Norovirus gutting globe, hits U.S. hard

A particularly nasty nemesis to worldwide wellbeing has made the United States its most recent port of call, subjecting hordes of people in various states to its own particular brand of stomach nuance. It is not influenza, it is not food poisoning, although the deceptive nature of the bug’s symptoms have fooled many an ailing patient.

The most cunning chameleon of sickness — the norovirus — is upon us, and it has patients belly-up and bunkered down with little to do save wait it out.

According to the latest report from the Centers for Disease Control and Prevention (CDC), a majority of the current crop of cases  — 54 percent of cases from September-December 2012, and now nearly 60 percent of all cases heading into the new year — share the strand designation of GII.4 Sydney, the newest norovirus strain originating from Australia. The affliction has been known to cause 21 million instances of illness and 70,000 hospitalizations and 800 deaths (in the U.S.) each year; 51 percent of these cases are said by the CDC to be transmitted via person-to-person contact, and 20 percent due to contaminated food or the consumption of raw milk.

Although the virus is often likened to food poisoning and the stomach flu, the virus bears no relation to influenza and typically entails 2-3 days worth of vomiting, diarrhea, stomach pain, low-grade fever and muscle aches as a result of interpersonal transmission and/or consumption of sullied foods. There is currently no vaccine or antibiotic available to treat the condition.

“Noroviruses are the leading cause of epidemic gastroenteritis, including foodborne outbreaks, in the United States,” the CDC noted.  

“Compared with other norovirus genotypes, GII.4 noroviruses have been associated with increased rates of hospitalizations and deaths during outbreaks. Healthcare providers and public health practitioners should remain vigilant to the potential for increased norovirus activity in the ongoing season related to the emergent GII.4 Sydney strain. Continued surveillance for norovirus outbreaks through CaliciNet and additional data on clinical and epidemiologic features of outbreaks collected through the National Outbreak Reporting System will enable further assessment of the public health implications of the new GII.4 Sydney strain, including any association with increased severity or level of activity in the ongoing 2012–13 winter norovirus season. Proper hand hygiene, environmental disinfection, and isolation of ill persons remain the mainstays of norovirus prevention and control,” the CDC advised in its Morbidity and Mortality Weekly Report released Jan. 25.

National headlines place outbreaks of the often dubbed “winter vomiting disease” in various state sects, from counties in Virginia, New Jersey and Arkansas, to cities in New York and Pennsylvania. The Guardian declared that approximately 1.1 million people in Britain alone have come down with the virus, and similar trends are occurring across Europe, Japan and other populated parts of the world. Furthermore, a norovirus outbreak in December of 2012 on the U.S. cruise ship Queen Mary II has been confirmed as an additional happenstance of the GII.4 Sydney strain. Another mass affliction in Arkansas involving 300 middle school children last week was supposedly perpetrated by an older strain. [Refer to the figure below for more information on settings that breed norovirus for seasons past.]

All information and data courtesy of the Centers for Disease and Prevention. Presentation by PhysBizTech.

“We see new strains emerge every few years and sometimes they are associated with increased disease activity,” CDC epidemiologist Aron Hall told WebMD Medical News. “We certainly want people to be aware that this potential exists, but the mainstays of norovirus prevention are still the most important things people can do to protect themselves.”

The CDC suggests that physicians should conduct themselves as follows if they come in contact with a patient or colleague exhibiting symptoms of norovirus:

  • In a healthcare facility, patients with suspected norovirus may be placed in private rooms or share rooms with other patients with the same infection.
  • Follow hand-hygiene guidelines, and carefully wash hands with soap and water after contact with patients with norovirus infection.
  • Use gowns and gloves when in contact with, or caring for patients who are symptomatic with norovirus.
  • Routinely clean and disinfect high-touch patient surfaces and equipment with an Environmental Protection Agency-approved product with a label claim for norovirus.
  • Remove and wash contaminated clothing or linens.
  • Healthcare workers who have symptoms consistent with norovirus should be excluded from work.

For more facts and prevention materials to share with staff and patients, click here.