The norovirus outbreak that spread like wildfire through Casper, Wyoming last December sickening several hundred people was a restaurant-associated event, meaning the illnesses were not acquired in the community at large. Instead, the virus got a push from 31 sickened food handlers at the restaurant who mostly kept working their normal shifts.
Those facts led to the finding that the outbreak was almost entirely the doing of Casper’s new Golden Corral restaurant and it is but one of the conclusions by Kelly Weidenbach-Virgil, Wyoming ‘s state epidemiologist, in a 15-page final report on the health crisis.
The report says Casper experienced 344 illnesses with 282 primary cases during an outbreak that centered on a Golden Corral, a buffet-style restaurant that only opened for the first time on Nov. 3, 2012. The other cases were due to secondary exposure, meaning when a Golden Corral patron gave the virus to someone else.
The epidemic curve presented in the report suggests a common source outbreak. “Over 95 percent of cases report patronizing the restaurant on or after December 7, 2012, which indicates some event occurred that allowed a large number of people to be exposed over that weekend,” says the report. “Furthermore, attack rates among parties of multiple Golden Corral patrons are high (61-73 percent), which is not commonly seen in community-wide outbreaks and is more common during restaurant-associated outbreaks.”
Wyoming’s investigation did not determine exactly how the virus was introduced at the Golden Corral. The virus could have been spread by patrons or employees, It is possible that one or more of those ill or previously ill employee working in the food-handling area of the restaurant was “an important contributing factor in the propagation of this outbreak.”
No single food item was found to be the pathogen vehicle in the Golden Corral outbreak.
Under the Wyoming Food Safety Rule, any food handler who suffers from gastrointestinal symptoms such as diarrhea or vomiting must be excluded from work activities for at least 48 hours after recovery.
The report says restaurant employees are also required under the rule to report diseases they may have that are transmissible through food to a person-in-charge, including any bouts of diarrhea, vomiting, jaundice, sort throat with fever or lesions containing pus, infected wound, or a diagnosis of Salmonella, Shigella, E. coli, Hepatitis, or norovirus.
Specific recommendations for the Golden Corral included in the report were:
- Enhanced surface disinfection with a product effective against norovirus, such as a concentrated bleach solution.
- Gloves should be used in handling ready-to-eat foods, such as lettuce. The use of gloves does not negate the need for proper hand-washing.
- All vomitus accidents should be handled as if they are highly contagious, quarantine and clean the area using a concentrated bleach solution. Dispose of all towels, rags, and mops in a quarantined manner.
- Report all suspected cases of foodborne illnesses to health authorities for an objective investigation and effective mitigation strategies
- Seek help from local environmental health specialists.
From Dec. 7 to Dec. 11, 2012, the Golden Corral estimated it served more than 7,000 people. Most of the illnesses occurred during this period. Late on Dec. 13, the restaurant voluntarily closed for deep cleaning for about 24 hours.
There is no evidence of the virus being spread by the restaurant after it re-opened. Among the foods consumed by restaurant patrons before it closed for cleaning were: salad bar, bakery/bread station, beef, beverages, cheese, chicken/poultry, egg product, fish fillet, gravy, ice cream, cheese mashed potatoes, port or other salads.
But no single food stood out in the epidemiological study.
Both home and emergency room care was provided for the victims of the December outbreak.© Food Safety News