Of all the so-called minor illnesses, gastroenteritis is probably the most hated. Intense nausea is a challenge to anyone’s sanity. Diarrhea is not much fun either. As adults we pride ourselves in having things under control. Loss of stomach or bowel contents, suddenly, and not necessarily behind a closed bathroom door, is a good lesson in humility, but that’s a steep price to pay for it.
All this misery is thanks to a little virus called Norovirus. This is such a tiny thing that it was known as the “Norwalk agent” for decades, as it was too small to identify even with an electron microscope. This little virus puts the “C” in contagious. It is highly concentrated in the vomit and diarrhea of infected people. Forceful vomiting will aerosolize the virus, allowing it to spread person to person. One study followed every patron in a restaurant after someone vomited at their table. The table right next to it had an 80% infection rate within three days. As they tallied cases at farther away tables, the infection rate steadily declined.
Health departments often get involved with outbreaks of Norovirus (as it can present as a food-borne illness). It seems that in some foreign countries the sewage system is not totally contained or well separated from potable water. Only a few drops of sewage in contact with agricultural irrigation water can contaminate a large volume of produce. One of the more recent cases involved green onions, which are only rinsed off and added to food uncooked. This can generate large numbers of sick people from a single restaurant or chain.
You perhaps remember the cruise ship “anti-holiday” that was in the news a few years ago. Norovirus loves closed communities. It infected virtually every person on the ship. Nowhere to run, nowhere to hide. I imagine more than a few passengers seriously considered jumping off the ship and swimming to the mainland.
The Norovirus makes you sick when you eat it. It is temporarily in the air after someone vomits or flushes a toilet. These virus particles quickly settle on any available surface, and can remain viable for weeks. Putting your hand on the table and absentmindedly wiping your mouth can be enough to ruin your week.
To prevent yourself from catching Norovirus, stay far away from anyone that has nausea/vomiting/diarrhea. They remain infectious for a couple of days after they feel better. Wash your hands before touching your face. Treat your foods as though you are in a foreign country. Don’t eat anything raw, and only eat well-cooked food from a trustworthy source.
This is a hard bug to avoid if anyone in your household or workplace gets it. It is self-limiting, and a vast majority of gastroenteritis patients are symptomatic for less than 24 hours. As long as you don’t get dehydrated, you will rapidly improve.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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