Is norovirus a foodborne or pandemic pathogen? An analysis of the transmission of norovirus-associated gastroenteritis and the roles of food and food handlers.

This study examined the association of norovirus with foodborne disease outbreaks linked to food handlers and foodborne outbreaks of acute gastroenteritis associated with norovirus, in comparison to Salmonella foodborne gastroenteritis. Comparative analysis using chi(2)-tests showed no similarity between the outbreaks from norovirus and those from Salmonella. Odds ratios also showed a stronger similarity between the proportions of food handler-implicated norovirus outbreaks than from Salmonella-implicated outbreaks. An analysis of data found norovirus transmission to occur more frequently spread person-to-person, unlike Salmonella, but similar to influenza or rotavirus. Norovirus was also not shown to be associated with food consumption. The data collection tool that focuses on food handlers as a source of the virus may be better including the general human population. Such an enteric virus would be better understood through its similarity to the person-to-person transmission model resulting in pandemic spread.