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Over 400 office workers from the same unit of a manufacturing company in Stockholm County, Sweden, fell ill with gastroenteritis. A retrospective cohort study of office workers in the affected unit demonstrated that canteen visitors on one day had an increased risk of illness [risk ratio (RR) 27.1, 95% confidence interval (CI) 15.7-46.8] compared to non-visitors. A second study, investigating canteen visitors' consumption of particular food items, showed that both tomatoes from the salad buffet (RR 5.6, 95% CI 3.2-9.6) and hamburgers (RR 4.9, 95% CI 2.4-9.8) were the most likely vehicles of infection. Norovirus GI.3 (Desert Shield) was identified in stool samples from three office workers and from a food handler who prepared the tomatoes for the salad buffet and hamburger ingredients before vomiting at the workplace on 12 November. The outbreak could have been prevented if the food items prepared by the food handler some hours before vomiting had not been served.

Rotarix and RotaTeq are both prophylactic vaccines against rotavirus (RV) gastroenteritis. In 2006, these vaccines obtained a European license and because RV infections are widespread among Dutch children inclusion of these vaccines in the Dutch National Immunization Program (NIP) should be considered. Using an evaluation model for introducing a new vaccine, we assessed the introduction of universal RV vaccination in the Netherlands. Although post-marketing surveillance will be essential, both RV vaccines have proven to be safe and effective. Furthermore, the vaccines will prevent most of the RV-related hospitalizations and deaths. However, for the Netherlands with the current vaccine prices, universal RV vaccination is not expected to be cost-effective.