Bella Blu Restaurant Norovirus Outbreak
On January 11, 2016, the New York Office of Environmental Investigations (OEI) received a complaint about a party of four people who became ill after sharing a meal on January 8, 2016 at Bella Blu Restaurant located at 967 Lexington Ave, New York, NY 10021. The following day, OEI received a second complaint regarding four of six people becoming ill after sharing a meal at the restaurant on January 9, 2016. Other restaurant attendees reported their illnesses on Yelp, describing becoming ill with symptoms of diarrhea, vomiting, nausea, cramps, fever, headache, and chills occurring one-to-two days after their meals.
OEI interviewed four of the six attendees of the initial complainant’s party and the complainant of the second party, and obtained exposure information as well as additional party attendees’ information. The Bureau of Communicable Disease (BCD) developed questionnaires about clinical symptoms and food exposures specific to each meal time (brunch, lunch, and dinner). BCD interviewed two additional party attendees of the initial complainant’s party, and all of the party attendees of the second party using the questionnaire. BCD also attempted to interview all patrons on the OpenTable reservation list. A case was defined as anyone who consumed food at Bella Blu restaurant and experienced (1) diarrhea and/or vomiting, and (2) either nausea, abdominal cramps or fever. BCD distributed stool kits to ill patrons who were willing to submit stool for testing and the New York City Department of Health and Mental Hygiene Public Health Laboratory.
In total, sixty-nine patrons who dined at Bella Blu between January 7, 2016 and January 16, 2016 were interviewed. Thirty-five patrons reported experiencing symptoms and thirty met the case definition. Among the cases, 20 (69%) were female and 9 (31%) were male. The median age of cases was 36, ranging from 23 to 68 years of age. The median incubation period was 2 days, with a range of <1 to 6 days. The median duration of illness was 2 days, with a range of 1 to 4 days. Two cases reported hospitalization, and onset dates of cases ranged from January 9 to January 15.
Epidemiological analysis was conducted for 96 food items offered on the Bella Blu menu and indicated that the mixed green starter with hearts of palm, avocado, roasted peppers, radish, corn and tiramisu Bella Blu dessert were significantly associated with illness.
Three stool samples submitted to the Public Health Laboratory by individuals who dined at Bella Blu restaurant tested positive for norovirus genogroup II. All six of the food handlers who submitted stool specimen tested positive for norovirus genogroup II.
OEI discussed proper food handling procedures, proper hand washing, safe food handling, and daily sanitization procedures with restaurant food handlers and management. Proper usage of gloves during food preparation was discussed and demonstrated with food handlers present. OEI also advised that all food handlers take or retake the New York City Food Protections Course and that Bella Blu hire an environmental consultant to oversee food operations.