Prevalence of human noroviruses in commercial food establishment bathrooms

Cortney M. Leone, Muthu Dharmasena, Chaoyi Tang, Erin Dicaprio, Yuanmei Ma, Elbashir Araud, Hannah Bolinger, Kitwadee Rupprom, Thomas Yeargin, Jianrong Li, Donald Schaffner, Xiuping Jiang, Julia Sharp, Jan Vinjé, Angela Fraser

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Although transmission of human norovirus in food establishments is commonly attributed to consumption of contaminated food, transmission via contaminated environmental surfaces, such as those in bathrooms, may also play a role. Our aim was to determine the prevalence of human norovirus on bathroom surfaces in commercial food establishments in New Jersey, Ohio, and South Carolina under nonoutbreak conditions and to determine characteristics associated with the presence of human norovirus. Food establishments (751) were randomly selected from nine counties in each state. Four surfaces (underside of toilet seat, flush handle of toilet, inner door handle of stall or outer door, and sink faucet handle) were swabbed in male and female bathrooms using premoistened macrofoam swabs. A checklist was used to collect information about the characteristics, materials, and mechanisms of objects in bathrooms. In total, 61 (1.5%) of 4, 163 swabs tested were presumptively positive for human norovirus, 9 of which were confirmed by sequencing. Some factors associated with the presence of human norovirus included being from South Carolina (odd ratio [OR], 2.4; 95% confidence interval [CI], 1.2 to 4.9; P < 0.05) or New Jersey (OR, 1.7; 95% CI, 0.9 to 3.3; 0.05 < P < 0.10), being a chain establishment (OR, 1.9; 95% CI, 1.1 to 3.3; P< 0.05), being a unisex bathroom (versus male: OR, 2.0; 95% CI, 0.9 to 4.1; 0.05 < P < 0.10; versus female: OR, 2.6; 95% CI, 1.2 to 5.7; P < 0.05), having a touchless outer door handle (OR, 3.3; 95% CI, 0.79 to 13.63; 0.05, P < 0.10), and having an automatic flush toilet (OR, 2.5, 95% CI, 1.1 to 5.3; 0.05 < P < 0.10). Our findings confirm that the presence of human norovirus on bathroom surfaces in commercial food establishments under nonoutbreak conditions is a rare event. Therefore, routine environmental monitoring for human norovirus contamination during nonoutbreak periods is not an efficient method of monitoring norovirus infection risk.

Original languageEnglish (US)
Pages (from-to)719-728
Number of pages10
JournalJournal of food protection
Volume81
Issue number5
DOIs
StatePublished - May 2018

All Science Journal Classification (ASJC) codes

  • Food Science
  • Microbiology

Keywords

  • Bathrooms
  • Environment
  • Fomites
  • Norovirus
  • Restaurants
  • Retail food

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