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Wednesday, January 11, 2012

Norovirus – Don’t make it your winter weight loss program


I finally got around to watching the movie Contagion. I had expected great performances from its stellar cast, but I was enthralled by the cinematography of how they portrayed the concept of hands and surfaces playing such crucial roles in infection transmission. While I’m not certain I agree with Dr. Erin Mears’ (played by Kate Winslet) statement that the average person touches their face 2000 – 3000 times per day, I do agree that unknowingly we touch our faces a lot. I refuse to think of how many contaminated surfaces I touch during the course of any given day!

While Contagion was portraying an unknown virus (which of course makes for a better story), the movie could instead be the poster child for how Norovirus gets transmitted! And let’s face it, its winter, which is Norovirus season and from the statistics I have been seeing so far, the 2011-2012 Norovirus season is off to a banger start! The UK has confirmed that the number of cases seen across the UK is 19% higher than during the same period last year. Within the first 10 days of 2012 there are already 2 confirmed Norovirus outbreaks in 2012 aboard Cruise Ships (there was a total 10 outbreaks during 2011). The Public Health Agency of Canada says that of the provinces and territories that report data to the National Enteric Surveillance Program, all have experienced Norovirus outbreaks in long-term care and other institutions over the past few weeks with 11 outbreaks in long-term care facilities occurring within the Toronto area since Christmas. YIKES!!

So what is Norovirus? It’s a nasty little virus that causes vomiting and diarrhea, that’s what. Noroviruses are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide which equates to approximately 267,000,000 annual infections worldwide, and is also a major cause of foodborne illness. Scarier yet, is the fact that according to some published studies that only 1 case of Norovirus is identified for every 1562 cases that likely exist! Norovirus spreads easily and by multiple routes. A single visitor to a hospital ward or long-term care facility might initiate an outbreak by person-to-person contact, vomiting staff members or patients can disseminate the virus by airborne means, and contaminated surfaces, such as doorknobs and computer keyboards, can sustain an epidemic. As I write this blog it is only 9:30 am and already I have dropped my son off at daycare (germ city!), driven my car to work (when was the last time I disinfected the steering wheel), have touched countless surfaces around the office and ate my breakfast at my desk…..and no I did not wash my hands before I ate. I am walking on the wild side.

The ability of Noroviruses to persist in the environment for perhaps even 3–4 weeks likely contributes to the high number of outbreaks. Further studies have demonstrated that Norovirus can be transmitted sequentially to 7 different surfaces, including door handles and telephone receivers, after volunteers touched 1 surface originally contaminated with only 30 µL (which is really, really small) of fecal fluid. I shudder to think how many times the volunteers touched their faces after their hands were contaminated with poo……

To make matters worse, Norovirus is highly resistant to many of the commonly used disinfectants used to clean environmental surfaces on a daily basis in hospitals, long-term care facilities, schools, restaurants and office buildings. There are numerous products registered by Health Canada and the US EPA that carry efficacy claims against Norovirus, but it is imperative that you verify the product’s efficacy and do not assume the disinfectant you may currently be using will be effective should Norovirus decide to rear its ugly head at your facility. Nor can we rely on alcohol-based hand sanitizers as Norovirus exhibits resistance to these too. Plain soap and water is the best method to rid our hands of this pesky virus!

Needless to say, Norovirus is not a pathogen that should be treated lightly…unless of course like me you need to shed the weight you gained over Christmas!

Bugging Off!

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