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Morphologic Identification of Viral Gastroenteritis Caused by a Human Calicivirus Strain Undetected Initially by Molecular or Immunologic Methods

Molecular and immunologie assays for virus identification and characterization are well known for their high specificity and sensitivity. High specificity occasionally hampers efforts to detect virus strains distantly related to previously recognized types and may allow infectious agents to be undetected when these techniques are used for identification. We describe in this report such an example with an outbreak of foodborne gastroenteritis. Forty-six cases of gastrointestinal illness were reported in May 1994 among adult staff of a Parkville, Md., school after a catered luncheon. Symptoms included stomach cramps, nausea, diarrhea, and vomiting. Seven stool specimens, negative by routine bacteriological screening, and 14 acute-and convalescent-phase sera from patients involved in the outbreak were tested for viruses. The stool specimens were examined by electron microscopy (EM) and reverse transcription-polymerase chain reaction (RT-PCR) designed to detect small round structured viruses (SRSVs). In addition, serum specimens were tested for IgG antibody to recombinant capsid proteins from Norwalk virus (rNV) and Toronto virus (rTV) using a direct enzyme immunoassay (EIA).