Archive for the ‘Uncategorized’ Category

Norovirus Season: It’s Not Over ‘Til It’s Over

Friday, March 21st, 2014

Norovirus Season  Its Not Over Til Its OverNorovirus—sometimes dubbed “the stomach bug” – is making notable appearances around the nation as winter gives way to spring. Asheville, North Carolina and Alexandria, Virginia schools closed their doors in recent days to disinfect in an effort to stem outbreaks. Virginia students on a class trip to New York City were hospitalized after becoming sick at a performance of “Phantom of the Opera.” Norovirus is being cited as a possible factor in four deaths in a Minneapolis Veterans Home, leading to a hold on new admissions. Weld County, Colorado health officials report at least five outbreaks, most in nursing homes. And norovirus still shows up on cruise ships. According to the Centers for Disease Control and Prevention (CDC), 80 percent of norovirus outbreaks occur between November and April. As the old saying goes, “it’s not over ‘til it’s over,” and norovirus season is definitely not yet over.

Most Vulnerable: The Young and the Old

Norovirus Stats

According to CDC, norovirus is the most common cause of acute gastroenteritis in the US each year, causing approximately:

  • 19-21 million cases of illness
  • 56,000-71,000 hospitalizations
  • 800 deaths

Not to be confused with the flu, which affects the respiratory system, norovirus is a highly contagious virus that targets the human gastrointestinal tract, resulting in diarrhea and profuse vomiting. The CDC notes norovirus can affect anyone, but that symptoms can be serious for some people, especially young children and older adults. Norovirus thrives in closed environments, such as daycare centers, nursing

Tips for Combating Norovirus

  • To protect yourself and others, wash your hands frequently with warm water and soap for at least 20 seconds (the time it takes to hum the “Happy Birthday Song” twice), and dry thoroughly.
  • Stay home if you are sick, and even after symptoms subside, take extra precautions to avoid spreading norovirus, e.g., wash hands frequently and avoid handling food for others for at least three days.
  • Disinfect frequently touched surfaces with a solution of bleach plus water (see posters below).

The Water Quality & Health Council worked with CDC, the Somerset County, New Jersey Department of Health and the American Chemistry Council to develop two downloadable posters on norovirus disinfection (downloadable here). “Clean-up and Disinfection for Norovirus (“Stomach Bug”)” gives directions for responding to a vomiting or diarrhea incident. “Help Prevent the Spread of Norovirus (“Stomach Bug”)” offers tips on disinfecting when norovirus is known to be affecting the community. It is our hope that these posters will be of use in schools, veterans’ homes, nursing homes, cruise ships, and other environments in which norovirus spreads easily.

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

Don’t Let the Stomach Bug Ruin Your Sports Tournament

Friday, December 6th, 2013

By Bruce Bernard, PhD

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The family trip to see our children play in a sports tournament has become almost as American as apple pie. Yet recent news reports demonstrate the fun of these events can be destroyed by the infamous norovirus (aka stomach bug). A recent youth football tournament in Las Vegas, for example, was marred by a visit from the stomach bug, sending some players to hospital emergency rooms instead of onto the playing field. A news report indicated 28 people went to the hospital and 90 to 100 players, coaches and parents exhibited symptoms of nausea, vomiting and diarrhea during the four-day event. One of the football games had to be forfeited due to illness; tournament organizers even dispensed with end-of-the-game handshakes between opposing teams to help prevent the spread of infection. A tournament spokesperson speculated in the news report that “some people might have caught the sickness before coming to the tournament, and spread it to others during long bus rides.”

Norovirus, is a highly contagious virus; it is the leading cause of outbreaks of diarrhea and vomiting in the US. It is notorious for ruining many cruises. It spreads by contact with an infected person, touching a contaminated surface, eating contaminated food, or drinking contaminated water. Norovirus particles can float through the air and settle on surfaces. In 2010, a norovirus outbreak among the members of a girls’ travel soccer team was traced to a grocery bag filled with snacks (CDC study). It is thought that the bag of snacks was contaminated when a team member became ill in a bathroom in which the bag was stored. Team members were exposed to norovirus when they retrieved snacks from the bag.

Sports Travel: Lessons from the Field

1. Stay home if you are sick: Long bus rides in crowded conditions present the perfect opportunity for norovirus to spread. Real “team players” will want to prevent the spread the norovirus to their teammates. It is important to know that people can transfer norovirus to others for at least three days after being sick. Additionally, if players become sick while on the road, they should be kept as isolated as possible.

2. Don’t share water bottles or sports drink containers: Viruses can spread from person to person when drink containers or eating utensils are shared. Water bottles and sports drink containers should be labeled with team members’ names and never shared.

3. Don’t share mouth guards, keep them separate from other sports equipment and wash and disinfect after each use: Mouth guards can harbor pathogens. After scrubbing a mouth guard with cool water, let it dry out thoroughly, then soak it in products designed to clean dentures or orthodontic retainers. A mild solution of chlorine bleach (2 teaspoons bleach in 2 cups of water) can be used to help disinfect and deodorize mouth guards. After soaking in bleach solution, rinse well with plain water.

4. Wash hands thoroughly and often: Rest stops present the perfect opportunity for sports players to wash up while on the road, especially following a trip to the bathroom or before eating. Follow recommendations from the US Centers for Disease Control and Prevention for proper hand-washing.

5. Hand sanitizer may not be effective: Hand sanitizers may not be effective against norovirus. CDC notes that alcohol-based hand sanitizers can be used in addition to hand washing, but they should not be used as a substitute for washing with soap and water.

6. Be prepared to respond appropriately to a vomiting or diarrhea incident: The Water Quality & Health Council worked with CDC and other public health partners to develop a free downloadable “Clean-up and Disinfection for Norovirus (“Stomach Bug”) poster.” Keep this information handy for responding to norovirus “incidents.”

I have spent many, many weekends taking my kids to soccer games and tournaments, and I know all the work that goes into a sports trip (e.g., practice, team work, travel, family togetherness). ALL THIS CAN BE DESTROYED BY JUST ONE INFECTED PERSON! Protect your family and your team!

Bruce Bernard, PhD, is President of SRA Consulting, Inc., Associate Editor of the International Journal of Toxicology and lives in the Neck District of Dorchester County, Maryland.

Avoiding a Norovirus Nightmare on Your Cruise

Friday, March 22nd, 2013

Avoiding a Norovirus Nightmare on Your CruisePlanning to take a cruise? Are you concerned that a tranquil voyage could turn nightmarish if norovirus spreads throughout the ship? Norovirus is a highly contagious virus that causes nausea, vomiting and diarrhea—truly an unwelcomed passenger on a cruise. Here are some helpful facts about cruise ships and norovirus.

Norovirus is Not Limited to Cruises and It is Not a Stomach Flu

As Cruise Critic points out, although it is sometimes known as the “cruise ship virus,” norovirus is not limited to cruise ships.  It is a seasonally recurring virus, especially in nursing homes, hospitals, schools and other confined venues because of the close quarters and the ability of the virus to spread so quickly. It is commonly associated with foodborne disease.  The elderly and the very young are most prone to norovirus infection although it also affects many healthy people.  Norovirus is frequently associated with cruise travel because health officials are required to track illnesses on ships and report the number of cases of diarrhea to the Centers for Disease Control and Prevention (CDC) within 24 hours of arrival at a US port. 

Norovirus has another misnomer:  It is frequently called the “stomach flu.” But, norovirus is not flu:  Flu is characterized by fever, fatigue, muscular aches and pains and inflammation of the respiratory passages although the flu can sometimes cause nausea and vomiting.  Norovirus infects the gastrointestinal system.

The Sick Should Not Go Cruising

If you are sick, don’t risk spreading your illness by boarding a cruise ship. Although symptoms usually last only a few days, people remain contagious for at least three days after being sick with norovirus.  Norovirus can spread quickly in enclosed spaces like cruise ships, putting everyone at risk.  Both feces and vomit are infectious.  Vomiting can produce miniscule particles suspended in the air that can enter the mouths of others and be swallowed.   

It is possible to have norovirus infections multiple times over a lifetime because the virus mutates into new forms.  In other words, norovirus can ruin more than one cruise for you.  If you are planning a cruise, purchasing travel insurance is a good idea, letting you cancel your trip without financial penalty.

Norovirus can Spread in Several Different Ways

Understanding the many ways norovirus spreads can help you avoid norovirus on land and sea:

  • Consuming contaminated food, drinks or ice
  • Touching surfaces or objects contaminated with norovirus and then putting hands or fingers into your mouth
  • Having direct contact with another person who is infected, e.g., sharing food or eating from the same utensils as someone who is ill
  • Taking in norovirus particles spread through the air by someone vomiting

Hand Washing is Key and Hand Sanitizer May Not be as Helpful

According to CDC, good hand hygiene is one of the most critical control strategies in managing infectious disease outbreaks. Wash hands with warm water and soap for about 30 seconds–including vigorous rubbing and getting under the fingernails too–followed by thorough drying with paper towels. Hand-washing is especially important after using the bathroom and before preparing food or eating. Hand sanitizers may not be as effective against norovirus because not enough of the virus is killed or removed.

All Aboard for Cruise Ship Infection Control

CDC’s Vessel Sanitation Program specifies isolating infected persons for at least 48 hours after the resolution of the last symptom.  Food handlers suffering from any communicable disease should be excluded from food preparation and service.  Additionally, according to NBCNEWS.com, self-service buffets are now disappearing and passengers are given a “welcome letter” offering tips on hand-washing and remaining in their cabins when ill.

When norovirus is about, infection control measures need stepping up to prevent germ transmission. The virus can live for days on surfaces and it is hard to kill.  Frequently touched hard surfaces must be properly cleaned and disinfected. Additionally, norovirus “incidents” of diarrhea or vomiting must be promptly cleaned and affected surfaces disinfected with solutions of chlorine bleach to help reduce the transmission of norovirus (downloadable poster resources).  Anything that has been in contact with vomit or diarrhea should be discarded or disinfected.  Affected fabrics should be machine washed with detergent, hot water and bleach–if recommended–choosing the longest wash cycle, then machine dried.  Carpets and upholstery should be steam-cleaned.

Keeping your cruise safe and enjoyable is a matter of common sense and hygiene. Bon voyage!

Barbara M. Soule, R.N. MPA, CIC, FSHEA, is an Infection Preventionist and a member of the Water Quality & Health Council.

ESPN Finds Foodborne Illness Risk Associated with Sports Stadium Vendors

Monday, August 16th, 2010

In certain sports stadiums and arenas across the country, millions of Americans are inadvertently putting themselves at risk of serious illness when patronizing some concession stands. ESPN’s “Outside the Lines” reviewed health department inspection reports for food and beverage outlets at all 107 North American arenas and stadiums that were home to professional baseball, football, hockey and basketball teams in 2009. In more than a quarter of the venues, half of the concession stands or restaurants had at least one “critical” or “major” health violation cited. Such violations pose a risk for foodborne illnesses that can make someone sick, or, in extreme cases, cause death.

Major violations included food stored at inappropriate temperatures, improper employee hygiene, insufficient kitchen equipment, and cross-contamination of foods, including raw food contaminating ready-to-serve food. Some food preparation surfaces were found to be contaminated with insects or rodent droppings.
Listen up, sports arena food vendors! Even though you have a major challenge to serve a lot of food very quickly, don’t forget about food safety. The process of killing foodborne germs on surfaces takes two easy steps: Cleaning and disinfection. First, surfaces must be washed with hot, soapy water, and rinsed with clear water. This is to remove dirt or food that would interfere with the disinfectant. The second step is disinfection or “killing germs.” This is normally accomplished by applying a solution of one tablespoon of chlorine bleach in one gallon of water to food preparation surfaces. Surfaces can be left to air-dry. Bleach solutions break down over time, so solutions should be re-made by each kitchen or food preparation shift. Bleach and ammonia-containing products should never be combined.

In partnership with the National Environmental Health Association and the American Chemistry Council, the Water Quality and Health Council has developed two new free, user-friendly resources on disinfecting food-contact surfaces, such as countertops and utensils. The Safe Food Depends on a Clean Kitchen poster series was designed for restaurant and institutional kitchens. The poster displays simple directions in steps, available in both English and Spanish, to instruct staff on the proper ways to disinfect the food prep area as well as items in the sink bay.
The resources are featured on the Water Quality and Health Council’s new “Disinfect for Health” website. Posters are easily downloadable.

(Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.)