Norwalk, Ohio, “The Maple City,” is a community not unlike our own. It is located in the north of Ohio not too far from Toledo and just south of the Great Lakes. Quite a small town, it has a population of around 16,000. That you have even heard of this quiet little burg arises from it being the centre of an outbreak of viral gastroenteritis in 1972.
Norwalk experienced a
large increase in cases of diarrhea and vomiting in one of its elementary schools. Public health authorities were quick to jump in to control the spread of illness. They pinpointed the cause as a virus transmitted via the vomit and stool (diarrhea) of those infected. Its spread was very rapid, and broad. Thus began the story of the Norwalk Virus. Since then, other viruses with similar features have been labelled Norwalk-like viruses, or NLV (properly called the Norovirus), and classified as members of the calicivirus family.
Viral gastroenteritis is often called the “stomach flu,” but it is not the flu (influenza). It is a virus. The NLV is particularly hardy and is capable of surviving on practically any surface, including metal and glass. It is spread when people fail to wash their hands properly after using the toilet, or by contact after someone has been sick. The virus can also spread through the air in microscopic droplets which may be breathed in or ingested.
The hardiness and ease of transfer of NLV means outbreaks happen quickly. They tend to occur in places where people congregate in close quarters for extended periods: schools, daycares, nursing homes, cruise ships and hospitals, for example. Lately, we have seen regular outbreaks around North America. Indeed, 2002/03 has been particularly good for this illness. One reason for this is that diagnosis via laboratory tests has improved dramatically to identify Norovirus as the cause of outbreaks.
The symptoms are easy enough to identify: nausea, vomiting, diarrhea and abdominal cramps. Some people will also experience headache and a low-grade fever. Fortunately, recovery usually takes only 2-3 days with no serious or long-term health effects. Because you may be infectious for up to two days after you feel better, it is best to continue to be careful during that time, too. There is some good news to add: being sick with NLV does enable a person to develop some immunity. Unfortunately, it is specific to the particular strain you had, and only lasts about 14 weeks.
Prevention is the best strategy for dealing with this kind of viral illness. That means thorough hand washing — using soap, warm running water, and rubbing vigorously for at least 30 seconds. Everyone, especially children, should learn how to properly wash their hands, and to make sure they do it every time they use the toilet. And in the case where someone in the household is afflicted, effective cleanup may be the only hope for avoiding the spread. Because most household cleaners, other than bleach, are ineffective against many strains of NLV, use a 1:50 dilute bleach solution to clean all surfaces.
As for treatment, don’t get your hopes up; there is no antibiotic that can kill the viruses. All you can do is to replace fluids lost in vomiting and diarrhea, rest and be patient. And don’t forget, wash your hands often, and well. After all, there may not be any long-term health effects, but imagine how much better you will feel not having to deal with it in the first place!
— 30 — Call-out: “Prevention is the best strategy… means thorough hand washing — using soap, warm running water, and rubbing vigorously for at least 30 seconds.”