Watch Out: The Norovirus is lurking!

Many people are coming down with rather similar symptoms lately: nausea, vomiting, diarrhea, & cramping.  There is a virus that is going around, which spreads quickly, and you could be at risk. I wanted to discuss what the Norovirus is, how to know you have it, treatments, and, most importantly, prevention!

What is the Norovirus?
It is actually the name for a group of viruses that all act similarly, if not the same, on the gastrointestinal (GI) tract and cause nausea/vomiting, diarrhea, abdominal cramping, etc. and are thought of as a gastroenteritis (an infection of the GI tract). They were once referred to as the “Norwalk Like” viruses after an outbreak of these viruses in Norwalk, Ohio in the early 1970′s. They also gained a lot of press after hundreds (if not thousands) of guests on cruise ships were getting infected, and ships had to go to port due to such high rates of illness (If I ever even ponder taking a cruise, I remember this fun time, and I’m all set; could you imagine how horrible that must have been? Gross!) The tough part of the Norovirus is that the virus strains are highly virulent, in that they spread from person to person quickly and easily, and infections from these viruses are usually at the highest during cold winter months. That is a true bummer for all of us living here in New England! Fun fact? Norovirus is the leading cause of food-related gastroenteritis in the United States.  Another fun fact: You will never forget how miserable you feel while infected!

What are the symptoms?
Nausea
Vomiting
Diarrhea
Stomach cramps
Low grade fever, chills
Headache
Muscle cramps
*the symptoms can occur very suddenly 12-24 hours after exposure to the virus, and normally last around 12 hours and people feel better within 48 hours (see below: you are still a carrier for much longer and can infect others)

How is it spread?
Most often it is spread from person to person through contaminated food and/or water, caring for an infected person, or through contact with contaminated surfaces. It can live on hard surfaces that are infected for around 12 hours and has been found in infected carpet fibers (i.e. an area that someone threw up on) for up to 12 days, plus it can withstand pretty high amounts of chlorine before being killed off. The viruses live in the stool (poop) and vomit from people with the virus, so when caring for children, elderly, or anyone who needs a lot of assistance with care/cleanup, there is a high rate of spreading the infection. You are contagious from the moment you are infected (even before you feel ill) until a full three days after your symptoms end! Which makes this virus so quick to spread especially in places where people live/work closely together, and it is hard to stop the spread once it starts.

What is the treatment?
There is no vaccine or antiviral for these viruses, unfortunately. And as we all know antibiotics only treat bacterial infections, so they are useless against the Norovirus. So you are really just trying to treat/prevent the dehydration that can occur after the diarrhea and vomiting; fluids such as gatorade and coconut water will help to replace fluids and nutrients lost, but really any fluids that you can get in and keep down will help to prevent severe dehydration. If your mouth and tongue are really dry and you cannot make saliva, you feel dizzy when changing positions, you aren’t urinating (or it is very dark), you are clinically dehydrated.  When dehydrated, if you are unable to take in fluids, you should go to the Emergency Department for intravenous (IV) fluids. With children, they often will become restless, cry without tears, and have dry oral cavities; they need treatment with IV fluids if they refuse, or cannot keep down, fluids. The best assessment of dehydration status is to watch your pee (frequency, amount, and color- if it appears on the darker side, drink more).

How do I prevent this from happening?
-Wash your hands FREQUENTLY!!
-Eat food that is thoroughly cooked if you are eating out (or unsure of food quality)
-Wash fruits and veggies before eating them
-Wash areas that have become contaminated with hot soapy water or bleach
-Immediately wash all clothes, bed linens, etc that have become in contact with vomit or stool of an infected person
-If you do get infected, avoid contact with others and preparing food until three days after symptoms are gone

Generally, the Norovirus is a nasty couple of days where you feel horrible (absolutely miserable), but it always ends and there are no long-term effects. But if you have chronic illnesses or other active diseases, it can be deadly because of the effects of dehydration and the electrolyte imbalances that can occur. In children, the elderly, and chronically ill, you need to make sure they are taking in fluids with nutrients (pedialyte, Gatorade, coconut water) and if they cannot, you need to seek medical assistance.  Even if you are vomiting, still try to push those fluids…even absorbing small amounts are better than nothing!

So wash your hands, cook that food, and steer clear of anyone with those symptoms and you will be Norovirus free this winter!

Yours in Good Health
B

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