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A major gastroenteritis outbreak was reported in a vacation resort in Central Italy in 2003. A total of 183 cases were identified. The case-control study identified a statistically significant correlation between the disease and sea bathing, use of sanitary facilities in bungalows and of common showers. Stool samples taken from people affected were found positive for Norovirus (68%, 13 of 19 samples), Rotavirus (38%, 1 of 14 samples) and Campylobacter (7%, 3 of 8 samples). Environmental investigations revealed serious faecal contamination of the groundwater and the presence of Norovirus in the seawater near the resort. The mixing of groundwater and seawater with the non-drinking water system - which was also found to be connected to the drinking water system - had a primary role in the onset and spread of infection within the village. The complete absence of any gastroenteritis epidemics among the site guests since 2006 demonstrates the effectiveness of the environmental corrective measures taken.

During the summer of 2003, a gastroenteritis outbreak spread throughout a holiday resort in central Italy. Fecally contaminated groundwater and seawater were leaking into the non-drinking-water system, which was found to be connected to the drinking-water system of a large resort. This contamination had a primary role in the onset of the outbreak and spread of the infection.

An international outbreak linked to oyster consumption involving a group of over 200 people in Italy and 127 total subjects in 13 smaller clusters in France was analyzed using epidemiological and clinical data and shellfish samples. Environmental information from the oyster-producing area, located in a lagoon in southern France, was collected to investigate the possible events leading to the contamination. Virologic analyses were conducted by reverse transcription-PCR (RT-PCR) using the same primer sets for both clinical and environmental samples. After sequencing, the data were analyzed through the database operated by the scientific network FoodBorne Viruses in Europe. The existence of an international collaboration between laboratories was critical to rapidly connect the data and to fully interpret the results, since it was not obvious that one food could be the link because of the diversity of the several norovirus strains involved in the different cases. It was also demonstrated that heavy rain was responsible for the accidental contamination of seafood, leading to a concentration of up to hundreds of genomic copies per oyster as detected by real-time RT-PCR.