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Quantitative Risk Assessment of Norovirus Transmission in Food Establishments: Evaluating the Impact of Intervention Strategies and Food Employee Behavior on the Risk Associated with Norovirus in Foods

Author

Listed:
  • Steven Duret
  • Régis Pouillot
  • Wendy Fanaselle
  • Efstathia Papafragkou
  • Girvin Liggans
  • Laurie Williams
  • Jane M. Van Doren

Abstract

We developed a quantitative risk assessment model using a discrete event framework to quantify and study the risk associated with norovirus transmission to consumers through food contaminated by infected food employees in a retail food setting. This study focused on the impact of ill food workers experiencing symptoms of diarrhea and vomiting and potential control measures for the transmission of norovirus to foods. The model examined the behavior of food employees regarding exclusion from work while ill and after symptom resolution and preventive measures limiting food contamination during preparation. The mean numbers of infected customers estimated for 21 scenarios were compared to the estimate for a baseline scenario representing current practices. Results show that prevention strategies examined could not prevent norovirus transmission to food when a symptomatic employee was present in the food establishment. Compliance with exclusion from work of symptomatic food employees is thus critical, with an estimated range of 75–226% of the baseline mean for full to no compliance, respectively. Results also suggest that efficient handwashing, handwashing frequency associated with gloving compliance, and elimination of contact between hands, faucets, and door handles in restrooms reduced the mean number of infected customers to 58%, 62%, and 75% of the baseline, respectively. This study provides quantitative data to evaluate the relative efficacy of policy and practices at retail to reduce norovirus illnesses and provides new insights into the interactions and interplay of prevention strategies and compliance in reducing transmission of foodborne norovirus.

Suggested Citation

  • Steven Duret & Régis Pouillot & Wendy Fanaselle & Efstathia Papafragkou & Girvin Liggans & Laurie Williams & Jane M. Van Doren, 2017. "Quantitative Risk Assessment of Norovirus Transmission in Food Establishments: Evaluating the Impact of Intervention Strategies and Food Employee Behavior on the Risk Associated with Norovirus in Food," Risk Analysis, John Wiley & Sons, vol. 37(11), pages 2080-2106, November.
    • Handle: RePEc:wly:riskan:v:37:y:2017:i:11:p:2080-2106
    DOI: 10.1111/risa.12758
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    References listed on IDEAS

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    1. Philip J. Schmidt, 2015. "Norovirus Dose–Response: Are Currently Available Data Informative Enough to Determine How Susceptible Humans Are to Infection from a Single Virus?," Risk Analysis, John Wiley & Sons, vol. 35(7), pages 1364-1383, July.
    2. Syed A Sattar & Mohammad Ali & Jason A Tetro, 2011. "In Vivo Comparison of Two Human Norovirus Surrogates for Testing Ethanol-Based Handrubs: The Mouse Chasing the Cat!," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-6, February.
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    Cited by:

    1. Amir Mokhtari & Jane M. Van Doren, 2019. "An Agent‐Based Model for Pathogen Persistence and Cross‐Contamination Dynamics in a Food Facility," Risk Analysis, John Wiley & Sons, vol. 39(5), pages 992-1021, May.
    2. Steven Duret & Hong‐Minh Hoang & Evelyne Derens‐Bertheau & Anthony Delahaye & Onrawee Laguerre & Laurent Guillier, 2019. "Combining Quantitative Risk Assessment of Human Health, Food Waste, and Energy Consumption: The Next Step in the Development of the Food Cold Chain?," Risk Analysis, John Wiley & Sons, vol. 39(4), pages 906-925, April.

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