The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4263.0: Tuesday, November 18, 2003 - Board 10

Abstract #55229

Not only on cruise ships! A Norwalk virus outbreak at a golf course in Arizona

Mare Schumacher and Alisa Diggs-Gooding. Division of Epidemiology and Data Services, Maricopa County Department of Public Health, 1825 E. Roosevelt, Phoenix, AZ 85006, 602-506-3078,

This is a report on an outbreak of Norwalk virus that was unique in several respects. One death and 71 cases were associated with being present at a particular golf course in Phoenix Arizona in July 2002. Few secondary cases were reported during the early stages of the investigation, leading epidemiologists to consider non-infectious causes. The first case was a death of unknown cause, which is highly unusual for Norwalk-like virus outbreaks. The nature of the event a sports tournament without shared meals necessitated creating a special questionnaire that did not focus on food history. Finally, this is the first reported outbreak of gastrointestinal illness associated with a golf course that does not involve contaminated municipal water. The virus was most likely transmitted through water receptacles that were not properly cleaned and golf players who reached into communal dispensers. The majority of the cases were adolescent boys participating in a junior golf tournament. The paucity of secondary cases may have been due to the lifestyles of adolescent boys of higher SES. These individuals may be less likely to share meals, participate in meal preparation, share sleeping and bathroom facilities with other family members, thereby protecting those family members from the spread of disease. Epidemiologists should keep in mind that Norwalk-like outbreaks may present in atypical ways as relates to organism vectors, secondary spread, and clinical presentations of initial cases.

Learning Objectives:

Keywords: Outbreaks, Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Tuberculosis and Outbreaks: Poster Session

The 131st Annual Meeting (November 15-19, 2003) of APHA