Related Experiment Video
Updated: May 24, 2026

Swab Sampling Method for the Detection of Human Norovirus on Surfaces
Published on: February 6, 2017
A norovirus outbreak triggered by copper intoxication on a coach trip from the Netherlands to Germany, April 2010
J Hoefnagel1, Dh van de Weerdt, O Schaefer
1Department of Infectious Diseases, Public Health Service (GGD) Nijmegen, Nijmegen, the Netherlands. jhoefnagel@ggd-nijmegen.nl
Abstract:
We report an unusual outbreak of norovirus infection on a coach trip. Overall, 30 of 40 people (including drivers and crew) developed nausea, vomiting and/or diarrhoea, 11 of them on the first day of the trip. The incidence epidemic curve showed a first peak on Day 1 and a second on Day 4. Nine passengers were hospitalised with gastrointestinal symptoms. Norovirus was found in stool samples from two patients, but the infection could not explain the first peak in the epidemic curve only a few hours after departure. Interviews with the passengers and an inspection of the coach and its water supply implicated the water used for coffee and tea as the potential source. Microbiological investigations of the water were negative, but chemical analysis showed a toxic concentration of copper. Blood copper levels as well as renal and liver function were determined in 28 of the 32 passengers who had been exposed to the water. One passenger who did not have gastrointestinal symptoms had an elevated copper level of 25.9 μmol/L, without loss of liver or renal function. It is likely that the spread of norovirus was enhanced because of vomiting of one of the passengers due to copper intoxication.
More Related Videos
12:32EPA Method 1615. Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. Part III. Virus Detection by RT-qPCR
Published on: January 16, 2016
10:48EPA Method 1615. Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. I. Collection of Virus Samples
Published on: March 28, 2015
Related Concept Videos
Investigation of Disease Outbreaks
Cholera
Bacterial Gastroenteritis
Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
Reservoir of Infection
Microbial Corrosion