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Norovirus gastroenteritis general outbreak associated with raw shellfish consumption in South Italy

DOI: 10.1186/1471-2334-4-37

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A retrospective cohort study was performed in order to assess risk factors associated with illness. All households where a case occurred were included in the study. Faecal specimens were collected from ill individuals. NV-specific RT-PCR was performed. Eleven samples of mussels were collected from fish-markets involved in the outbreak. A nested PCR was used for mussel samples.One hundred and three cases, detected by means of active surveillance, met the case definition. Raw shellfish eating was the principal risk factor for the disease, as indicated by the analytic issues (Risk Ratio: 1.50; IC 95%: 1.18 – 1.89; p < 0.001). NVs were found by means of RT-PCR of all the stool specimens from the 24 patients tested. Eleven samples of shellfish from local markets were tested for the presence or NVs; six were positive by nested PCR and genotypes were related to that found in patients' stools.This is the first community outbreak caused by NVs related to sea-food consumption described in Italy. The study confirms that the present standards for human faecal contamination do not seem to be a reliable indicator of viral contaminants in mussels.Norovirus (NV, previously "Norwalk-like viruses"), one of four genera in the Caliciviridae family, includes a group of morphologically similar but genetically different single-stranded RNA viruses. NVs represent the most important cause of non-bacterial gastroenteritis worldwide. In industrialised countries NVs may be responsible for up to 80% of all outbreaks of gastroenteritis [1]. Outbreaks may affect all age groups and generally occur in crowded communities such as restaurants, tourist resorts, hospitals, schools and nursing homes.Contaminated food or water commonly represents the main source of infection. Epidemics spread by the faecal-oral route, even if transmission may also occur through direct person-to-person contact or aerosolised viral particles.The incubation period of NV gastroenteritis is 24–48 hours and symptoms include vo


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