Uh Oh. Keep the Mop Handy. Norovirus Makes an Early Appearance

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It's only early December, but already there's been some nasty norovirus outbreaks in the U.S. One was bad enough to close an entire school. Another hit 400 people at the U.S. Air Force Academy. In response, some bits of wisdom (and humor) about this dreaded stomach bug.

As if winter isn't bad enough. Perhaps a visit from Santa might cheer you up, especially if you've already had a visit from Satan (note the brilliant juxtaposition of letters!).

I don't mean the big guy down there, but rather the evil little guys he sent up here (See Norovirus: From Satan's Biohazard Lab To Your Duodenum), which will have your digestive system going both up and down, maybe at the same time. (There must be some literary term for the use of all those "ups" and "downs" together but I flunked poetry.)

It's a bit too early for an entire school to be shut down in Mesa Valley, Colorado, or to have 400 very ill cadets at the Air Force Academy in Colorado Springs. Hmm. What's the common element here?

Josh's "Bad Puns of the Southwest® Map" Sorry. Couldn't help myself. 

And it's not just here. At a Lego Show in the U.K. 40 people Lego of their lunch. There were numerous complaints of unsanitary restrooms. I'll say.

It is more than a little disturbing to see outbreaks starting in November (1). This does not bode well for the rest of the winter. The virus doesn't hit its stride for about two more months.

Source: Reported Norovirus Outbreaks by Primary Transmission Mode and Month of Onset, CDC

ABOUT THE BUG

Norovirus is one of the world's most contagious pathogens and it's not merely an inconvenience. It's the second most common infectious disease in the US (20 cases million/year, the cold is about 10X that). While it is rarely fatal in the US (<1,000 deaths per year) worldwide it's a different story; 685 million people catch it each year and 50,000 children will die from the resulting dehydration.

CAN YOU PREVENT IT?

Yes and no. Hand washing helps, but since as few as ten virus particles are sufficient to cause infection, this can only do so much. It's a tough little SOB; it stays "alive" on surfaces for weeks and will survive exposure to alcohol, so those dispensers you see all over the place won't help. As if this isn't bad enough, it can also be spread through the air via tiny droplets expelled by the person vomiting. And you'd be amazed how far this mist can travel. There is one crazy epidemiological study where a woman vomited in a restaurant (this is considered to be in poor taste in some cultures) and people at tables that were nearby (and not so nearby) caught it; the closer the table the more people became infected. There is also evidence that some people have partial immunity to norovirus because of their blood type.

IS THERE ANY HOPE FOR A VACCINE?

Yes, there is hope but the real evidence isn't available yet. Vaxart, a small San Francisco vaccine biotech, is developing an oral vaccine that is supposed to protect people from the two most common strains of the bug. In healthy human volunteers, the vaccine generated a strong immune response against both strains. Now it moves to Phase II trials where people will be inoculated with live virus to see if the immune response is strong enough to prevent infection. (I believe the term "#$%#% no" is sufficient to convey my eagerness to be part of that endeavor.)

So, wash your hands (or hold them together and pray) and hope that what we've seen so far is not predictive of winter. If you have any questions just shoot me an email. I'll answer even though I'll be on vacation in Colorado.

Just kidding.

NOTE:

(1) The cadets got it even worse. The outbreak there started in October. Ick.