Published Date: 2004-11-11 23:50:00
Subject: PRO/EDR> Viral gastroenteritis update 2004 (32)
Archive Number: 20041111.3049
VIRAL GASTROENTERITIS UPDATE 2004 (32)
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] Norovirus confirmed - Canada (Calgary)
[2] Norovirus, Flamingo hotel outbreak update - USA (Nevada)
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[1] Norovirus confirmed - Canada (Calgary)
Date: Wed 10 Nov 2004
From: Kevin Fonseca <K.Fonseca@provlab.ab.ca>
Re: Calgary Shelter Outbreak: Confirmation of Norovirus Infection
------------------------------------------------------------------
[The following information has been received from Kevin Fonseca amplifying
the media report describing a presumptive norovirus outbreak in a
drop-in/rehab centre in Calgary, Saskatchewan: see "Viral gastroenteritis
update 2004 (31) 20041109.3030. ProMED-mail welcomes the opportunity to
publicise confirmation of the identity of the causative agent. - Mod.CP]
The results of laboratory testing on stool samples submitted from these
patients showed the causative agent to be a norovirus G2 genotype, by
RT-PCR testing; electron microscopy on these samples was negative for other
agents of viral diarrhoea. Culture for bacterial enteric agents are
negative thus far. There has been an increasing amount of norovirus-like
illness over the past few weeks in this region.
--
Kevin Fonseca
Clinical Virologist
Provincial Laboratory of Public Health (Microbiology)
<K.Fonseca@provlab.ab.ca>
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[2] Norovirus, Flamingo hotel outbreak update - USA (Nevada)
Date: Wed 10 Nov 2004
From: ProMED-mail <promed@promedmail.org>
Source:gamblingates.com, News, Mon 8 Nov 2004 [edited]
<http://www.gamblinggates.com/News/08112004/LasVegasNorovirus02021.html>
Norovirus outbreak Affects 1252 people in Las Vegas Hotel-Casino
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[The initial phase of this outbreak was reported as part [1] of the
ProMED-mail post archived as "Viral gastroenteritis update 2004 (30)
20041101.2954. The management of the Hotel-Casino complex appear to have
contributed to the duration of the outbreak by their reluctance to
communicate its full extent. - Mod.CP]
A norovirus outbreak at a Las Vegas Strip hotel-casino has affected over
1200 people, health officials reported. Brian Labus, the Clark County
Health District's senior epidemiologist, said on Thu [4 Nov 2004] that a
total of 1252 employees and guests of the Flamingo Las Vegas have suffered
symptoms of the vomit and diarrhea-inducing virus. Health officials said
airlines and other transportation carriers are being warned about the
outbreak in Las Vegas. With the Centers for Disease Control reporting that
the incubation period for the ailment is usually 24 to 48 hours,
out-of-town visitors might have gotten ill after returning home.
Robert Stewart, a spokesman for Caesars Entertainment, which owns the
Flamingo, welcomed statistics from the health district on Thu 4 Nov 2004
that showed new reports of virus infection down to fewer than 100 a week
from a high of more than 500 a week during late October. Clark County
health officials said calls have come in to the health district from across
the nation from people suspecting they acquired the illness in Las Vegas,
but authorities have not tracked the calls by state.
People from Oregon, Washington, Ohio, North Carolina and New York have
complained that they caught the virus in Las Vegas. All maintain they
should have been told by Flamingo officials that a norovirus outbreak was
present. They said they never saw the 2 dozen 22-inch-by-28-inch signs that
were on walls inside the hotel. A letter had been placed in rooms, Stewart
said, but some guests say they never saw that either. Stewart said front
desk personnel and the hotel's call center have not informed people of the
virus outbreak "because so few people have been affected. You have to
remember we have 3500 rooms," he said.
[A woman from] Long Island, N.Y., said her 75-year-old father was
hospitalized for 4 days at Desert Springs Hospital and is now recuperating
at his North Carolina home from an infection caused by vomit going into his
lungs. Because the virus is so contagious, Clark County health authorities
have been in contact with airlines and other transportation carriers. "We
have let them know that we have an outbreak and that they have to do deep
chemical cleaning if anyone gets sick," said Dave Tonelli, a health
district spokesman. "This is not the kind of thing where you slop around a
little cleaning fluid and think you've done the job." Shuttle bus companies
in Las Vegas have been advised to use special cleaning solvents should
someone become sick during a ride.
Noroviruses are transmitted primarily through consumption of contaminated
food or by direct person-to-person spread. Federal health officials said
the norovirus accounts for more than 2/3 of the estimated cases of
food-borne illnesses in the United States each year. Infected food handlers
are usually the cause of the contamination.
Virus generally passes through the system in about 72 hours. Though Stewart
was heartened by the declining numbers of reported norovirus cases, he was
concerned by a report from an employee that suggested more employees had
contracted the virus than first thought. Initially, Stewart estimated about
180 employees had the virus. If Flamingo employees are found to have the
virus, they get 6 days off with pay, he said.
Dr. Donald Kwalick, Clark County's chief health officer, praised hotel
management for alerting the health district to the outbreak on 20 Oct 2004.
"Health district and Flamingo Las Vegas staff are continuing to work
together to mitigate the outbreak," Kwalick said. "Heightened sanitation
practices have been implemented and staff is working to quickly identify
any ill employees so they may be excused from work until well." Tonelli
said the district cannot tell hotel officials how to inform guests or
potential guests about the virus. "That's up to them," he said.
No one knows how the virus reached Las Vegas, Tonelli said. "It's no
different than colds or flu," he said. "We're not the source of all colds
or flu. But we have a lot of visitors congregating in one place and then it
spreads quickly."
--
ProMED-mail
<promed@promedmail.org>
See Also
Viral gastroenteritis update 2004 (31) 20041109.3030Viral gastroenteritis update 2004 (30) 20041101.2954
Viral gastroenteritis update 2004 (29) 20040915.2569
Viral gastroenteritis update 2004 (01) 20040117.0182
2003
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Norovirus activity 2002 - USA 20030123.0206
Viral gastroenteritis update 2003 (28) 20031227.3141
Viral gastroenteritis update 2003 (01) 20030108.0058
2002
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Norwalk-like virus, decontamination: RFI 20020612.4475
Norwalk-like virus, decontamination methods 20020615.4497
Norwalk-like virus, decontamination methods (02) 20020617.4519
Norwalk-like viruses, control guidelines 20020620.4549
.......................cp/pg/mpp
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