U.S. Stumped by Spread of Gastrointestinal Virus

Reuters ^ | Thursday, January 23, 2003 | Paul Simao

[Willie Green]

For education and discussion only. Not for commercial use.

ATLANTA (Reuters) - U.S. health officials said on Thursday they could not explain why a virus that causes millions of cases of acute gastroenteritis in the United States each year appeared to be spreading more widely in nursing homes, prisons and other institutional settings.

In its weekly morbidity and mortality health report, the U.S. Centers for Disease Control and Prevention said data collected from health departments across the nation indicated illnesses linked to noroviruses had risen in the past year.

The viruses, which are usually spread by fecal-contaminated food and water and personal contact, cause an estimated 23 million cases of acute gastroenteritis, including 50,000 hospitalizations and 300 deaths, in the nation each year.

Symptoms typically include diarrhea, nausea and vomiting.

The viruses, which often fail to be diagnosed or are misdiagnosed, have become a growing health concern after a number of highly publicized outbreaks of acute gastroenteritis on cruise ships sailing into U.S. ports.

They also were the most frequent cause of disability among soldiers serving in the 1991 Gulf War.

"This increased activity could be due to increased reporting or increased awareness, however when we speak to experienced health officials it is clear that what they're seeing is beyond that," said Dr. Marc-Alain Widdowson, a norovirus expert at Atlanta-based CDC.

He said CDC did not have the data to determine the extent of the rise in cases compared to previous years.

But investigations of more than 100 recent outbreaks of acute gastroenteritis in New Hampshire, Washington State and New York City since the beginning of 2002 have revealed significant exposure to noroviruses, according to the report.

NO DRUGS TO TREAT NOROVIRUSES

Although there are no drugs to treat noroviruses, most of those who become infected recover with fluid intake and prompt medical care. The rare deaths that do occur are usually caused by severe dehydration.

The spread of noroviruses can usually be prevented by using a bleach solution to clean up areas contaminated with vomit or feces, properly disposing of waste and monitoring those who come into contact with infected people.

In a separate report on Thursday, the CDC released an updated list of recommendations designed to help prevent the spread of hepatitis infections in U.S. correctional facilities.

They include vaccinating high risk inmates, such as intravenous drug users, against hepatitis B and monitoring those who test positive for hepatitis C for chronic infection and liver disease.

The CDC also recommended the hepatitis B vaccination for prison guards who come into frequent contact with blood products and said hepatitis prevention programs should be made a part of health education for all inmates.

Between 12 percent and 15 percent of all Americans with chronic hepatitis B and 39 percent of those with hepatitis C were released from a correctional facility in the year prior to testing positive for the viruses.

[Willie Green]

Maybe it's NAFTA related.

[Capt. Tom]

ATLANTA (Reuters) - U.S. health officials said on Thursday they could not explain why a virus that causes millions of cases of acute gastroenteritis in the United States each year appeared to be spreading more widely in nursing homes, prisons and other institutional settings.

I hope we do better with germ warfare agents. - Tom

[Lady Jag]

Norovirus (formerly called Norwalk-like Virus)

What are noroviruses?
Noroviruses are a group of viruses that can cause vomiting and diarrhea. 

Where are noroviruses found?
Infected humans are the only known source of this group of viruses.  Anyone can get these infections.

How are the viruses spread?
The viruses primarily are spread by direct contact with vomitus (including airborne particles) or feces from an infected person and then transferring the virus to the mouth from the hands.  This type of spread is a common cause of outbreaks in institutions such as nursing homes.  In addition, food may be contaminated by infected food handlers who fail to thoroughly wash their hands after using the bathroom.  Outbreaks also have occurred due to consumption of raw or undercooked oysters harvested from fecally contaminated waters.  Cooking kills the virus.  Drinking water contaminated by sewage can be a source of these viruses, as well.

What are the symptoms of norovirus illness?
The major symptoms are vomiting and/or watery diarrhea.  Other symptoms include nausea and stomach cramps.  A low-grade fever occurs in about half of cases.

Can noroviruses cause severe problems?
Most people recover on their own within 24 to 48 hours.  It can be a serious illness for persons who are unable to drink enough fluids to replace what they lose through vomiting or diarrhea.  Infants, young children, and persons who may be unable to care for themselves, such as the disabled or elderly, are at risk for dehydration from loss of fluids.  Persons who are immunocompromised are at risk for dehydration because they may get a more serious illness, with greater vomiting or diarrhea.  On rare occasions, deaths have been reported in nursing home residents. 

How soon after exposure do symptoms appear?
Symptoms usually start within 24 to 48 hours after exposure.

How long can an infected person spread noroviruses?
An infected person can spread the virus for three days or more after diarrhea or vomiting stops.

Do infected people need to be excluded from school or work?
Since the virus is passed in the feces, children in daycare, health care workers, or people who handle food should not go to school or work while they have diarrhea.  Persons who work in nursing homes, take care of patients, or handle food should stay out of work for at least three days after symptoms subside.

What is the treatment for norovirus illness?
There is no specific treatment.  Persons with diarrhea and/or vomiting should drink plenty of liquids to prevent dehydration.  Medications, including antibiotics (which have no effect on viruses) and other treatments, should be avoided unless specifically recommended by a physician.

To prevent norovirus illness:
·   Wash your hands frequently.
·   Promptly disinfect contaminated surfaces with household chlorine bleach-based cleaners.
·   Wash soiled clothing.
·   Avoid food or water from sources that may be contaminated.
·   Cook oysters completely to kill the virus.

Prepared by the Virginia Department of Health, January 2003

[Libloather]

Symptoms typically include diarrhea, nausea and vomiting.

Mine started with a batch of bad clams from some bay in Maryland.

[krodriguesdc]

bump

[blackdog]

Oysters from Hooters in Wisconsin got me. I was stupid. My dad always told me to never eat shellfish from an establishment more than 100 miles from the coast.

My little boy has it now, complete with the Linda Blair projectile alert.

[mewzilla]

Gee, like maybe people aren't as good about handwashing as they used to be? This ain't rocket science.

[DannyTN]

"complete with the Linda Blair projectile alert. "

My wife was putting our little girl in the tub when the projectile vomiting hit again. She nailed my wife right in the face. Grossest thing I've seen yet as a parent.

Couldn't kiss her for a week.

[KantianBurke]

They also were the most frequent cause of disability among soldiers serving in the 1991 Gulf War.

hello

[Dan Day]

U.S. health officials said on Thursday they could not explain why a virus that causes millions of cases of acute gastroenteritis in the United States each year appeared to be spreading more widely in nursing homes, prisons and other institutional settings.

Sounds to me like the virus is evolving the ability to be spread in an airborne fashion instead of just by direct contact.

[JameRetief]

Or, because we are using antibacterial soaps on a much larger scale, the more resistant forms of the virus (that can survive the antibacterial soaps and thus all future generations are resistant as well) are the only ones being widely spread now.

[norraad]

Perhaps, but did you ever hang out in a bathroom & notice how many idgits don't wursh der digits?

That anti-bacti slime never sees many paws, paws that smear the same handles, knobs, etc. that our higher order mitts share.

Also, take a good fresh garlic capsule every day or 12 hours, no better anti has or will ever be invented.

Do your own research, you'll be amazed!

[mewzilla]

Perhaps, but did you ever hang out in a bathroom & notice how many idgits don't wursh der digits?

Probably the biggest reason we don't eat out much. Seen what too many waitstaff don't do in the lav. ICK.

[Centurion2000]

That anti-bacti slime never sees many paws, paws that smear the same handles, knobs, etc. that our higher order mitts share

And people think I'm strange for opening the door with a paper towel when leaving the bathroom after washing my hands.

[Nick Danger]

because we are using antibacterial soaps on a much larger scale, the more resistant forms of the virus

I'm no doctor, but I don't believe antibiotics are useful against viruses anyway. They aren't "bacteria," they are just little chunks of RNA. I think there is even a debate as to whether they are "alive" in the usual sense of that word.

[mommadooo3]

In our house, we use garlic oil caps.

I have to wonder if this bug is truly a 'virus'. This thing started working its way through the family. After the first 3 kids 'went down', it was time for kid #4 and myself to get it. At the first sign of nausea/'pushed through a knot-hole', I gave us half of 'cow pill'. It's a med for cattle who get 'scours'. Kid #5 and hubby got it, started the vomiting....they got 1/2 cow pill. Knocked it right out.

Just a FWIW. And the 'research' I've done on this med is that it works by killing some 'bad germs' so that the body's immune system can kick in and conquer.

Oh, BTW... this med is listed for use in treating bacterial enteritis caused by salmonella typhimurium, and escherichia coli (colibacillosis) and bacterial pnuemonia (shipping fever)

We use it for our horses who are allergic to penicillin.

[Tailback]

I have a different theory about public restrooms. I know where my "little guy" has been, but I don't know where the hands of every single person that touches the faucet have been. Same for the door handle. I generally use my foot or elbow to flush, and my elbow to open the door. If the door opens in, I wait till someone opens it for me. The only time I wash is if the restroom has automatic faucets.

[hunter112]

Oysters from Hooters in Wisconsin got me.

Excuse me, somebody needs oysters in HOOTERS?

[gov_bean_ counter]

U.S. health officials said on Thursday they could not explain why a virus that causes millions of cases of acute gastroenteritis in the United States each year appeared to be spreading more widely in nursing homes, prisons and other institutional settings.

One would think that a brief visit to representative examples of any of the above referenced facilities would answer many of the more pressing quesions.

[gov_bean_ counter]

sorry, questions. Darn fingers.