Norovirus outbreak at New York restaurant linked to infected food handlers
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Key takeaways:
- A norovirus outbreak at a New York restaurant was likely caused by infected food handlers.
- Investigators identified four stool samples from food handlers and two from patrons who tested positive for norovirus.
A norovirus outbreak at a New York restaurant was traced back to sick food handlers, some of whom were unaware of the location’s paid sick leave policy, researchers reported at the CDC’s annual Epidemic Intelligence Service conference.
“In December, we received three reports of gastrointestinal illness in patrons [who] dined with a Manhattan restaurant. They were patrons [who] had been part of two different parties that dined on two different days at the same restaurant,” Leah D. Seifu, MD, MPH, Epidemic Intelligence Service with the CDC assigned to the New York City Department of Health and Mental Hygiene, told Healio. “So, we, at the health department decided to investigate these reports of gastrointestinal illness.”
After receiving the reservations list from the restaurant, Seifu and colleagues conducted case-finding by interviewing restaurant patrons who dined from December 11 through December 29 and had symptoms such as diarrhea or vomiting, and either nausea, abdominal cramps or fever.
According to the study, the investigators also evaluated restaurant food-handling practices and sick leave policies, interviewed food handlers, and tested stool samples from ill patrons and food handlers for enteric bacteria and viruses.
Overall, the team interviewed 93 patrons from the 243 restaurant reservations booked during the study period and found 20 (22%) cases of gastrointestinal illness. The most reported symptoms among them were nausea (95%), fatigue (95%), diarrhea (90%) and chills (90%), with illness onsets reported between December 12 and December 19. Throughout the investigation, they found that no food items were associated with illness. However, a food handler who prepared food during December 11 and 12 later called out sick. Because of this, the team then tested the stool of 11 food handlers who worked at the restaurant on the days in question, as well as two patrons who dined on 2 separate days at the restaurant. They found four samples from food handlers, and both patron samples tested positive for norovirus.
“So ultimately, it seems that norovirus was the culprit at hand here,” she said.
Half of the food handlers interviewed by the investigators said they were unaware of the restaurant’s paid sick leave policy. Based on this, Seifu said there are both a clinical and public health message to be taken away from the investigation.
“For the general public [this is] a reminder that norovirus is really the most common foodborne illness in the U.S., so, advise people to continue all the standard hygiene practices that they're doing [such as] washing their hands before and after eating,” she said.
For clinicians, she continued, this is a reminder to monitor for alerts about foodborne illness that come from the New York City Health Department and from the CDC so that they can stay informed as they're treating patients who might have been affected by one of these illnesses.
“Finally, from a broader public health perspective, I think a big message here is about the food handlers and really taking advantage of the sick leave policies that are in place,” she said, adding that New York City has laws that do require sick leave for food handlers in restaurants.
“The restaurant in question was adhering to these laws. However, we did still find that multiple food handlers were working when they tested positive with norovirus,” she said. “So really, it seems like there needs to be more education and outreach to make sure that food handlers are aware of these policies and taking advantage of the sick leave policies that their restaurants have to help curb the spread of these foodborne illnesses and restaurants.”
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Seifu LD, et al. Norovirus Outbreak at a Manhattan Restaurant — New York City, December 2023. Presented at: Epidemic Intelligence Service conference; April 23-April 26, 2024; Atlanta.
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