A reusable grocery bag left in a hotel bathroom caused an outbreak of norovirus-induced diarrhea and nausea that struck nine of 13 members of a girls' soccer team in October, Oregon researchers reported Wednesday. The outbreak also affected many family members after the team returned home.
Norovirus is a common, easily spread virus that causes various forms of gastric distress. It is "the perfect human pathogen" because it is highly contagious, rapidly and prolifically spread, produces limited immunity and is only moderately virulent, which allows it to continue spreading, said Dr. Aron J. Hall of the Centers for Disease Control and Prevention in an editorial accompanying the report in the Journal of Infectious Diseases. In the United States alone, noroviruses are responsible for an estimated 21 million acute cases of gastroenteritis annually, with more than 70,000 hospitalizations and nearly 800 deaths. Worldwide, the virus accounts for more than half of all diarrheal diseases, causing the deaths of 200,000 children annually.
The team of 13 girls and four chaperones traveled to an out-of-town soccer tournament. One of the girls got sick shortly after arrival, from a norovirus she presumably acquired prior to the trip, Dr. Kimberly K. Repp of the Oregon Health and Science University and Dr. William E. Keene of the Oregon Public Health Division reported in the journal. The sick girl was then isolated in the room of one of the chaperones. Nonetheless, eight other girls became ill. The investigation showed that the virus was found on a reusable grocery bag that had been used to store snacks for the team. It had, unfortunately, been stored in the bathroom. When the sick girl used the bathroom, the norovirus was aerosolized and deposited on the bag, where it was later transferred to other girls when they got snacks.
"While we certainly recommend not storing food in bathrooms," Repp and Keene wrote, "it is more important to recommend that areas where aerosol exposures may have occurred should be thoroughly disinfected; this includes not only exposed surfaces, but objects in the environment" such as grocery bags.