,000.

Results Cont.

Epidemiological Triangle

The Norovirus

The most common cause of acute gastroenteritis in the United States.

Accounts for approximately 70,000 hospitalizations and 800 deaths per year.

Agent

Contaminated food and

infected individuals

The norovirus is spread by infected humans, contaminated food or fluids, and inanimate objects contaminated the virus on them.

The most contagious time for the norovirus is when a person has the illness and up to three days after recovery.

Host

Unsanitary food preparation

and/or uncleanly environment

Washing your hands before food preparation must be done, especially after using the restroom.

Proper washing of fruits and vegetables

Sanitizing cooking areas

Instructing employees not to work when they are sick.

Environment

A person can be contagious the same day

they contract the norovirus and are highly contagious from onset of symptoms to three days after recovery.

The virus can remain in your stool for two weeks or more after recovery.

Time

Education, Education, Education!!! Hand washing Washing fruits and vegetables thoroughly Cooking seafood thoroughly Do not prepare food or take care of others

when you are sick. Do not eat or drink after another person Keep sick children and adults away from food

preparation areas.

How can we stop the spread of the

Norovirus

No know treatment for the viral infection.

Treat dehydration with IV and oral fluids. The symptoms are treated with medications (ex. nausea and fever).

The Norovirus can be serious especially in young children, the elderly, and the immunocompromised.

Norovirus

How long is a person contagious with the

norovirus?a. one yearb. two weeksc. twenty four to forty eight hoursd. for life

It’s quiz time

two weeks

Answer

People with the norovirus are treated with

antibiotics?a. Trueb. False

Question

False

Answer

The norovirus is

a. only contagious by human to human contact

b. contracted from animals that live in close quarters with other animals

c. the most common cause of acute gastroenteritisd. all of the above

Question

The most common cause of acute gastroenteritis

Answer

The norovirus is responsible for approximately

how many hospitalizations each year?a. 800b. 8,000c. 700,000d. 70,000

Question

70,000

Answer

What was the host in the Kent Norovirus

outbreak of 2008?a. A birdb. Contaminated foodc. The door handles of the entrance to the

restaurantd. None of the above

Question

Contaminated food

Answer

Questions

Action News 19, (2008). Test results are back for Norovirus at Kent Chipotle.

Retrieved from http://www.woio.com/global/story.asp?s8236821

Centers for Disease Control and Prevention, (2012). Norovirus. Retrieved from http://www.cdc.gov/norovirus/about/overview.html

Foodborne Illness Database, (2012). Chipotle grill restaurant burritos 2008. Retrieved from http://www.outbreakdatabase.com/details/chipotle-grill-restaurant-burritos-2008/?organism=Norovirus&year=2008&state=18&month=4

Payne, J. W., 2008. Ohio disease outbreak linked to Chipotle restaurant. Retrieved from http://health.usnews.com/health-news/family-health/articles/2008/04/21/ohio-disease-outbreak-linked-to-chipotle-restaurant

References