Rocky Mountain Infectious Disease is aware that most people in our community have heard about the recent rise in norovirus reports in our community. Many of you probably received this report yesterday from the Natrona County School District.
“The Casper Natrona County Health Department (CNCHD) has informed Natrona County School District that they are receiving reports of increased norovirus infection activity county-wide. While norovirus (Viral Gastroenteritis) may be food-borne, the virus is more typically spread via dirty surfaces and/or dirty hands. CNCHD has asked NCSD to help reduce further transmission by sharing information about norovirus.”
We asked Dr. Dowell here at Rocky Mountain Infectious Diseases to offer some light on the situation.
“Norovirus causes approximately 20 million illnesses in the United States per year, but for the most part is not dangerous. Occasionally it can lead to hospitalization but that is generally in people that have underlying health issues.” Dr. Dowell continues, “It is the most common form of foodborne illness in the United States. It is highly contagious. It classically can lead to outbreaks where people congregate, such as in schools and in care facilities such as nursing homes and assisted living centers. It is not uncommon to have outbreaks involving restaurants as well. Symptoms usually lasts 18 to 36 hours, and it does not cause a long lasting infection.Treatment is supportive because there is no specific medication for this virus.”
Here are some facts from the Wyoming Department of Health with tips to help keep your family informed and healthy.
VIRAL GASTROENTERITIS: FACTS
What is viral gastroenteritis?
Gastroenteritis means inflammation of the stomach and small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses which results in vomiting or diarrhea. It is often called the “stomach flu,” although it is not caused by the influenza viruses.
What causes viral gastroenteritis?
Many different viruses can cause gastroenteritis, including rotaviruses; noroviruses ; adenoviruses , types 40 and 41; sapoviruses; and astroviruses. Noroviruses are the leading cause of viral gastroenteritis in the United States. Viral gastroenteritis is not caused by bacteria (such as Salmonella species or Escherichia coli ), or parasites (such as Giardia lamblia ), or by medications, or other medical conditions, although the symptoms may be similar. Your doctor can determine if the diarrhea is caused by a virus or by something else.
What are the symptoms of viral gastroenteritis?
The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. The affected person may also have headache, fever, and abdominal cramps (“stomach ache”). In general, the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days, depending on which virus causes the illness.
How serious is viral gastroenteritis?
For most people, it is not. People who get viral gastroenteritis almost always recover completely without any long-term problems. Gastroenteritis is a serious illness, however, for persons who are unable to drink enough fluids to replace what they lose through vomiting or diarrhea. Infants, young children, and persons who are unable to care for themselves, such as the disabled or elderly, are at risk for dehydration from loss of fluids. Immune compromised persons are at risk for dehydration because they may get a more serious illness, with greater vomiting or diarrhea. They may need to be hospitalized for treatment to correct or prevent dehydration.
How do people become infected with viral gastroenteritis?
Viruses that cause gastroenteritis are found in the stool or vomit of infected people. People can become infected when they accidentally ingest material that is contaminated with virus. This accidental ingestion can occur in several ways:
- Eating food or drinking liquids that are contaminated with virus;
- Touching surfaces or objects contaminated with virus, and then placing their hand in their mouth;
- Having direct contact with another person who is infected and showing symptoms (for example, caring for someone with illness, or sharing foods or eating utensils with someone who is ill). Persons working in day-care centers or nursing homes should pay special attention to children or residents who have gastroenteritis. These viruses are very contagious and can spread rapidly throughout such environments.
When do symptoms begin?
Symptoms of viral gastroenteritis usually begin about 24 to 48 hours after ingestion of the virus, but they can appear as early as 12 hours after exposure.
Is viral gastroenteritis contagious?
Yes, viral gastroenteritis is contagious. The viruses that cause gastroenteritis are spread through close contact with infected persons. Individuals may also become infected by eating or drinking contaminated foods or beverages.
How long are people contagious?
People infected with viral gastroenteritis are contagious from the moment that they begin feeling ill to at least 3 days after recovery. Some people may be contagious for as long as 2 weeks after recovery. Therefore, it is important to use good handwashing and other hygienic practices.
Who gets viral gastroenteritis?
Anyone can get it. Viral gastroenteritis occurs in people of all ages and backgrounds. However, some viruses tend to cause diarrheal disease primarily among people in specific age groups.
What treatment is available for people with viral gastroenteritis?
The most important aspect in treating viral gastroenteritis in children and adults is to prevent severe loss of fluids (dehydration). This treatment should begin at home. Your physician may give you specific instructions about what kinds of fluid to give. CDC recommends that families with infants and young children keep a supply of oral rehydration solution (ORS) at home at all times and use the solution when diarrhea first occurs in the child. ORS is available at pharmacies without a prescription. Follow the written directions on the ORS package, and use clean or boiled water. Medications, including antibiotics (which have no effect on viruses) and other treatments, should be avoided unless specifically recommended by a physician.
What should I do if I have viral gastroenteritis?
Viral gastroenteritis is usually brief in healthy individuals. When people are ill with vomiting and diarrhea, they should drink plenty of fluids to prevent dehydration. Dehydration among young children, the elderly, and the chronically-ill can be common, and it is the most serious health effect that can result from infection. By drinking oral rehydration fluids (ORF), juice, or water people can reduce the chance of becoming dehydrated. Ill persons should take extra care to avoid the possible spread of the virus to others, by minimizing contact with other persons while ill and practicing good hygiene such as hand washing. This is especially important for persons who work in food-handling, healthcare, or child care, and these workers should notify their supervisors for special instructions if they are ill. If you experience blood in your stool and/or if your illness lasts more than 72 hours, this may be indicative of a more serious gastrointestinal, bacterial infection like E. coli or Salmonella and you may want to see your primary healthcare provider for testing.
Can viral gastroenteritis be prevented?
YES. You can decrease your chance of becoming infected or spreading the virus by following these preventive steps:
- Frequently wash your hands , especially after using the restroom, after changing diapers, and before eating or preparing food.
- If you are ill, stay home from work and school, especially if you work in food-handling, healthcare, or child care.
- Thoroughly clean and disinfect contaminated surfaces immediately after an episode of illness by using a solution of 1/3 cup bleach per 1 gallon of water (50:1 dilution). Always follow the manufacturer’s safety precautions.
- Immediately remove and wash clothing or linens that may be contaminated with the virus after an episode of illness (use hot water and soap).
- Flush or discard any vomit and/or stool in the toilet and make sure that the surrounding area is kept clean.
- Ill persons should take extra care to avoid the possible spread of the virus to others, by minimizing contact with other persons while ill and practicing good hygiene such as hand washing.
Is there a vaccine for viral gastroenteritis?
Currently there are two licensed rotavirus vaccines available that protect against severe diarrhea from rotavirus infection in infants and young children. These vaccines are given to children in their first year of life with other childhood vaccines. These vaccines are not useful against other causes of viral gastroenteritis.
Viral gastroenteritis illnesses are not reportable to the Wyoming Department of Health unless they are part of a cluster of illness or outbreak. If you suspect that your illness is part of a larger cluster of illnesses or an outbreak related to the same venue (i.e. restaurant, nursing home, daycare, etc), please contact the Wyoming Department of Health’s Infectious Disease Epidemiology Program at 1-877-996-9000 or call the 24/7 emergency number at 1-888-996-9104.