It’s that time of year, when a particularly nasty virus rears its head. Often called “stomach flu,” norovirus is not really related to the influenza virus but is a miserable viral infection all its own. Your family physicians here at the Medical Group of South Florida see it throughout the year, but it is especially prevalent in the winter, from November to April.
Norovirus causes inflammation (acute gastroenteritis) of the stomach or intestines or both. The most common symptoms include severe diarrhea and vomiting, stomach pain, fever, chills, headache and body aches. The frequent vomiting and diarrhea can lead to dehydration, which in turn triggers the additional symptoms of decrease in urination, dry mouth and throat, and dizziness on standing. Another common marker for norovirus is the rapidity of onset; the patient can be feeling fine one minute and sick the next.
NBC News reported this week that outbreaks across the country have been spreading rapidly, even forcing some schools to close. Although not usually deadly, the Centers for Disease Control and Prevention (CDC) estimates that the virus causes between 19 million and 21 million cases in the United States every year, leading to 56,000-71,000 hospitalizations and nearly 800 deaths annually, mainly in young children and the elderly.
The reason norovirus is so dreaded—besides the misery it causes in the patient—is because it is highly contagious and extremely difficult to eradicate. The virus can be found in the stool of infected individuals as long as two weeks after recovery, as well as on contaminated surfaces for up to two weeks. It spreads easily in such closed environments as hospitals, schools, restaurants and cruise ships because the violent vomiting that is one of its hallmarks is thought to release at least a million particles of the virus into the atmosphere, which then settles everywhere in the immediate environment.
Once in place, it is also difficult to remove. Hand wipes and sanitizers won’t do the trick. It takes at least 30 seconds of vigorous hand washing (including under the nails) with soap and hot water to eradicate the virus, and a bleach solution to remove it from surfaces.
So what can you do to protect yourself? Based on suggestions from the CDC, your physicians at the Medical Group of South Florida recommend the following:
1. Wash your hands carefully and thoroughly with soap and hot water often throughout the day, especially after using the toilet and changing diapers, and always before eating, preparing, or handing food.
2. Wash fruits and vegetables before eating them, and be sure to cook oysters and shellfish thoroughly: the quick steaming process frequently used to cook shellfish often isn’t sufficient, as the virus can withstand temperatures as high as 140° F.
3. Do not prepare food for others while you are experiencing symptoms and for at least two days after your symptoms subside. If you are sick, stay home.
4. Use a chlorine bleach solution of 25 tablespoons of bleach per gallon of water to clean contaminated surfaces, or use another disinfectant registered by the Environmental Protection Agency (EPA) as effective against norovirus (check the product’s label).
5. Immediately remove and wash clothing or bed linens that may be contaminated with vomit or feces in hot water on the longest-available cycle length and machine-dry on the hottest setting. Wear disposable gloves while handling such items and wash your hands afterward.
The norovirus usually runs its course in one to three days. If you catch it, it is important to stay in bed until fully recovered and drink plenty of water and fruit juices to allay dehydration. If your symptoms are especially severe, or if you have any concerns regarding possible complications, please contact your physician at the Medical Group of South Florida. And remember that antibiotics are totally ineffective against any type of virus, including the norovirus.