Norovirus Infection (Norwalk and Norwalk-Like Virus Infection ; Cause of Gastroenteri

[Chuck1j]

Norovirus Infection (Norwalk and Norwalk-Like Virus Infection ; Cause of Gastroenteritis)

 

The reason I am posting this is that there is very little information about this subject available. I also don't want to post this in any particular Cruise line Thread as it pertains to them all, so I chose Ask a Question as it seemed most relevant.

 

In light of one of the worst Holiday season out breaks on ships in the Caribbean, I felt it is time to bring this subject to light. Lets leave specific cruise lines, ships and personalities out of this discussion as this is not just a cruise industry problem.

 

Questions like at the time of the out break what kind of preventative measures were in place on the ship if any.

 

How many people in your group had it? (Lets not speculate only people you actually know with the illness.)

 

How many report the illness to the ships Doctor?

 

It is suggested that less than 30% of people report the illness to the Doctor as there cabin will be quarantined for the duration of the illness.

 

What are the ships procedure & regulations once the illness is reported?

 

What are the levels of contamination and what do they mean?

 

Are there any benefits to the passenger who reports the illness, besides his moral responsibility?

 

The following have been taken from the Center for Disease Control.

 

http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-qa.htm

 

http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-foodhandlers.htm

 

What are noroviruses?

 

Noroviruses are a group of viruses that cause the “stomach flu,” or gastroenteritis (GAS-tro-en-ter-I-tis), in people. The term norovirus was recently approved as the official name for this group of viruses. Several other names have been used for noroviruses, including:

 

Norwalk-like viruses (NLVs)

caliciviruses (because they belong to the virus family Caliciviridae)

small round structured viruses.

Viruses are very different from bacteria and parasites, some of which can cause illnesses similar to norovirus infection. Like all viral infections, noroviruses are not affected by treatment with antibiotics, and cannot grow outside of a person’s body.

 

What are the symptoms of illness caused by noroviruses?

 

The symptoms of norovirus illness usually include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people the illness is self-limiting with symptoms lasting for about 1 or 2 days. In general, children experience more vomiting than adults. Most people with norovirus illness have both of these symptoms.

 

 

 

What is the name of the illness caused by noroviruses?

 

Illness caused by norovirus infection has several names, including:

 

stomach flu – this “stomach flu” is not related to the flu (or influenza), which is a respiratory illness caused by influenza virus.

viral gastroenteritis – the most common name for illness caused by norovirus. Gastroenteritis refers to an inflammation of the stomach and intestines.

acute gastroenteritis

non-bacterial gastroenteritis

food poisoning (although there are other causes of food poisoning)

calicivirus infection

How serious is norovirus disease?

 

People may feel very sick and vomit many times a day, but most people get better within 1 or 2 days, and they have no long-term health effects related to their illness. However, sometimes people are unable to drink enough liquids to replace the liquids they lost because of vomiting and diarrhea. These persons can become dehydrated and may need special medical attention. This problem with dehydration is usually only seen among the very young, the elderly, and persons with weakened immune systems.

 

How do people become infected with noroviruses?

 

Noroviruses are found in the stool or vomit of infected people. People can become infected with the virus in several ways, including:

 

eating food or drinking liquids that are contaminated with norovirus;

touching surfaces or objects contaminated with norovirus, and then placing their hand in their mouth;

having direct contact with another person who is infected and showing symptoms (for example, when 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 norovirus illness. This virus is very contagious and can spread rapidly throughout such environments.

 

 

 

When do symptoms appear?

 

Symptoms of norovirus illness usually begin about 24 to 48 hours after ingestion of the virus, but they can appear as early as 12 hours after exposure.

 

Are noroviruses contagious?

 

Noroviruses are very contagious and can spread easily from person to person. Both stool and vomit are infectious. Particular care should be taken with young children in diapers who may have diarrhea.How long are people contagious?

 

People infected with norovirus are contagious from the moment 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 particularly important for people to use good handwashing and other hygienic practices after they have recently recovered from norovirus illness.

 

Who gets norovirus infection?

 

Anyone can become infected with these viruses. There are many different strains of norovirus, which makes it difficult for a person’s body to develop long-lasting immunity. Therefore, norovirus illness can recur throughout a person’s lifetime. In addition, because of differences in genetic factors, some people are more likely to become infected and develop more severe illness than others.

 

What treatment is available for people with norovirus infection?

 

Currently, there is no antiviral medication that works against norovirus and there is no vaccine to prevent infection. Norovirus infection cannot be treated with antibiotics. This is because antibiotics work to fight bacteria and not viruses.

 

Norovirus illness 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, the sick, can be common, and it is the most serious health effect that can result from norovirus infection. By drinking oral rehydration fluids (ORF), juice, or water, people can reduce their chance of becoming dehydrated. Sports drinks do not replace the nutrients and minerals lost during this illness.

 

Can norovirus infections be prevented?

 

You can decrease your chance of coming in contact with noroviruses by following these preventive steps:

 

Frequently wash your hands, especially after toilet visits and changing diapers and before eating or preparing food.

Carefully wash fruits and vegetables, and steam oysters before eating them.

Thoroughly clean and disinfect contaminated surfaces immediately after an episode of illness by using a bleach-based household cleaner.

Immediately remove and wash clothing or linens that may be contaminated with virus after an episode of illness (use hot water and soap).

Flush or discard any vomitus and/or stool in the toilet and make sure that the surrounding area is kept clean.

[splinkaone]

This virus is currently spreading all over the U.S. (my husband did some internet research and found the same info. posted above). My family and I came in contact with it somehow around New Years Eve (we haven't cruised and stayed home and had a few friends over) and it spread like wildfire taking us all down (5 of us) one at a time and it is AWFUL, I have talked with other friends and family members and heard of several other people who have gotten it. So don't think that you are only suseptible on a ship, yes in those close quarters there is a much higher risk of catching it. Follow the above posters suggestions and avoid getting this if you can!

[Chuck1j]

I am sorry if I gave you that idea. I am aware that it is everywhere but I am just investigating cruises. New York City had a bad event late last year, in a hospital. It is a bad illness where ever you contact it.

Thanks for your reply.

[SheilaNC]

FYI, there have been many threads on this subject and several citations of the CDC Web site. Today, on another thread, an outbreak in 2 major, well respected Boston hospitals was reported.

 

Handwashing is a known deterrant to spread of any infection as is sanitizing surface areas like computer keyboards, telephones, handrails and doorknobs, etc. usually with a bleach solution. Unfortunately none of these methods is infallible and susceptible people are easily infected since it takes such a small number of virus particles to begin the infection (unlike other diseases which often require large numbers). Anti-biotics are not useful since they work against bacterial infections so bringing prophylactic antibiotics onboard with you is not a good idea.

 

Hope this adds a bit more information to this ongoing discussion. BTW, I am an RN and have oftent pointed folks towards the CDC Web site for additional information.

[Wylie Coyote]

Just a question.... if a person has recently experienced the nationwide outbreak of the Norovirus, can you get re-infected? I thought after your body experienced a certain virus (like the flu) and fights it off, you have somewhat of an immunity to re-infection. So, if I am cruising in February and I have already experienced the virus less than 6 months ago, will I be more protected from re-exposure?

[Karysa]

We were on a cruise in Dec. of 2006 and there had been outbreaks of this virus on many ships so we were told not to shake hands with the staff and they were instructed of this as well to avoid spreading this virus around the ship.

Karysa

[SheilaNC]

Wylie,

As far as I know, prior infection does not convey protection with Norovirus. I know several people who have had it more than once. With this ongoing discussion, I've just reminded myself to pack Chlorox wipes for telephone, door knobs, etc. in our cabin....any little bit of help makes me feel better even if it's not foolproof...

[cmacf1]

I live in Maryland and work in a preschool. In December 2006 up until holiday break, numerous kids (and staff) had norovirus, including me. We are very very careful about washing our hands, washing the kids' hands and using hand sanitizers and yet, a whole lot of us got it. And like splinkaone said, it was truly awful. I wanted to die. Somehow, though, my DH and DDs didn't get it despite the fact that they were all in very close contact with me. However, my MIL, who arrived AFTER I was better, got it. So it seems the virus hangs around for awhile.

 

Thanks chuck1j for posting that information. I never knew much about it until I got it myself last month!

[Jules215]

Partner and I just got off our first cruise Monday...Initially the first night, I thought I was having some sea sickness, as the water was a little rough...(But have no history of motion sickness, and have spent lots of time on smaller boats, so wasn't sure)...Partner began having intestinal probs on Saturday, but thought it was just a change in environment/food ( he'd come over from the UK for the New Year)...He went down to the medical area 2X's finding it closed both X's, but wasn't too bothered, as he was just looking for some Pepto B or Kaopectate...I continued to feel somewhat unwell thru Sunday, and he got worse...Finally, on Sunday he went back down only to find the place packed out...In the middle of helping him fill out the form, I saw the wording "possible quarantine"...After seeing that, and also because of the wait time, he decided he'd made it this far, and he didn't need to see the doctor...Wadded up the form, tossed it, and went on our way.

 

About an hour later our phone rang in the cabin, and it was guest services, asking how we were both feeling, and STRONGLY suggesting we go back down to the medical area to be seen...(Yep, someone had pulled the form he was filling out out of the trash)...He went back down, and bottom line, we both got quarantined for the last day of the cruise...( We're suppose to receive compensation for 1 cruise day lost)...When it was time to get off, they wouldn't touch our luggage, our setsail cards, etc...We also got to bypass all the lines to get off, and they had a special customs area to go through...Could have been worse I guess, but not a great way for a first cruise to go...Even though we weren't quarantined the entire time, BF felt lousy during the whole trip, but what do you do??...We're already planning another cruise, so obviously we were happy with the experience when we were both feeling somewhat "OK"

 

I'm going on a second cruise at the end of this month, and hoping for a much more pleasant experience.

[dkjretired]

If you check further on the CDC web site you will see that every year about 45 million Americans get Norovirus and about 4 to 5 thousand on cruise ships. Perhaps this will help to put a little perspective on this issue...

[momofmeg]

I have never had it while on a cruise-but I used to get this a couple of times a year until I learned NOT to eat anything before washing my hands.

 

I was bad to grab something I had just bought and eat it in the car-after buying groceries-and had my hands all over those nasty carts. It has been 4 years now since I have had a stomach virus. I do believe my being more careful has spared me!

[momofmeg]

I have never had it while on a cruise-but I used to get this a couple of times a year until I learned NOT to eat anything before washing my hands.

 

I was bad to grab something I had just bought and eat it in the car-after buying groceries-and had my hands all over those nasty carts. It has been 4 years now since I have had a stomach virus. I do believe my being more careful has spared me!

 

I shouldn't have posted this as I picke dup a "bug" since posting this! I guess I was tempting the powers that be-saying by washing my hands especially before I ate kept me from getting it-still it HAS been 4 years-so I still say that it works to wash your hands.

 

 

One thing though-since it has been almost 4 months since I was on a cruiseship-I guess I can't blame it on that- but I was in Walmarts Tuesday-I imagine it was there that I picked up this nasty bug.

[auntyhelen]

Just a question.... if a person has recently experienced the nationwide outbreak of the Norovirus, can you get re-infected?

 

Yes indeed you can. There are many different 'strains' of Norovirus. Immunity to one of them - through having been infected with it - does not ensure immunity to any of the others. Recently a friend of ours was unlucky enough to go down with one strain of Norovirus in November and succumb to another in January.

 

At the opposite end of the scale there are some people - very few - who will never suffer from Norovirus because their genes protect them against it.

 

Meanwhile, the majority of us who go on cruises are at far greater risk from Norovirus for two main reasons.

 

1. The close communal environment that exists on cruise ships;

 

2. The fact that cruises are very popular with the elderly.

 

Compared to the rest of the population elderly people are far more likely to have visited hospitals not long before going on holiday. And since hospitals these days are ridden with all sorts of nasty bugs, including Norovirus, it is easy to understand the crucial role played by the elderly in bringing illness aboard cruise ships. They pick up bugs like Norovirus in hospitals, go cruising and unwittingly infect other passengers. Coach trips and any other types of vacation with signifcant numbers of elderly participants are also susceptible to this phenomenon.

 

But please don't think I am against elderly people. I am one myself. I mention the above merely as a matter of fact.

 

Sadly, it looks as if the best way of avoiding Norovirus on holiday is to go self-catering. :(

[momofmeg]

Yes indeed you can. There are many different 'strains' of Norovirus. Immunity to one of them - through having been infected with it - does not ensure immunity to any of the others. Recently a friend of ours was unlucky enough to go down with one strain of Norovirus in November and succumb to another in January.

 

At the opposite end of the scale there are some people - very few - who will never suffer from Norovirus because their genes protect them against it.

 

Meanwhile, the majority of us who go on cruises are at far greater risk from Norovirus for two main reasons.

 

1. The close communal environment that exists on cruise ships;

 

2. The fact that cruises are very popular with the elderly.

 

Compared to the rest of the population elderly people are far more likely to have visited hospitals not long before going on holiday. And since hospitals these days are ridden with all sorts of nasty bugs, including Norovirus, it is easy to understand the crucial role played by the elderly in bringing illness aboard cruise ships. They pick up bugs like Norovirus in hospitals, go cruising and unwittingly infect other passengers. Coach trips and any other types of vacation with signifcant numbers of elderly participants are also susceptible to this phenomenon.

 

But please don't think I am against elderly people. I am one myself. I mention the above merely as a matter of fact.

 

Sadly, it looks as if the best way of avoiding Norovirus on holiday is to go self-catering. :(

 

Boy, you are bored to bring up a 2 year old thread for your very first post here.

[sail7seas]

FYI, there have been many threads on this subject and several citations of the CDC Web site. Today, on another thread, an outbreak in 2 major, well respected Boston hospitals was reported.

 

Handwashing is a known deterrant to spread of any infection as is sanitizing surface areas like computer keyboards, telephones, handrails and doorknobs, etc. usually with a bleach solution. Unfortunately none of these methods is infallible and susceptible people are easily infected since it takes such a small number of virus particles to begin the infection (unlike other diseases which often require large numbers). Anti-biotics are not useful since they work against bacterial infections so bringing prophylactic antibiotics onboard with you is not a good idea.

 

Hope this adds a bit more information to this ongoing discussion. BTW, I am an RN and have oftent pointed folks towards the CDC Web site for additional information.

 

 

Host Sheila,

 

Could you mention where the thread is that mentions the two Boston Hospitals and Noro breakout, please.

 

I remember about 2 years ago, Brigham and Womens's Cardiac Unit had a breakout so stubborn and severe they had to close the section to finally clean it all out. Last thing Open Heart Surgery patients need post op is a bout of Noro Virus. Brigham's Heart Surgery is almost always rated in the top five for the country.

 

(Thankfully, I went to Mass General. :))

[Mary Ellen]

Could you mention where the thread is that mentions the two Boston Hospitals and Noro breakout, please.

Did you notice that Host Shelia's post was dated January 9th, 2008? IMHO that is a little far back for her to remember the thread she mentioned.

[Cruiser2323]

Just got back from xmas cruise on the Sea Princess. Norovirus was prevalent.... 10 of the 11 relatives I sailed with contracted the virus. Only 2 however were quaratined as the rest of us only fell ill on the last day or after arriving home....

 

Sea Princes records will show that the ship went into code RED about 6 days before arriving home.

 

Anyone from the following cruise starting 29 DEC 09 know of further infections???? There didn't seem to be much time to disinfect before the next lot boarded...