Stomach bug cases are back: how not to get sick with norovirus

Out with the new, in with the old?

As COVID slowly moves out of the epidemiological spotlight (but it’s still here to stay), outbreaks of another nasty germ, norovirus, are returning and returning to pre-pandemic numbers, according to a new CDC report.

Commonly known as the stomach flu, the “cruise virus,” food poisoning, or the stomach bug, norovirus is the kind of germ you never forget if you (and probably all of your family and friends at the same time) experience its symptoms. It is an extremely contagious pathogen that causes acute gastroenteritis, or inflammation in the stomach or intestines, leading to severe bouts of diarrhea, vomiting, stomach pain, and nausea. Symptoms can last up to three days and may also include headaches, fever and body aches in some people.

Although it’s sometimes called the stomach flu, it has nothing to do with the flu, the respiratory virus that comes out in waves every year. There is no vaccine against norovirus.

Contact with particles of contaminated poop or vomit can make you sick, and this can happen when you share eating utensils, consume meals or liquids prepared by an infected person, or change a nappy, for example. Although norovirus affects people of all ages, children younger than 5 and adults 65 and older are more likely than people in other age groups to experience severe symptoms.

The bug infects about 20 million people each year in the US, causing about 900 deaths (most among adults 65 and older) and about 109,000 hospitalizations.

But after a quiet 2020 and 2021, likely due to COVID-19 precautions that forced many other viruses into hiding, norovirus made a rapid comeback starting in January of this year, according to data from 12 Departments of state health The number of reported outbreaks during the 2021-2022 surveillance year was almost triple that of 2020-2021.

“I think a lot of people have forgotten that there are other viruses these days, but norovirus is still here,” said Anita Kambhampati, a CDC epidemiologist and lead author of the report. “This is just a reminder that we’re seeing it return to pre-pandemic levels.”

Between August 2021 and July 2022, 992 norovirus outbreaks were reported to the CDC, compared to 343 in the previous surveillance year (when COVID dominated the virus landscape) and 1,056 in the year previous For further comparison, there were about 1,200 and 1,400 norovirus outbreaks reported between 2015 and 2016 and 2018 and 2019, respectively.

Most of the outbreaks (59%) included in the new report occurred in long-term care facilities, which is not unusual, Kambhampati confirmed; the pre-pandemic range was between 53% and 68%. Norovirus typically enters healthcare facilities through infected patients, staff, visitors, or contaminated food, and outbreaks sometimes last for months.

Outbreaks are also common in schools, dormitories, restaurants, daycare centers and cruise ships, places where people share dining rooms and close living spaces.

Norovirus generally spreads easily where there is a lot of person-to-person contact and little access to hand hygiene, including outdoor activities. In fact, outbreaks have been documented in Grand Canyon National Park after backpacking and rafting.

The largest norovirus outbreak began in April when seven people on a commercial rafting group experienced vomiting and diarrhea, according to a CDC report. As of June, at least 222 backpackers and backpackers in the area had come down with a suspected norovirus infection. Swabs from portable toilets used by rafting groups tested positive for the germ.

The good news is that norovirus circulating in the population behaves as expected and shows no signs of mutating into more serious versions of itself, Sara Mirza, a CDC epidemiologist and co-author of the new report, told BuzzFeed News .

“At least that’s not what the data we’ve seen yet has shown us,” Mirza said. “But it’s something we’re monitoring.”

The same strain of norovirus that has spread this year first emerged in 2015 and makes up a large portion of the new cases.

“We definitely expect to see a return to more of our traditional norovirus season,” Mirza said. The US is already seeing other viruses, especially those affecting the respiratory tract, making a comeback as well.

How to avoid getting sick with norovirus

Norovirus outbreaks can happen anytime, anywhere, but they tend to appear between November and April, when more people flock indoors to escape the colder temperatures. This means hand hygiene is especially important during the holiday season, when you may be sharing meals and utensils prepared and prepared by others.

A person usually develops symptoms 12 to 48 hours after exposure, and most people recover within one to three days. It only takes 18 viral particles to make a person sick, according to the CDC. Infected people shed billions of these particles in their stool and vomit while they are symptomatic and may continue to do so even when they feel better. Stool can carry norovirus for more than two weeks after a person has recovered.

So you might want to be extra careful if you share a bathroom with someone who is sick. Norovirus particles can be aerosolized when you flush a toilet that contains contaminated vomit or diarrhea, so closing the lid is a good idea, Kambhampati said.

Projectile vomiting, which is common with norovirus, can also cause aerosolization.

However, norovirus is not a respiratory germ, so wearing a face mask is not the best way to prevent infection, Kambhampati said. But wearing a simple one in situations where it can be cleaned after someone is infected can help you avoid touching your mouth or inhaling droplets.

The virus can survive on a variety of surfaces, including counters and serving utensils, and in water for up to two weeks. It can even remain infectious in food at freezing temperatures and above 140 degrees Fahrenheit.

And probably worst of all is the fact that norovirus resists many common disinfectants and hand sanitizers, so the best way to avoid infection is to wash your hands with soap and water for at least 20 seconds, especially before and after eating and after using. The toilet. (In the case of the outbreaks in people who went rafting, the hand sanitizer was not enough to kill the germs.)

In general, it’s a good idea to avoid touching your face (especially your mouth) in public.

If you’re caring for someone with norovirus, experts recommend wearing a simple mask and disposable gloves when cleaning the areas they touch and use. Start by wiping all contaminated surfaces with paper towels and spraying a bleach-based cleaner, letting it sit for at least five minutes. You should then clean the entire area again with hot soapy water. It’s a good idea to then put the sick person’s clothes in the washing machine, take out the trash, and wash your hands.

Unfortunately, you can get norovirus multiple times because different strains can infect you. Although you develop some immunity to specific types of norovirus after infection, experts don’t yet know how long it lasts.

There are no treatments for the virus, but with consistent hygiene and plenty of fluids (repetitive vomiting and diarrhea can lead to dehydration), you’ll be on the road to recovery.

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