A recent article in The Washington Post warned us that the "Dreaded ‘stomach flu’ wreaks havoc on families — and it’s only going to get worse." Is this true, or were they just trying to sell more newspapers?
"Dreaded ‘stomach flu’ wreaks havoc on families — and it’s only going to get worse"
Lena H. Sun, Washington Post, January 5, 2017
Uh oh. When it comes to choosing a common infectious disease that you would avoid, it's a pretty sure bet that most would say "the stomach flu." Although the term is incorrect—the bug is called norovirus, and it has nothing in common with influenza—everyone knows what that means: A day or two of hell, during which various components inside your gastrointestinal tract decide that they really don't want to be in your body. You know the drill. We've all been through it.
As if the "stomach flu" isn't enough to worry about, especially if you have kids in school (1), it is going to "get worse", the journalist warns us. How? Is there going to be a new strain that makes you even sicker, prolongs the course of the disease, or is more contagious? Will the new strain be more likely to kill people?
How else can it get worse?
Here are the answers: no, no, no, no, and unknown.
Norovirus, which got its name from the place where it was first isolated (Norwalk, Ohio in 1968), is essentially the perfect virus.
- Norovirus is the most or one of the most (2) contagious pathogens on earth.
- Norovirus is hard to kill, and can persist on surfaces for weeks.
- Catching norovirus offers little or no protection against getting it again.
- Norovirus can be spread in four different ways (3).
- You can spread norovirus one day before symptoms arise, and two weeks after.
- There is no vaccine for norovirus (4) or any medicine to treat it (5), aside from using supportive therapy, such as rehydration.
This is bad enough (6). Why is it going to get worse?
The reporter used a scary headline to get attention, but if you read the article, there is not one single difference that applies to this year's expected winter outbreak and that of any other year:
- "cold weather usually coincides with an increase in one of winter's most dreaded horrors: norovirus." (Yes, that's true. Always has been)
- "In some instances, doctors and patients are reporting more severe cases of illness than in previous years" (Are there doctors are reporting less severe cases? How many doctors?)
- "Many patients spiked fevers between 102 and 103 degrees." (Fevers usually range from 100-104. The Mayo Clinic suggests seeking medical attention for adults if they reach 104, and 102 for children)
The article is also full of contradictions:
“Most of what people are saying is that it’s more severe, lasting longer, and people feel a lot worse” (Maryland pediatrician)
"This year, norovirus outbreaks reported to the CDC appear to be “pretty much on par with previous years” (Kentucky pediatrician)
“So far, we’re seeing essentially the same viruses in circulation as we saw during last season,” he said, with no indication of new or especially virulent strains" (CDC epidemiologist)
If you are still not sure they are confused, and perhaps why, take a look for yourself.
Suspected and confirmed norovirus outbreaks reported to CDC 7 days after being reported to 9 state health departments. Source: Centers for Disease Control and Prevention
The 2016-17 season is shown in red. The gray area is a composite of the other years. One could interpret this graph in any of three ways, all equally valid:
- This winter is worse so far
- This winter is better so far
- This winter is the same so far
So, why the scary headline? I think we all know by now that fear sells newspapers, yet that didn't stop even a prestigious newspaper in the post-fake-news era from using this cheap trick. It's enough to make you sick.
For other recent ACSH articles about the virus, see:
(1) Rotavirus, a "children's version" of norovirus can be prevented by a vaccine.
(2) Estimates of the number of viruses required to infect someone range from 10-100. This is a crazy low number.
(3) Fecal-to-oral, on surfaces, contact with the vomit, aerosolized virus particles, usually near someone who is vomiting.
(4) A norovirus vaccine from Takeda is currently in Phase II trials, where it is showing evidence of an immune response. I am unaware of efficacy data. Other companies are also doing research in this area.
(5) Zofran, a drug designed to treat nausea and vomiting from cancer chemotherapy is also useful in controlling norovirus symptoms.
(6) There is a particular saying that is sometimes used to describe a norovirus infection: "It doesn't kill you, but you'll wish it did." The saying is wrong. Norovirus kills about 600 people per year in the US, and 200,000 world-wide.