The cafeteria worker from Trinity High School in Dickinson, N.D., had spent part of the weekend vomiting and racked with diarrhea. But on Monday, May 2, 2005, she apparently felt well enough to report to work, chopping lettuce that would be served for lunch.

The next day, students began to feel sick, and by that Wednesday, 52 students and eight faculty members had fallen ill with the same symptoms the sick worker had suffered.

When state health officials investigated, they blamed norovirus, which causes symptoms consistent with stomach flu. The lettuce, they determined, apparently was contaminated by the worker, who hadn’t worn gloves as she cut it. She likely remained contagious for as many as 48 hours after her symptoms stopped, unwittingly spreading norovirus throughout the school, the investigators said.

No food-borne illness has sickened more schoolkids in the past decade than norovirus, and none is linked as consistently to improper food handling in cafeterias, a USA TODAY investigation found.

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