Foodborne Snow Mountain agent gastroenteritis in a school cafeteria

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Gastroenteritis outbreaks pose significant public health challenges, particularly in institutional settings like schools.
• Identifying the causative agent and transmission routes is crucial for effective control measures.

Purpose of the Study:

• To investigate a 1984 gastroenteritis outbreak at a Brooklyn school.
• To identify the causative agent and transmission pathways of the outbreak.

Main Methods:

• A single-stage cluster sample of 375 students was surveyed.
• Case-control analysis was performed, implicating specific foods and cafeteria exposure.
• Blocking enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies for Snow Mountain agent.

Main Results:

• 34% of surveyed students experienced vomiting or diarrhea.
• French fries and hamburgers were implicated foods, with relative risks of 1.7 and 1.6, respectively.
• 55% of case students showed antibody increases for Snow Mountain agent, suggesting viral involvement.

Conclusions:

• The Snow Mountain agent, a Norwalk-like virus, is strongly suspected as the cause of the outbreak.
• Ill food handlers likely contaminated hot foods, but additional transmission routes may have contributed.
• Effective outbreak investigation requires a combination of epidemiological and laboratory methods.