It's not just Montezuma's revenge anymore ... - Free Online Library

Editor's note Editor's Note (foaled in 1993 in Kentucky) is an American thoroughbred Stallion racehorse. He was sired by 1992 U.S. Champion 2 YO Colt Forty Niner, who in turn was a son of Champion sire Mr. Prospector and out of the mare, Beware Of The Cat.

Trained by D.
: The Journal recognizes the importance of providing readers with practical and relevant legal information through Legal Briefs Legal Briefs is an interactive television program aired on CablePulse24 and CourtTV Canada, hosted by Lorne Honickman, a lawyer and journalist, as he discusses the ins & outs of the Canadian legal system and provides free legal advice.  columns. In every other issue of the Journal, this information is presented by one or more of several insightful and dedicated columnists: Bill Marler, Denis Denis, king of Portugal: see Diniz.  Stearns, Drew Falkenstein, Patti Waller, and David W. Babcock, all of the law firm Marler Clark.

The attorneys at Seattle-based Marler Clark, LLP LLP - Lower Layer Protocol , PS (www.marlerclark.com) have developed a nationally known practice in the field of food safety. Marler Clark represents people who have been seriously injured, or the families of those who have died, after becoming ill with foodborne illness during outbreaks traced to restaurants, grocery chains, and other food suppliers. The attorneys have litigated thousands of food contamination cases throughout the United States, many of them high-profile, including the Jack in the Box and Odwalla E. coli E. coli: see Escherichia coli.
E. coli
 in full Escherichia coli

Species of bacterium that inhabits the stomach and intestines. E. coli can be transmitted by water, milk, food, or flies and other insects.
 outbreaks; the Malt-O-Meal, Sun Orchard, and Chili's Salmonella outbreaks; the Senor Felix Shigella shigella

Any of the rod-shaped bacteria that make up the genus Shigella, which are normal inhabitants of the human intestinal tract and can cause dysentery, or shigellosis. Shigellae are gram-negative (see gram stain), non-spore-forming, stationary bacteria. S.
 outbreak; and the Subway and Chi-Chi's hepatitis A Hepatitis A Definition

Hepatitis A is an inflammation of the liver caused by a virus, the hepatitis A virus (HAV). It varies in severity, running an acute course, generally starting within two to six weeks after contact with the virus, and lasting no
 outbreaks.

David W. Babcock, the author of this month's installment, joined Marler Clark as the firm's senior litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute.

When a person begins a civil lawsuit, the person enters into a process called litigation.
 associate in 2001. Representing children and the elderly has been central to Mr. Babcock's practice at Marler Clark, where he focuses on litigation resulting from foodborne-illness outbreaks.

Last night you attended a catered function for your favorite charity. Now, 24 hours later, you are feeling less than charitable. In the past hour, you have vomited five times. Your head is pounding, your back aches, and you have a fever. Just before the diarrhea begins, a friend from the charity's board calls to see how you are doing. She informs you that several others who attended the function are sharing in your misery.

Noroviruses 101

If you found yourself in a scenario such as this one, chances would be that you had contracted a norovirus. You would not be alone. Noroviruses is the name given to a group of related viruses that cause acute gastroenteritis gastroenteritis: see enteritis.
gastroenteritis

Acute infectious syndrome of the stomach lining and intestines. Symptoms include diarrhea, vomiting, and abdominal cramps.
 in 23 million cases a year, according to estimates by the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center.  (CDC See Control Data, century date change and Back Orifice.

CDC - Control Data Corporation
). (1) Of viruses, only the common cold is reported more often than viral gastroenteritis viral gastroenteritis Intestinal flu Infectious disease A generic term for GE induced by viruses Clinical presentations 1. Epidemic VGE, most often caused by the Norwalk agent or Norwalk-like viruses Clinical N&V, diarrhea, abdominal pain, anorexia, . (2)

Norovirus is recognized as the cause of over half of all foodborne-illness outbreaks. In fact, of 232 outbreaks of norovirus between July 1997 and June 2000, 57 percent were food-borne, 16 percent were spread from person to person, and 3 percent were waterborne. (3)

The good news about noroviruses is that they are very unlikely to cause serious or lasting injury While the acute symptoms of norovirus--nausea, vomiting, diarrhea, fever, chills, and aches--can be severe, they typically last less than 60 hours. (4) People infected with norovirus usually recover in two to three days; however, in some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children, the elderly, and immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer).  adults in hospitals and nursing homes. (5)

Reported outbreaks associated with noroviruses are on the rise. It is not clear, however, whether this rise is due to any increase in illnesses. In the past 10 to 15 years, diagnostic techniques for identifying noroviruses have advanced significantly, and increased reports may simply be due to an increase in surveillance. One way or the other, public awareness seems to be increasing.

Increased public awareness of noroviruses could be due in large part to the most common settings for outbreaks. Those settings include restaurants and catered meals (36 percent); nursing homes (23 percent); schools

(13 percent); and "vacation settings or cruise ships" (10 percent). (6) Nursing homes, schools, and cruise ships rank high on this list primarily because proximity among potential outbreak members plays a dominant role in the spread of noroviruses.

Noroviruses are highly contagious--spreading either in fecal matter or vomitus vomitus /vom·i·tus/ (vom´i-tus) [L.]
1. vomiting.

2. matter vomited.


vom·i·tus
n.
Vomited matter.



vomitus

1. vomiting.

2. vomited material.
. There is strong evidence that norovirus is prone to "aerosolization," allowing microscopic droplets to contaminate con·tam·i·nate
v.
1. To make impure or unclean by contact or mixture.

2. To expose to or permeate with radioactivity.



con·tam·i·nant n.
 surfaces and making for easy transmission from person to person. (7) Charmingly enough, the "projectile projectile

something thrown forward.


projectile syringe
see blow dart.

projectile vomiting
forceful vomiting, usually without preceding retching, in which the vomitus is thrown well forward.
" nature of vomiting associated with noroviruses is a contributing factor here as well.

Elderly populations, such as residents of long-term care facilities long-term care facility
n.
See skilled nursing facility.
, are more likely to suffer severe complications from norovirus infection. Factors that play a role in this heightened virulence among elderly populations include

* age-induced decrease in stomach acid production, which allows ingested in·gest  
tr.v. in·gest·ed, in·gest·ing, in·gests
1. To take into the body by the mouth for digestion or absorption. See Synonyms at eat.

2.
 pathogens to enter the intestinal tract; (8)

* age-induced decrease in cellular and hu-moral immunity, which is caused by decreased T-cell activity, and thus decreases resistance to pathogens; (9) and

* age-induced decrease in peristalsis peristalsis: see digestive system.
peristalsis

Progressive wavelike muscle contractions in the esophagus, stomach, and intestines, and sometimes in the ureters and other hollow tubes.
, (11) which significantly slows the elimination of enteric enteric /en·ter·ic/ (en-ter´ik) within or pertaining to the small intestine.

en·ter·ic
adj.
1. Of, relating to, or within the intestine.

2.
 pathogens.(12)

Legal Implications

The legal fallout from outbreaks of noroviruses depends largely on the setting of the outbreak and the vehicle of transmission. Determining whether the method of transmission was foodborne or waterborne or was person to person will go a long way toward determining the causes of action available to those who were made ill.

Foodborne Norovirus Claims

Foodborne norovirus outbreaks in commercial food service settings give rise to strict product liability claims, just as they would with more notorious pathogens like E. coli 0157:H7, Salmonella, and hepatitis A. Contaminated contaminated,
v 1. made radioactive by the addition of small quantities of radioactive material.
2. made contaminated by adding infective or radiographic materials.
3. an infective surface or object.
 food cases were among the earliest cases to establish strict liability principles, in Washington and elsewhere. (12) Today it is plainly established that restaurant or catered meals are in fact a product, and that the act of preparing them is manufacturing. (13) Because prepared food items contaminated with a pathogen are essentially per se defective, such cases turn almost entirely on the issue of causation. (14) In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently
, the focus of the plaintiff's case would be proving the link between the individual plaintiff's illness and the established outbreak.

Person-to-Person Transmission in Commercial or Institutional Settings

Different issues arise outside of the foodborne context. When transmission of the illness cannot be tied to consumption of a product, strict liability principles are most likely not available. (15) Where the spread of a norovirus outbreak has occurred through person-to-person transmission without the aid of a food item, traditional notions of negligence (16) and premises liability (17) are more applicable.

The duties of hotels, conference centers, health care facilities, and cruise ships to prevent the spread of noroviruses among their patrons are consistent with their general duties under common carrier (18) and business invitee business invitee n. a person entering commercial premises for the purpose of doing business, rather than just taking a short cut to the next street. It is important since a business is liable to a business invitee for injury caused by dangerous conditions such as bad  (19) doctrines. Consistent with these principles, such businesses would have a duty to take reasonable steps to prevent such transmission, to respond accordingly in high-risk scenarios, and to sufficiently warn patrons of the risks of transmission. For example, Marler Clark is involved in litigation resulting from an outbreak of a norovirus involving more than 1,000 people associated with a large hotel in 2004. A central issue in that litigation is whether the hotel took adequate steps to prevent the spread of the illness, such as removing sick employees from the workplace; cleaning properly after ill guests; and restricting access to high-risk areas and activities. Also at issue is the adequacy of the hotel's communication of the situation to its guests and other patrons.

Cruise Ships

Outbreaks of noroviruses on cruise ships present some additional legal considerations. According to CDC,
  Cruise-ship outbreaks demonstrate how easily noroviruses can be
  transmitted from person to person in a closed environment, resulting
  in large outbreaks. The continuation of these outbreaks on consecutive
  cruises ... suggests that environmental contamination and infected
  crew members can serve as reservoirs of infection for passengers. (20)


The CDC now operates a Vessel Sanitation Program Vessel Sanitation Program See Sanitation score.  designed to combat the problem. (21) In addition, measures implemented by cruise ships to combat the spread of illnesses on board often include quarantining of passengers who report themselves ill. While this method is likely effective in curbing the spread of illness, it is not always a welcome development for the sick individual or family.

Passengers' rights in such situations are frequently curtailed by conditions imposed through the purchase of the ticket. These limitations often include forum selection clauses, (22) shortened statutes of limitations, (23) and arbitration clauses. (24) As a general rule, these limitations have been upheld. (25)

Protecting Against Norovirus

There are a few things that individuals can do to reduce the risk of contracting noroviruses. These include frequent handwashing, washing fruits and vegetables before consumption, quickly and thoroughly cleaning contaminated areas, and removing and perhaps discarding implicated im·pli·cate  
tr.v. im·pli·cat·ed, im·pli·cat·ing, im·pli·cates
1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot.

2.
 clothing and linens.

For businesses hoping to avoid sickening patrons and incurring potential legal hassles, there are additional precautions to take. A first step is to educate employees on the importance of personal hygiene. In conjunction, food service and hospitality industry businesses should make every effort to keep sick workers out of the workplace. Finally, each establishment should have a well-thought-out and feasible plan for responding to incidence of illness on the premises quickly and effectively.

Efforts on both sides of the "table," as it were, will help all of us enjoy a healthier and safer environment.

(Portions reprinted, with permission, from Bar Bulletin, August 2007, Volume 25, Issue 12, pages 12-13, a publication of the King County Bar Association.)

Disclaimer: Legal Briefs is published for informational purposes only; none of the information is intended to be, nor is, formal legal advice. NEHA NEHA National Environmental Health Association
NEHA National Executive Housekeepers Association
NEHA Northern Estates Homeowners Association (Indianapolis, Indiana) 
 and the Journal of Environmental Health are not liable or responsible for actions taken on the basis of the information contained in these columns.

References

1. CDC. Norovirus: Technical Fact Sheet. at http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm. Last updated on August 3, 2006. Accessed on August 14, 2007.

2. FDA/Center for Food Safety and Applied Nutrition. The Bad Bug Book: Norwalk Virus Nor·walk virus
n.
A norovirus.


Norwalk virus (nôr´wôlk),
n.
 Family, at http://www.cfsan.fda.gov/~mow/chap34.html. January 1992 with periodic updates. Accessed on September 4, 2007.

3. See CDC Web site n. 1 Supra A relational DBMS from Cincom Systems, Inc., Cincinnati, OH (www.cincom.com) that runs on IBM mainframes and VAXs. It includes a query language and a program that automates the database design process. .

4. Id.

5. Mayo Clinic. Norovirus. April 5, 2007. at http://www.mayoclinic.com/health/norovirus/DS00942/DSECTION=1. Accessed on August 15, 2007.

6. See CDC website n. 1 Supra

7. Id.

8. See, James L. Smith. Foodborne Illness and the Elderly. Journal of Food Protection. Sept. 1998 at 1229-39.

9. Id.

10. Peristalsis is the rhythmic contraction of smooth muscles to propel contents through the digestive tract digestive tract
n.
See alimentary canal.


Digestive tract
The organs that perform digestion, or changing of food into a form that can be absorbed by the body.
.

11. Supra at 21.

12. Mazetti v. Armour & Co., 75 Wash. 622 (1913).

13. Almquist v. Finley School District, 114 Wn. App. 395, 57 P.3d 1191 (2002).

14. See R. Drew Falkenstein. An Introduction to Liability, Negligence, and All Things in Between: Part I. Journal of Environmental Health. Sept. 2005 at 41.

15. The illness need not be tied to a specific food item, which is often very difficult. A link to a meal, or even to food from a particular source over a time frame is sufficient. For example, a sick food service worker might contaminate a wide variety of foods over a certain time frame, making isolation to a specific food very difficult, but not exonerating the food service establishment.

16. Supra at 10.

17. See David W. Babcock. Legal Implications of Zoonotic Disease Outbreaks at Petting Zoos and Animal Exhibits. Journal of Environmental Health. November, 2006 at 46.

18. A common carrier is an organization that transports persons or goods, and offers its services to the general public. See WILLSTN-CN [section]58:3 (4th ed.).

19. A business invitee is a person who is invited to enter or remain on land for a purpose directly or indirectly connected with business dealings with the possessor of the land. See Restatement (Second) of Torts [section]332 (1965).

20. CDC. Outbreaks of gastroenteritis associated with noroviruses on cruise ships--United States, 2002. MMWR MMWR Morbidity & Mortality Weekly Report Epidemiology A news bulletin published by the CDC, which provides epidemiologic data–eg, statistics on the incidence of AIDS, rabies, rubella, STDs and other communicable diseases, causes of mortality–eg, , Dec. 13, 2002 at 1112-1115.

21. "Vessel Sanitation Program." at http://www.cdc.gov/nceh/vsp/desc/aboutvsp.htm. Accessed on August 16, 2007.

22. A "forum selection" provision in a contract designates a particular state or court as the jurisdiction in which the parties will litigate disputes arising out of the contract. See 17A Am. Jur. 2d Contracts [section]259.

23. Statues of limitation are designed to protect potential defendants from stale claims by requiring plaintiffs to assert claims within a reasonable time period while evidence is fresh. See 51 Am. Jur. 2d Limitation of Actions [section]15.

24. An arbitration clause is a provision to a contract requiring the arbitration of disputes under the contract. See 67 Am. Jur. 2d Sales [section]156.

25. Carnival Cruise Lines, Inc. v. Shute Carnival Cruise Lines, Inc. v. Shute, 499 U.S. 585 (1991)[1], was a case in which the Supreme Court of the United States held that United States federal courts will enforce forum selection clauses so long as the clause is not unreasonably burdensome to , 499 U.S. 585 (1991).

David W. Babcock, J.D.

[ILLUSTRATION OMITTED]

Editor's note Editor's Note (foaled in 1993 in Kentucky) is an American thoroughbred Stallion racehorse. He was sired by 1992 U.S. Champion 2 YO Colt Forty Niner, who in turn was a son of Champion sire Mr. Prospector and out of the mare, Beware Of The Cat.

Trained by D.
: The Journal recognizes the importance of providing readers with practical and relevant legal information through Legal Briefs Legal Briefs is an interactive television program aired on CablePulse24 and CourtTV Canada, hosted by Lorne Honickman, a lawyer and journalist, as he discusses the ins & outs of the Canadian legal system and provides free legal advice.  columns. In every other issue of the Journal, this information is presented by one or more of several insightful and dedicated columnists: Bill Marler, Denis Denis, king of Portugal: see Diniz.  Stearns, Drew Falkenstein, Patti Waller, and David W. Babcock, all of the law firm Marler Clark.

The attorneys at Seattle-based Marler Clark, LLP LLP - Lower Layer Protocol , PS (www.marlerclark.com) have developed a nationally known practice in the field of food safety. Marler Clark represents people who have been seriously injured, or the families of those who have died, after becoming ill with foodborne illness during outbreaks traced to restaurants, grocery chains, and other food suppliers. The attorneys have litigated thousands of food contamination cases throughout the United States, many of them high-profile, including the Jack in the Box and Odwalla E. coli E. coli: see Escherichia coli.
E. coli
 in full Escherichia coli

Species of bacterium that inhabits the stomach and intestines. E. coli can be transmitted by water, milk, food, or flies and other insects.
 outbreaks; the Malt-O-Meal, Sun Orchard, and Chili's Salmonella outbreaks; the Senor Felix Shigella shigella

Any of the rod-shaped bacteria that make up the genus Shigella, which are normal inhabitants of the human intestinal tract and can cause dysentery, or shigellosis. Shigellae are gram-negative (see gram stain), non-spore-forming, stationary bacteria. S.
 outbreak; and the Subway and Chi-Chi's hepatitis A Hepatitis A Definition

Hepatitis A is an inflammation of the liver caused by a virus, the hepatitis A virus (HAV). It varies in severity, running an acute course, generally starting within two to six weeks after contact with the virus, and lasting no
 outbreaks.

David W. Babcock, the author of this month's installment, joined Marler Clark as the firm's senior litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute.

When a person begins a civil lawsuit, the person enters into a process called litigation.
 associate in 2001. Representing children and the elderly has been central to Mr. Babcock's practice at Marler Clark, where he focuses on litigation resulting from foodborne-illness outbreaks.

Last night you attended a catered function for your favorite charity. Now, 24 hours later, you are feeling less than charitable. In the past hour, you have vomited five times. Your head is pounding, your back aches, and you have a fever. Just before the diarrhea begins, a friend from the charity's board calls to see how you are doing. She informs you that several others who attended the function are sharing in your misery.

Noroviruses 101

If you found yourself in a scenario such as this one, chances would be that you had contracted a norovirus. You would not be alone. Noroviruses is the name given to a group of related viruses that cause acute gastroenteritis gastroenteritis: see enteritis.
gastroenteritis

Acute infectious syndrome of the stomach lining and intestines. Symptoms include diarrhea, vomiting, and abdominal cramps.
 in 23 million cases a year, according to estimates by the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center.  (CDC See Control Data, century date change and Back Orifice.

CDC - Control Data Corporation
). (1) Of viruses, only the common cold is reported more often than viral gastroenteritis viral gastroenteritis Intestinal flu Infectious disease A generic term for GE induced by viruses Clinical presentations 1. Epidemic VGE, most often caused by the Norwalk agent or Norwalk-like viruses Clinical N&V, diarrhea, abdominal pain, anorexia, . (2)

Norovirus is recognized as the cause of over half of all foodborne-illness outbreaks. In fact, of 232 outbreaks of norovirus between July 1997 and June 2000, 57 percent were food-borne, 16 percent were spread from person to person, and 3 percent were waterborne. (3)

The good news about noroviruses is that they are very unlikely to cause serious or lasting injury While the acute symptoms of norovirus--nausea, vomiting, diarrhea, fever, chills, and aches--can be severe, they typically last less than 60 hours. (4) People infected with norovirus usually recover in two to three days; however, in some cases, severe dehydration, malnutrition, and even death can result from norovirus infection, especially among children, the elderly, and immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer).  adults in hospitals and nursing homes. (5)

Reported outbreaks associated with noroviruses are on the rise. It is not clear, however, whether this rise is due to any increase in illnesses. In the past 10 to 15 years, diagnostic techniques for identifying noroviruses have advanced significantly, and increased reports may simply be due to an increase in surveillance. One way or the other, public awareness seems to be increasing.

Increased public awareness of noroviruses could be due in large part to the most common settings for outbreaks. Those settings include restaurants and catered meals (36 percent); nursing homes (23 percent); schools

(13 percent); and "vacation settings or cruise ships" (10 percent). (6) Nursing homes, schools, and cruise ships rank high on this list primarily because proximity among potential outbreak members plays a dominant role in the spread of noroviruses.

Noroviruses are highly contagious--spreading either in fecal matter or vomitus vomitus /vom·i·tus/ (vom´i-tus) [L.]
1. vomiting.

2. matter vomited.


vom·i·tus
n.
Vomited matter.



vomitus

1. vomiting.

2. vomited material.
. There is strong evidence that norovirus is prone to "aerosolization," allowing microscopic droplets to contaminate con·tam·i·nate
v.
1. To make impure or unclean by contact or mixture.

2. To expose to or permeate with radioactivity.



con·tam·i·nant n.
 surfaces and making for easy transmission from person to person. (7) Charmingly enough, the "projectile projectile

something thrown forward.


projectile syringe
see blow dart.

projectile vomiting
forceful vomiting, usually without preceding retching, in which the vomitus is thrown well forward.
" nature of vomiting associated with noroviruses is a contributing factor here as well.

Elderly populations, such as residents of long-term care facilities long-term care facility
n.
See skilled nursing facility.
, are more likely to suffer severe complications from norovirus infection. Factors that play a role in this heightened virulence among elderly populations include

* age-induced decrease in stomach acid production, which allows ingested in·gest  
tr.v. in·gest·ed, in·gest·ing, in·gests
1. To take into the body by the mouth for digestion or absorption. See Synonyms at eat.

2.
 pathogens to enter the intestinal tract; (8)

* age-induced decrease in cellular and hu-moral immunity, which is caused by decreased T-cell activity, and thus decreases resistance to pathogens; (9) and

* age-induced decrease in peristalsis peristalsis: see digestive system.
peristalsis

Progressive wavelike muscle contractions in the esophagus, stomach, and intestines, and sometimes in the ureters and other hollow tubes.
, (11) which significantly slows the elimination of enteric enteric /en·ter·ic/ (en-ter´ik) within or pertaining to the small intestine.

en·ter·ic
adj.
1. Of, relating to, or within the intestine.

2.
 pathogens.(12)

Legal Implications

The legal fallout from outbreaks of noroviruses depends largely on the setting of the outbreak and the vehicle of transmission. Determining whether the method of transmission was foodborne or waterborne or was person to person will go a long way toward determining the causes of action available to those who were made ill.

Foodborne Norovirus Claims

Foodborne norovirus outbreaks in commercial food service settings give rise to strict product liability claims, just as they would with more notorious pathogens like E. coli 0157:H7, Salmonella, and hepatitis A. Contaminated contaminated,
v 1. made radioactive by the addition of small quantities of radioactive material.
2. made contaminated by adding infective or radiographic materials.
3. an infective surface or object.
 food cases were among the earliest cases to establish strict liability principles, in Washington and elsewhere. (12) Today it is plainly established that restaurant or catered meals are in fact a product, and that the act of preparing them is manufacturing. (13) Because prepared food items contaminated with a pathogen are essentially per se defective, such cases turn almost entirely on the issue of causation. (14) In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently
, the focus of the plaintiff's case would be proving the link between the individual plaintiff's illness and the established outbreak.

Person-to-Person Transmission in Commercial or Institutional Settings

Different issues arise outside of the foodborne context. When transmission of the illness cannot be tied to consumption of a product, strict liability principles are most likely not available. (15) Where the spread of a norovirus outbreak has occurred through person-to-person transmission without the aid of a food item, traditional notions of negligence (16) and premises liability (17) are more applicable.

The duties of hotels, conference centers, health care facilities, and cruise ships to prevent the spread of noroviruses among their patrons are consistent with their general duties under common carrier (18) and business invitee business invitee n. a person entering commercial premises for the purpose of doing business, rather than just taking a short cut to the next street. It is important since a business is liable to a business invitee for injury caused by dangerous conditions such as bad  (19) doctrines. Consistent with these principles, such businesses would have a duty to take reasonable steps to prevent such transmission, to respond accordingly in high-risk scenarios, and to sufficiently warn patrons of the risks of transmission. For example, Marler Clark is involved in litigation resulting from an outbreak of a norovirus involving more than 1,000 people associated with a large hotel in 2004. A central issue in that litigation is whether the hotel took adequate steps to prevent the spread of the illness, such as removing sick employees from the workplace; cleaning properly after ill guests; and restricting access to high-risk areas and activities. Also at issue is the adequacy of the hotel's communication of the situation to its guests and other patrons.

Cruise Ships

Outbreaks of noroviruses on cruise ships present some additional legal considerations. According to CDC,
  Cruise-ship outbreaks demonstrate how easily noroviruses can be
  transmitted from person to person in a closed environment, resulting
  in large outbreaks. The continuation of these outbreaks on consecutive
  cruises ... suggests that environmental contamination and infected
  crew members can serve as reservoirs of infection for passengers. (20)


The CDC now operates a Vessel Sanitation Program Vessel Sanitation Program See Sanitation score.  designed to combat the problem. (21) In addition, measures implemented by cruise ships to combat the spread of illnesses on board often include quarantining of passengers who report themselves ill. While this method is likely effective in curbing the spread of illness, it is not always a welcome development for the sick individual or family.

Passengers' rights in such situations are frequently curtailed by conditions imposed through the purchase of the ticket. These limitations often include forum selection clauses, (22) shortened statutes of limitations, (23) and arbitration clauses. (24) As a general rule, these limitations have been upheld. (25)

Protecting Against Norovirus

There are a few things that individuals can do to reduce the risk of contracting noroviruses. These include frequent handwashing, washing fruits and vegetables before consumption, quickly and thoroughly cleaning contaminated areas, and removing and perhaps discarding implicated im·pli·cate  
tr.v. im·pli·cat·ed, im·pli·cat·ing, im·pli·cates
1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot.

2.
 clothing and linens.

For businesses hoping to avoid sickening patrons and incurring potential legal hassles, there are additional precautions to take. A first step is to educate employees on the importance of personal hygiene. In conjunction, food service and hospitality industry businesses should make every effort to keep sick workers out of the workplace. Finally, each establishment should have a well-thought-out and feasible plan for responding to incidence of illness on the premises quickly and effectively.

Efforts on both sides of the "table," as it were, will help all of us enjoy a healthier and safer environment.

(Portions reprinted, with permission, from Bar Bulletin, August 2007, Volume 25, Issue 12, pages 12-13, a publication of the King County Bar Association.)

Disclaimer: Legal Briefs is published for informational purposes only; none of the information is intended to be, nor is, formal legal advice. NEHA NEHA National Environmental Health Association
NEHA National Executive Housekeepers Association
NEHA Northern Estates Homeowners Association (Indianapolis, Indiana) 
 and the Journal of Environmental Health are not liable or responsible for actions taken on the basis of the information contained in these columns.

References

1. CDC. Norovirus: Technical Fact Sheet. at http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-factsheet.htm. Last updated on August 3, 2006. Accessed on August 14, 2007.

2. FDA/Center for Food Safety and Applied Nutrition. The Bad Bug Book: Norwalk Virus Nor·walk virus
n.
A norovirus.


Norwalk virus (nôr´wôlk),
n.
 Family, at http://www.cfsan.fda.gov/~mow/chap34.html. January 1992 with periodic updates. Accessed on September 4, 2007.

3. See CDC Web site n. 1 Supra A relational DBMS from Cincom Systems, Inc., Cincinnati, OH (www.cincom.com) that runs on IBM mainframes and VAXs. It includes a query language and a program that automates the database design process. .

4. Id.

5. Mayo Clinic. Norovirus. April 5, 2007. at http://www.mayoclinic.com/health/norovirus/DS00942/DSECTION=1. Accessed on August 15, 2007.

6. See CDC website n. 1 Supra

7. Id.

8. See, James L. Smith. Foodborne Illness and the Elderly. Journal of Food Protection. Sept. 1998 at 1229-39.

9. Id.

10. Peristalsis is the rhythmic contraction of smooth muscles to propel contents through the digestive tract digestive tract
n.
See alimentary canal.


Digestive tract
The organs that perform digestion, or changing of food into a form that can be absorbed by the body.
.

11. Supra at 21.

12. Mazetti v. Armour & Co., 75 Wash. 622 (1913).

13. Almquist v. Finley School District, 114 Wn. App. 395, 57 P.3d 1191 (2002).

14. See R. Drew Falkenstein. An Introduction to Liability, Negligence, and All Things in Between: Part I. Journal of Environmental Health. Sept. 2005 at 41.

15. The illness need not be tied to a specific food item, which is often very difficult. A link to a meal, or even to food from a particular source over a time frame is sufficient. For example, a sick food service worker might contaminate a wide variety of foods over a certain time frame, making isolation to a specific food very difficult, but not exonerating the food service establishment.

16. Supra at 10.

17. See David W. Babcock. Legal Implications of Zoonotic Disease Outbreaks at Petting Zoos and Animal Exhibits. Journal of Environmental Health. November, 2006 at 46.

18. A common carrier is an organization that transports persons or goods, and offers its services to the general public. See WILLSTN-CN [section]58:3 (4th ed.).

19. A business invitee is a person who is invited to enter or remain on land for a purpose directly or indirectly connected with business dealings with the possessor of the land. See Restatement (Second) of Torts [section]332 (1965).

20. CDC. Outbreaks of gastroenteritis associated with noroviruses on cruise ships--United States, 2002. MMWR MMWR Morbidity & Mortality Weekly Report Epidemiology A news bulletin published by the CDC, which provides epidemiologic data–eg, statistics on the incidence of AIDS, rabies, rubella, STDs and other communicable diseases, causes of mortality–eg, , Dec. 13, 2002 at 1112-1115.

21. "Vessel Sanitation Program." at http://www.cdc.gov/nceh/vsp/desc/aboutvsp.htm. Accessed on August 16, 2007.

22. A "forum selection" provision in a contract designates a particular state or court as the jurisdiction in which the parties will litigate disputes arising out of the contract. See 17A Am. Jur. 2d Contracts [section]259.

23. Statues of limitation are designed to protect potential defendants from stale claims by requiring plaintiffs to assert claims within a reasonable time period while evidence is fresh. See 51 Am. Jur. 2d Limitation of Actions [section]15.

24. An arbitration clause is a provision to a contract requiring the arbitration of disputes under the contract. See 67 Am. Jur. 2d Sales [section]156.

25. Carnival Cruise Lines, Inc. v. Shute Carnival Cruise Lines, Inc. v. Shute, 499 U.S. 585 (1991)[1], was a case in which the Supreme Court of the United States held that United States federal courts will enforce forum selection clauses so long as the clause is not unreasonably burdensome to , 499 U.S. 585 (1991).

David W. Babcock, J.D.

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