Norovirus Outbreak Makes the Flu Look Like a Cakewalk

There's a norovirus outbreak in the U.S., and beware: This GI virus hits hard.

'Vomiting Larry' is a British model that shows just how contagious norovirus can be: Vomited particles can fly ten feet away. (Photo: British Health and Safety Laboratory)

Jan 30, 2013· 3 MIN READ
Shari Roan is an award-winning health writer based in Southern California.

It was Christmas Eve 2008 when Sal Cardoni first started to feel truly horrible. He'd helped take care of his cousin's infant son for a short time, and within hours he was sleeping on the bathroom floor, too ill to go to bed. "I started to get sick just after midnight," remembers Cardoni, an editor in Los Angeles. "Around 3 a.m. my dad brought me a blanket and pillow in the bathroom." Cardoni had come down with norovirus, which he'd contracted from the baby. "So starting at midnight on Christmas, I was sick and vomiting through the next day and well into the evening of the 26th," he says. "I wasn't back to 100 percent until almost New Year's." Though Cardoni tried his best not to pass along the highly contagious virus, his mom and a cousin ended up sick as well.

Not everyone is coughing and sniffling from this winter's miserable strain of flu. Like Cardoni, some people are doubled over with stomach cramps and nausea thanks to the outbreak of a new norovirus strain—a classic gastrointestinal virus that causes vomiting and diarrhea—that's circulating in the United States, according to the Centers for Disease Control and Prevention (CDC). Public health officials told TakePart they're watching the illness carefully because it has the hallmarks of being a particularly bad strain.

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Norovirus is best known for ruining people's vacations with outbreaks on cruise ships. The virus is highly contagious, so a confined space like a ship is a perfect target for it to spread. But it's a mistake to think this is a cruise-ship illness only, says Dr. Aron Hall, of the CDC's National Center for Immunization and Respiratory Diseases. "We hear a lot about norovirus on cruise ships causing outbreaks, but that is not the most common place we see it," he says. "That makes up fewer than five percent of the cases reported in the U.S. By far, the most common places we see norovirus outbreaks are nursing homes and hospitals."

From there, the viruses easily spread into communities. "These viruses are spread efficiently through a variety of means," he says. "But they are quite adept at spreading from direct person-to-person contact."

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The new strain is called GII.4 Sydney. That’s important because there are five main types of norovirus and the GII.4 subgroup is typically the worst of the lot. It's not clear yet whether GII.4 Sydney causes more severe illness than other strains, but it has already unleashed its fury in Australia and the United Kingdom and no one there is singing its praises.

"Every few years in the last decade a new strain of norovirus emerges and sometimes when it emerges it can cause a real increase in outbreaks," Hall says. "That's why we track new viruses in circulation and send out public health alerts. We've seen it widespread throughout the country." (There’s currently no vaccine for the virus, but researchers are working on one.)

"It's not clear yet if this is a more severe strain," adds Dr. Eyal Leshem, an Epidemic Intelligence Service officer at the CDC. "The peak of the season typically occurs in January." Even in a typical year, norovirus outbreals cause 20 million cases of illness, 70,000 hospitalizations, and 800 deaths. While anyone can become infected, complications are typically the most severe in the very young or very old or people with other health problems.

Norovirus usually spreads from direct contact. That's why the best way to prevent it is to wash your hands a lot with soap and warm water for at least 20 seconds, Leshem says. ("That's about the time it takes to [sing] 'Happy Birthday' twice," he instructs.)

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But, Hall cautions, "The spread is typically through that direct oral route…[what’s called] aerosolization. Some particles of vomit can float through the air for a few feet and settle on the surfaces that someone touches or that can be inhaled." If you're not convinced just how far the virus can travel, check out "Vomiting Larry," an invention from the United Kingdom's Health and Safety Laboratory. Scientists created this vomiting robot to demonstrate how contagious it can be. "Larry" stands about five feet tall and has a fluid-filled cylinder stomach that contains a fluorescent dye. When the fluid is ejected from Larry's mouth, UV lighting shows just where droplets land. Studies show some fly about ten feet away.

But you don't need Larry to tell you to steer clear of anyone who's coughing, sneezing, or doubled over with stomach cramps—at least until the norovirus is no longer a threat and flu season has passed.

Do you wash your hands religiously to stave off the flu and other illnesses? Have you had the flu or norovirus this year?

Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.