Norovirus--does it get worse than that? Yes, actually

Thursday, August 30, 2012 - 3:18pm

By Carmen MacKenzie

Norovirus - it sounds exotic. And nasty.

There’s no denying it’s the latter. Often characterized by the sudden onset of explosive diarrhea and vomiting, it’s a virus that takes you completely out of commission for a day or two.

“Anyone who’s had norovirus or norovirus-like symptoms knows how absolutely awful you feel,” said Dr. Gaynor Watson-Creed, medical officer of health for the Capital Health district. “But from a public health perspective, it’s not one of the illnesses we track or try to contain.”

Commonly referred to as the stomach flu, norovirus is considered the stomach version of the common cold by public health and infectious disease experts.

“Even though norovirus isn’t reportable to public health, we do investigate norovirus outbreaks in our community when we receive calls about them,” said Dr. Watson-Creed. “But our aim in a norovirus outbreak isn’t necessarily to contain it - it’s simply to rule out something more serious, like E. coli or salmonella.”

When a reportable - much more serious - disease rears its ugly head, public health pulls out all stops.

BY THE NUMBERS

2012 (Jan. - Aug.)

40 - the total number of outbreaks public health has investigated in the Capital Health district in the first half of 2012

  • 20 - outbreaks categorized as norovirus or “enteric” illness (i.e. having similar gastrointestinal symptoms, but not confirmed by the lab as norovirus)
  • 17 - outbreaks categorized as respiratory, influenza or influenza-like illness
  • 2 - chicken pox outbreaks investigated (not reportable in previous years)
  • 1 - outbreak of vancomycin-resistant enterococcus (VRE) investigated

2011 (Jan. - Dec.)

56 - the total number of outbreaks investigated in 2011

  • 24 - outbreaks categorized as norovirus or enteric
  • 30 - outbreaks categorized as respiratory, influenza or influenza-like illness
  • 1 - E. coli outbreak investigated
  • 1 - VRE outbreak investigated

"With reportable diseases like hepatitis A, measles, meningitis, rabies, tuberculosis, listeriosis, our job is to find the source and shut it down,” said Dr. Watson-Creed.

Caryll Tawse, manager of the protecting health unit at public health, said that her team has a number of tools at their disposal to track down and contain an outbreak of a reportable disease.

“A few years ago, we received a report of someone diagnosed with hepatitis A,” said Tawse. “We quickly investigated to find out who she had been in close contact with and within a day or two had vaccinated not only the person diagnosed, but all of her close contacts. Because we were able to vaccinate that circle of people quickly, no one else got sick and we prevented a potentially very serious outbreak.”

Public health investigates more than 2,000 cases of communicable disease in the district each year. Some of them turn into outbreaks of two or three people; others, like Chlamydia, affect hundreds.

“For serious diseases where containment is possible, we do everything we can to prevent an outbreak of two cases from turning into an outbreak of 20, 200 or 2,000,” said Dr. Watson-Creed.

Those measures may include vaccination, thorough cleaning of an environment, quarantining people or restricting visitor access to a hospital or care facility.

These actions at the front end of an outbreak are often enough to prevent it from spreading. But it’s in fact simple measures - like making sure people stay home when they’re sick, frequent and thorough hand washing, and cleaning and disinfecting of surfaces, particularly in places where groups of people share close quarters - that would prevent the vast majority of these cases and outbreaks from occurring, said Tawse.

“It’s simple, yet true, that if everyone washed their hands often and thoroughly with warm, soapy water, we wouldn’t be chasing nearly as many of these diseases.”