{"id":1575,"date":"2015-03-03T23:41:47","date_gmt":"2015-03-03T23:41:47","guid":{"rendered":"http:\/\/www.outbreakmuseum.com\/mobile\/?p=1575"},"modified":"2016-03-16T19:57:03","modified_gmt":"2016-03-16T19:57:03","slug":"frozen-oysters","status":"publish","type":"post","link":"https:\/\/www.outbreakmuseum.com\/mobile\/norovirus\/frozen-oysters\/","title":{"rendered":"Frozen Oysters"},"content":{"rendered":"\n<table id=\"tablepress-45\" class=\"tablepress tablepress-id-45\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\"><b>Outbreak:<\/b> Frozen Oysters<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><b>Product:<\/b> Frozen Oysters<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\"><b>Investigation Start Date:<\/b> 11\/22\/2006<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\"><b>Location:<\/b> Marion County, OR<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\"><b>Etiology:<\/b> Norovirus GI<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\"><b>Earliest known case onset date:<\/b> 11\/15\/2006<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\"><b>Latest case onset date:<\/b> 11\/17\/2006<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\"><b>Confirmed \/ Presumptive Case Counts:<\/b> 2 \/ 11<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\"><b>Positive Samples (Food):<\/b> 1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-45 from cache -->\n<div id=\"metaslider-id-1583\" style=\"width: 100%; margin: 0 auto;\" class=\"ml-slider-3-99-0 metaslider metaslider-flex metaslider-1583 ml-slider ms-theme-default\" role=\"region\" aria-label=\"Oysters 2006-225\" data-width=\"400\">\n    <div id=\"metaslider_container_1583\">\n        <div id=\"metaslider_1583\" class=\"flexslider\">\n            <ul class='slides'>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1868 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-06 17:09:05\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/oysters-e1425661760972-400x200.jpg\" height=\"200\" width=\"400\" alt=\"Over 25,000 pounds of product from the same lot was embargoed by the FDA.\" class=\"slider-1583 slide-1868 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Over 25,000 pounds of product from the same lot was embargoed by the FDA.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-2016 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-27 19:38:27\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Banquet-Food-List-400x200.jpg\" height=\"200\" width=\"400\" alt=\"List of foods served at the banquet;\" class=\"slider-1583 slide-2016 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">List of foods served at the banquet; note many accompanying items had to be written in to capture the full range of ingredients served.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-2015 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-27 19:38:25\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/OysterLabel-2006-225-400x200.jpg\" height=\"200\" width=\"400\" alt=\"Photo copy of label from frozen oysters imported from Korea.\" class=\"slider-1583 slide-2015 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Photo copy of label from frozen oysters imported from Korea.<\/div><\/div><\/li>\n            <\/ul>\n        <\/div>\n        \n    <\/div>\n<\/div>\n\n<table id=\"tablepress-43\" class=\"tablepress tablepress-id-43\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Outbreak Summary:<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"row-2\">\n\t<td class=\"column-1\">A rapid investigation of a Norovirus outbreak implicated commercially frozen oysters on the half shell that were thawed and served raw. Over 25,000 pounds of product from the same lot was embargoed by the FDA, which was then considering further restrictions on this type of product, which had been imported from Korea.<br \/>\n<br \/>\n<ul><li>\u2022 <a href=\"http:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/2006-225-final-Q1.pdf\" target=\"_blank\">Outbreak questionnaire (PDF)<\/a><\/li><\/ul><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-43 from cache -->\n\n<table id=\"tablepress-44\" class=\"tablepress tablepress-id-44\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Details:<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><b>Background<\/b><br \/>\nOn November 22, 2006, an infection control nurse notified the Marion County Health department about acute gastroenteritis among persons who attended a reception at a medical facility on November 16, 2006, and began at 6:00pm. The county asked the state health department to join the outbreak investigation. <br \/>\n<br \/>\n<b>Methods<\/b><br \/>\nAfter interviewing the caterer, organizers, and several attendees, we modified a questionnaire template to reflect potential exposures. This questionnaire was used in a retrospective cohort study among reception attendees identified from a ticket list of approximately 200 persons. The epidemiologists were able to sample 66 attendees from 50 households.<br \/>\n<br \/>\n<b>Results<\/b><br \/>\nTen persons met the case definitions of acute gastroenteritis, 53 had no symptoms, and three were excluded due to minor symptoms. Acute gastroenteritis cases were defined as reported vomiting or \u2265 3 loose stools within a 24 hour period within 18\u201372 hours of the event.<br \/>\n<br \/>\nThe median incubation period was 36 hours (range, 31\u201363 hours). Two stool samples were obtained, and both tested positive for norovirus (1 positive for genogroup II and 1 positive for both I and II). Illness was associated with consumption of raw oyster on the half shell, which was reported by 9 of the 10 cases (RR 11.8; 95%CI 2.8\u201350; p=0.0001). No other foods were associated with illness. <br \/>\n<br \/>\nThe oysters had been individually quick frozen on the half shell and packed loosely in cartons after being harvested in South Korea by growers approved by the US Food and Drug Administration. The oysters are pressure-treated to crack the shell, and then blast-frozen on the half shell in trays with a plastic seal over each tray. These oysters were packed in cardboard cartons\u2014144 oysters with a net weight of 6-kg per box. For the reception, a single 6-kg box of oysters was thawed and served raw. The box was from a shipment of 2,200 boxes legally imported in October 2006. Boxes from the same shipment had been distributed to 5 states. No similar outbreaks were reported in the other states that got oysters from the same lot, though case-finding efforts vary. FDA tested oysters from the implicated lot and found Norovirus.<br \/>\n<br \/>\n<b>Lessons learned\/historical significance<\/b><br \/>\nAlthough most reported foodborne norovirus outbreaks may stem from ill food handlers, it is important to rule out contaminated foods as the source of illness.<br \/>\n<br \/>\nBecause thorough outbreak investigations are time-consuming and gastroenteritis outbreaks are common, resource considerations often affect decisions about how intensively to pursue investigations. Oregon\u2019s use of integrated questionnaire, data entry, and analysis templates facilitated a quick and successful response to the outbreak described here. Questionnaire design, interviews, data entry, and analysis were completed within 6 hours of the initial report, and distributors and regulatory agencies quickly recalled other oysters from the same source, probably preventing additional illnesses. Widespread use of such templates may increase the number of outbreaks that could be investigated thoroughly.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-44 from cache -->\n<p><a href=\"https:\/\/www.outbreakmuseum.com\/mobile\/exhibits\/\"><strong>Back to Outbreak Exhibits<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Back to Outbreak Exhibits<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[68],"tags":[105,73,107],"class_list":["post-1575","post","type-post","status-publish","format-standard","hentry","category-norovirus","tag-frozen-oysters","tag-international-outbreak-museum-iom-dr-bill-keene-tribute-oregon-health-authority-integrated-food-safety-center-of-excellence-acute-and-communicable-disease-prevention-fomes","tag-norovirus"],"_links":{"self":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1575","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/comments?post=1575"}],"version-history":[{"count":7,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1575\/revisions"}],"predecessor-version":[{"id":1787,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1575\/revisions\/1787"}],"wp:attachment":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/media?parent=1575"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/categories?post=1575"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/tags?post=1575"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}