J Agric Med Community Health.  2018 Dec;43(4):258-269. 10.5393/JAMCH.2018.43.4.258.

Epidemiological investigation on the outbreak of foodborne and waterborne disease due to Norovirus with delayed notification

• Ha M
• Kim H
• Kim YH
• Na MS
• Yu MJ

• KMID: 2436290
• DOI: http://doi.org/10.5393/JAMCH.2018.43.4.258

Abstract

OBJECTIVES
There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June 5(th) but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification.
METHODS
First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June 2(nd) to June 12(th). Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus.
RESULTS
Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef)
CONCLUSIONS
We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.

Keyword

Epidemiological investigation; Outbreak; Waterborne and foodborne infectious disease; Norovirus

MeSH Terms

Abdominal Pain
Bacteria
Diarrhea
Drinking Water
Hand
Humans
Norovirus*
Vomiting
Water
Waterborne Diseases*
Drinking Water
Water