The Tennessee Department of Health continues to investigate an outbreak of illness after receiving more than 500 reports of gastrointestinal illness among visitors to the CLIMB Works Zipline Canopy Tour in Gatlinburg.


Testing is underway to try to identify the causes of the illnesses. Multiple patients who visited the facility since June 15, 2018 have tested positive for norovirus. One patient has tested positive for both norovirus and enteropathogenic E. coli.

“At this time we cannot point to one simple cause of this outbreak,” said TDH Deputy State Epidemiologist John Dunn, DVM, PhD. “Preliminary testing and environmental health assessments indicate the water system at the zipline facility may have contributed to the outbreak; however, there are likely other sources involved in the spread of the illnesses, including contaminated surfaces and person-to-person transmission.

“Water testing has indicated fecal contamination of the facility’s water system,” Dunn continued. “Additional preliminary testing has identified enteropathogenic E. coli. Testing of clinical and environmental samples is still underway to look for bacterial, viral and parasitic organisms. It’s important to note that while norovirus is reliably identified in stool samples during outbreak investigations, identifying it in food, water and the environment is more challenging.”

Norovirus causes acute gastrointestinal illness and is often characterized by sudden onset of nausea, vomiting and diarrhea; symptoms typically last one to two days. Enteropathogenic E. coli causes watery diarrhea; symptoms may last several days.

CLIMB Works is cooperating fully with the public health investigation and recommendations as well as regulatory actions. TDH continues to investigate the outbreak to confirm the causes of the illnesses, identify additional cases of illness and provide prevention recommendations.