Assessment of Food and Waterborne Viral Outbreaks by Using Field Epidemiologic, Modern Laboratory and Statistical Methods : Lessons Learnt from Seven Major Norovirus Outbreaks in Finland

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Polkowska , A , Räsänen , S , Nuorti , P , Maunula , L & Jalava , K 2021 , ' Assessment of Food and Waterborne Viral Outbreaks by Using Field Epidemiologic, Modern Laboratory and Statistical Methods : Lessons Learnt from Seven Major Norovirus Outbreaks in Finland ' , Pathogens , vol. 10 , no. 12 , 1624 . https://doi.org/10.3390/pathogens10121624

Title: Assessment of Food and Waterborne Viral Outbreaks by Using Field Epidemiologic, Modern Laboratory and Statistical Methods : Lessons Learnt from Seven Major Norovirus Outbreaks in Finland
Author: Polkowska, Aleksandra; Räsänen, Sirpa; Nuorti, Pekka; Maunula, Leena; Jalava, Katri
Contributor organization: Departments of Faculty of Veterinary Medicine
Food Hygiene and Environmental Health
Leena Maunula / Principal Investigator
Food and Environmental Virology Research Group
Department of Mathematics and Statistics
Faculty of Social Sciences
Date: 2021-12-14
Language: eng
Number of pages: 15
Belongs to series: Pathogens
ISSN: 2076-0817
DOI: https://doi.org/10.3390/pathogens10121624
URI: http://hdl.handle.net/10138/338636
Abstract: Seven major food- and waterborne norovirus outbreaks in Western Finland during 2014-2018 were re-analysed. The aim was to assess the effectiveness of outbreak investigation tools and evaluate the Kaplan criteria. We summarised epidemiological and microbiological findings from seven outbreaks. To evaluate the Kaplan criteria, a one-stage meta-analysis of data from seven cohort studies was performed. The case was defined as a person attending an implicated function with diarrhoea, vomiting or two other symptoms. Altogether, 22% (386/1794) of persons met the case definition. Overall adjusted, 73% of norovirus patients were vomiting, the mean incubation period was 44 h (4 h to 4 days) and the median duration of illness was 46 h. As vomiting was a more common symptom in children (96%, 143/149) and diarrhoea among the elderly (92%, 24/26), symptom and age presentation should drive hypothesis formulation. The Kaplan criteria were useful in initial outbreak assessments prior to faecal results. Rapid food control inspections enabled evidence-based, public-health-driven risk assessments. This led to probability-based vehicle identification and aided in resolving the outbreak event mechanism rather than implementing potentially ineffective, large-scale public health actions such as the withdrawal of extensive food lots. Asymptomatic food handlers should be ideally withdrawn from high-risk work for five days instead of the current two days. Food and environmental samples often remain negative with norovirus, highlighting the importance of research collaborations. Electronic questionnaire and open-source novel statistical programmes provided time and resource savings. The public health approach proved useful within the environmental health area with shoe leather field epidemiology, combined with statistical analysis and mathematical reasoning.
Subject: 11832 Microbiology and virology
norovirus
statistics
mathematics
disease outbreaks
cohort studies
fresh produce
Finland
FOODBORNE OUTBREAKS
FRESH PRODUCE
UNITED-STATES
RT-PCR
TRANSMISSION
GASTROENTERITIS
INFECTIONS
CRITERIA
HEALTH
IMPACT
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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