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Nicholas A. Daniels, David A. Bergmire-Sweat, Kellogg J. Schwab, Kate A. Hendricks, Sudha Reddy, Steven M. Rowe, Rebecca L. Fankhauser, Stephan S. Monroe, Robert L. Atmar, Roger I. Glass, Paul Mead, A Foodborne Outbreak of Gastroenteritis Associated with Norwalk-like Viruses: First Molecular Traceback to Deli Sandwiches Contaminated during Preparation, The Journal of Infectious Diseases, Volume 181, Issue 4, April 2000, Pages 1467–1470, https://doi.org/10.1086/315365
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Abstract
In March 1998, an outbreak of acute gastroenteritis occurred among students at a Texas university. Overall, 125 ill students sought medical care. Case-control studies revealed that illness was significantly associated with eating foods from the university's main cafeteria deli bar on 9 and 10 March. Stool specimens from 9 (50%) of 18 ill students and samples of deli ham showed evidence of Norwalk-like viruses (NLVs) by reverse-transcriptase (RT) polymerase chain reaction (PCR) assay. A food handler who prepared sandwiches for lunch on 9 March reported that her infant had been sick with watery diarrhea since just before the outbreak. A stool sample from the infant was positive for NLV by RT-PCR, and the sequence of the amplified product was identical to that of amplified product from deli ham and students' stool specimens. This is the first time RT-PCR and sequence analysis have successfully confirmed viral contamination of a food item likely to have been contaminated by a food handler.