Norovirus & Ebola Zaire: same transmission vector (vanity w/CDC links)

ElenaM w/CDC quotes

[ElenaM]

In light of the first domestic transmission of Ebola Zaire, I thought it would be useful to compare Ebola Zaire with a well-known viral disease that hits American communities every year: Norovirus.

People keep comparing Ebola to influenza, which is an apples to broccoli comparison. Ebola Zaire and norovirus have the same transmission profile (at least based upon the CDC's claims of Ebola transmission vectors, which are publicly admitted to be incomplete)so the best comparison of the spread of Ebola in the US to any other viral pathogen is norovirus.

According to the CDC:

CDC About Norovirus: Transmission

Norovirus is a highly contagious virus. Anyone can get infected with norovirus and get sick. Also, you can get norovirus illness many times in your life. One reason for this is that there are many different types of noroviruses. Being infected with one type of norovirus may not protect you against other types.

Norovirus can be found in your stool (feces) even before you start feeling sick. The virus can stay in your stool for 2 weeks or more after you feel better.

You are most contagious

1.when you are sick with norovirus illness, and

2. during the first few days after you recover from norovirus illness.

You can become infected with norovirus by accidentally getting stool or vomit from infected people in your mouth. This usually happens by

1. eating food or drinking liquids that are contaminated with norovirus,

2. touching surfaces or objects contaminated with norovirus then putting your fingers in your mouth, or

3. having contact with someone who is infected with norovirus (for example, caring for or sharing food or eating utensils with someone with norovirus illness).

Norovirus can spread quickly in closed places like daycare centers, nursing homes, schools, and cruise ships. Most norovirus outbreaks happen from November to April in the United States.

Additionally:

JID 2012: Noroviruses: The Perfect Human Pathogens?

The success of noroviruses should come as no surprise once one considers how well adapted they are for transmission within human populations. First, noroviruses have an extremely low infectious dose ( ≥ 18 viral particles), coupled with copious viral shedding (10^5 – 10^11 viral copies per gram of feces), even among asymptomatic infections, suggesting that up to 5 billion infectious doses may be shed by an infected individual in each gram of feces. Second, noroviruses are environmentally stable, able to survive both freezing and heating (although not thorough cooking), are resistant to many common chemical disinfectants, and can persist on surfaces for up to 2 weeks. Third, there are a myriad of ways in which noroviruses may be spread, including direct contact between hosts via fecal-oral transmission, ingestion of contaminated foods or water, handling of contaminated fomites followed by hand-to-mouth contact, and — unique among enteric pathogens — via ingestion of aerosolized particles.

A virus that is communicable only through direct and indirect exposure to infected feces and vomit should be incredibly easy to stop, right? After all, we have modern plumbing, soap, etc. No one eats with their hands from a communal pot. Norovirus isn't airborne. Yet norovirus is the most common cause of the ubiquitous "stomach bug" that sweeps through the US every year.

Now compare norovirus to Ebola Zaire. Even if we discount the norovirus food/liquid contamination issue in the context of Ebola, a virus that can only be transmitted via feces and vomit contact spreads very quickly in the US. How often do your kids or entire household come down with the "stomach flu?"

Now imagine that same event only you and/or your family is infected by Ebola Zaire.

Tell me again how protected we are from a virus that is every bit as prolific in several bodily fluids (not just feces and vomit) with an infective dose even lower than norovirus (Ebola ID50 is 1-10 virons) and a 70-90% fatality rate.

[palmer]

True. Same with the claims of Ebola being airborne. Two months after the virus entered the West Point slum it is just as crowded as ever with people taking precautions not to touch other people (that much).

[palmer]

Conspiracy much?

[Alas Babylon!]

I just had a norovirus Thursday and Friday. Thursday night was brutal; I was very sick. And I was thinking then that this was no doubt a stomach flu but man, it hurt! I couldn’t help but think how sorry it would be to get Ebola.

While I wish we could show more compassion for those who are ill, the primary focus of such a deadly disease is to prevent its spread.

This is what all the powers that be should be concentrating on. NOT politics, but limiting and then eradicating the disease.

What the Hell are they waiting for???!!!

[palmer]

Cruise ships have norovirus because it survives well even with cleaning.

[Jack Hydrazine]

Well, not that you mention it...

[sarasmom]

I have a question regarding the decontamination processes the healthcare workers are undergoing.

(It hearkens back to my old Cold War Bio/Chem warfare training)

The decon exercises I remember required multiple layers of steps, including an intermediate test step, with a non-lethal but pervasive gas element, to test the security of the equipment itself, after initial “showers” of the protective gear, but before removing said gear.

Seconds to suit up properly, potentially hours to properly decontaminate afterwards...

Is the CDC doing that?

Are they skipping basic, best practices when they know in fact they are in a severe BIO hazard deadly situation?

[Jane Long]

...we are screwed especially under this POTUS who seems hellbent on getting it into the US.

Hellbent? Heck...he's already succeeded. And, he's shipping in 150 *reinforcements*, each day. Just to be sure.

[Red in Blue PA]

What USED TO BE on the Web page of the CDC as of 8/2/14:

“In this guidance healthcare personnel (HCP) refers all persons, paid and unpaid, working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. 

https://web.archive.org/web/20140802085653/http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

Transmission of Ebola virus from pigs to non-human primates

A study conducted in 2012 showed that Ebola was able to travel between pigs and monkeys that were in separate cages and were never placed in direct contact.

http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html

[palmer]

That's the problem, 150 new potential carriers per day means an increasing number of actual cases. The infection rate is about 0.1% or less over there but the more it increases the more these people are inclined to flee when they see it nearby.

Even at 0.1% we should expect see a new ebola immigrant here every week.

[tiki]

We got Norovirus from a waiter who had just come off a cruise ship. Everyone he waited on got sick. My husband and DIL got dog sick, he stood between them while he took the order. My son and I just got a little sick.

[palmer]

Well a definition of “contaminated air” would help. That source does not appear to use very exact terminology. In any case any serious airborne contamination would have killed half of the crowds in West Point a month ago.

[Red in Blue PA]

It could be airborne in the later stages of the illness. Who knows? But we are being sold crap from on high which simply is not true......at least according to these two sources.

[GrandJediMasterYoda]

Yep I read that, 150 Africans every day and just think; After the midterms he’s going to go into overdrive.

[Jane Long]

Right.

[palmer]

No, it is "airborne" at early stages. Found first in saliva:

Of particular concern is the frequent presence of EBOV in saliva early during the course of disease, where it could be transmitted to others through intimate contact and from sharing food, especially given the custom, in many parts of Africa, of eating with the hands from a common plate.

That's from my Oxford Journal link above. Obviously along with eating from the same plate comes sneezing and coughing. The viral load increases greatly with the illness but that means surfaces like taxis are being infected. The virus is the same throughout the illness and can really only be airborne in droplets.

[Jane Long]

For some reason, the Pubbies aren’t running on, or even talking about this.

We need to forge our own social media campaign....there’s so much to work with.

[Jack Hydrazine]

Here they are!!!

Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals
https://web.archive.org/web/20140802085653/http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

Transmission of Ebola virus from pigs to non-human primates
http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html

[BenLurkin]

Isn’t norovirus what causes cruise ships to have lots of sick customers?

[getmeouttaPalmBeachCounty_FL]

Funny how the CDC mandates that monkeys coming into the USA have to be quarantined but not people with deadly diseases.

[palmer]

The cages were 20cm apart.