ProMED-mail |

Published Date: 2004-12-30 23:50:00
Subject: PRO/EDR> Viral gastroenteritis update 2004 (37)
Archive Number: 20041230.3447

VIRAL GASTROENTERITIS UPDATE 2004 (37)
**************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:

[1] Norovirus, restaurant - USA (New Mexico)
[2] Rotavirus, children - Israel (Tel Aviv)
[3] & [4] Norovirus, hospital - New Zealand (Christchurch)
[5] Norovirus, hotel closure - UK (England)
[6] Norovirus, outbreaks increase - USA (New York)

*******
[1] USA (New Mexico)
Date: Wed 22 Dec 2004
From: ProMED-mail <promed@promedmail.org>
Source: Alamogordo Daily News, Wed 22 Dec 2004 [edited]
<http://www.alamogordonews.com/artman/publish/article_6249.shtml>

New Mexico: Investigation Points to Norovirus Infection at Restaurant
--------------------------------------------------
The investigation into what caused patrons of a local restaurant to
become ill is focusing on a viral infection, according to the New
Mexico Environment Department. Frank Fiore, staff manager for the
agency's Las Cruces and Alamogordo field office, said on Tue 21 Dec
2004 that the cause of the illness that has affected more than 50
customers of Margo's in Alamogordo appears to be a norovirus.

According to the Center for Disease Control website, noroviruses are
a group of related viruses that cause acute gastroenteritis in
humans. The symptoms of norovirus-associated illness usually include
nausea, vomiting, diarrhea, and some stomach cramping, the website
said. People also have a low-grade fever, chills, headache, muscle
aches and a general feeling of tiredness.

The illness usually begins suddenly and the infected person may feel
very sick. The length of the illness is usually brief, with symptoms
lasting only about one or 2 days.

Fiore said the staff and owners of Margo's have been sanitizing the
entire restaurant in preparation for reopening the business. In the
meantime interviews are still being conducted with staff to determine
how the illness might have been spread. Until samples from staff
members come back from the lab, those employees will not be allowed
to return to work. "The restaurant is OK to reopen," Fiore said.
"They've accomplished those things that we have required them to do,
they've gotten training and they've done an extensive and thorough
cleanup in the facility. They've thrown out food that might have been
contaminated. They can reopen as soon as they have people available
to work in the kitchen. But a number of the employees can't go back
to work until we have sample results back from lab that show that
they are not sick anymore. That's the big hold-up as far as the
reopening."

Because humans can carry norovirus and not know it, taking samples
from employees is very important, according to Fiore. "People have to
be cleared to go back into the kitchen. People can be carriers --
that's why we're doing the testing of the folks that work in the
kitchen. Sometimes people just don't realize that they're sick."

While the interviews will continue, it appears that the outbreak has
ended. Fiore said the number of affected persons has not risen in
recent days. "There have been no new cases reported," said Fiore.
"And we think we're at the end of the outbreak. We think it's pretty
much over. We're optimistic it is."

[Byline: Monica M. Brown]

--
ProMED-mail
<promed@promedmil.org>

******
[2] Israel (Tel Aviv)
Date: Fri 24 Dec 2004
From: ProMED-mail <promed@promedmail.org>
Source: The Tel Aviv Weekly, Fri 24 Dec 2004 (translated from Hebrew
by Mod.AS) [edited]

Tel Aviv: Serious Outbreak of Rotavirus Infection in Children's Hospital
---------------------------------------------------
During the last 2 months the situation related to rotavirus infection
has deteriorated. The virus causes diarrhea and vomiting in children,
affecting mainly infants under the age of 2 years. The main hazard
(damage) is dehydration. Though the virus is common every winter,
this year it has been particularly serious.

During the past 2 months, more than 1000 toddlers have been
hospitalised in the Danna Children's Hospital in Tel-Aviv. However,
the Hospital's director, Dr Shimeon Reiff, says there is no cause for
panic but room for increased alertness/vigilance.

[Byline: Mariana Ulitzky]

--
PoMED-mail
<promed@promedmail.org>

******
[3] New Zealand (Christchurch)
Date: Tue 28 Dec 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Press online, Health, Tue 28 Dec 2004 [edited]
<http://www.stuff.co.nz/stuff/0,2106,3140605a7144,00.html>

New Zealand: Outbreak of Norovirus Infection at Christchurch Hospital
--------------------------------------------------
Christchurch Hospital is urging people with vomiting and diarrhoea to
stay away from its emergency department (ED) as it battles to contain
an outbreak of norovirus infection. Yesterday 7 people were seen by
staff at the ED with the symptoms of norovirus infection --
noroviruses are highly infectious gastric viruses that causes severe
vomiting and diarrhoea. The hospital is now warning those with the
symptoms of the infection to call or see their GP or 24-hour medical
centre first rather than turning up at the hospital.

Norovirus infection swept through Princess Margaret Hospital earlier
this year, closing several wards and infecting 200 patients and
staff. It has now hit Christchurch Hospital, forcing the temporary
closure of 2 wards to new admissions and the introduction of strict
infection control measures.

Yesterday, a 3rd ward -- ward 30 -- was quarantined as 2 more
patients fell ill with suspected cases of norovirus infection. Dr
Steve Chambers, the hospital's clinical director, infectious diseases
control, said there had been no new cases of norovirus in ward 28 but
there had been one further case in ward 27.

In a worrying development, the ED was seeing an increasing number of
people with vomiting and diarrhoea. At this time of year, when people
were prone to over-indulge or fall victim to food poisoning, it was
difficult to distinguish norovirus infection from other [forms of
gastroenteritis], but the hospital was erring on the side of caution
and imposing strict infection control measures. Healthy people who
contracted norovirus infection normally recovered within 48 hours,
but the virus can be more harmful to children, the elderly and the
infirm.

Asked how the patients who had contracted the virus were recovering,
Chambers said: "So far, so good." Chambers said anyone in the
community suffering from diarrhoea or vomiting should wash their
hands thoroughly, observe strict hygiene, and limit their contact
with others.

[Byline: Lois Watson]

--
ProMED-mail
<promed@promedmail.org>

******
[4] New Zealand (Christchurch)
Date: Wed 28 Dec 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Press online, National news, Wed 28 Dec 2004 [edited]
<http://www.stuff.co.nz/stuff/0,2106,3141274a11,00.html>

New Zealand: Progress of Norovirus Outbreak at Christchurch Hospital
-------------------------------------------------
Dr Steve Chambers, the Christchurch Hospital's clinical director,
infectious diseases control, said Ward 28 was now open. The situation
had improved overnight in ward 27 with no new cases of the virus
identified. Monitoring would continue for another 24 hours before the
ward would be admitting new patients again.

"There are 5 patients with norovirus infection in ward 30 and another
3 under observation." Dr Chambers said strict hygiene precautions
applied and the hospital suggested that visitors check with the ward
staff before coming in to see patients in this ward. Children and
elderly people are particularly vulnerable to the virus.

"The Emergency Department (ED) is extremely busy at this time of the
year, and we are asking anyone with norovirus symptoms to phone or
see their GP or go to a 24-hour Medical Centre first." Dr Chambers
said if people were being brought into the Emergency Department for
any medical reason, it was important to restrict the number of people
travelling with them. "Sometimes a family or several friends will
come with a patient. This is a potential issue with norovirus because
it is highly infectious. We need to reduce the numbers of people
coming into ED who are supporting a patient."

--
ProMED-mail
<promed@promedmail.org>

*****
[5] United Kingdom (England)
Date: Wed 29 Dec 2004
From: ProMED-mail <promed@promedmail.org>
Source: The Evening Telegraph (Peterborough) online, Wed 29 Dec 2004 [edited]
<http://www.peterboroughtoday.co.uk/ViewArticle2.aspx?SectionID=845&ArticleID=911598>

England: Outbreak of Norovirus Infection Closes Hotel in Peterborough
---------------------------------------------------
A hotel has been forced to close and 45 patients at a city hospital
have been stricken in separate incidents involving a viral
gastroenteritis outbreak. A total of 39 people staying at the Moat
House Hotel, in Thorpe Wood, Peterborough, were struck down by
norovirus infection between Christmas Eve and Boxing Day, and one
person was taken to Peterborough District Hospital after contracting
the virus. Today, the hotel was closed as specialist cleaning
companies began disinfecting the building to prevent a further spread
of the disease.

Meanwhile, at Edith Cavell Hospital in Bretton, patients and staff in
3 wards have been affected by an outbreak of the same virus
infection. A total of 45 patients and 24 staff were all affected by
norovirus infection. Pam McNicol, a spokesperson for the hospital,
said: "The infection control team and ward staff have contained the
infection, and no new patients have been accepted onto the wards.
Staff have not worked elsewhere in the trust to reduce the chance of
the infection spreading. These precautions continue until no new
cases are reported for 48 hours. "Plans are in place to re-open 2 of
the wards affected today. We will then be able to accept new
patients."

The hotel outbreak began when 7 guests were taken ill on Christmas
Eve. They were treated by a district nurse for the symptoms of the
virus infection, which causes nausea, vomiting and diarrhoea. The
affected people were quarantined in their rooms to prevent the
airborne virus spreading on Christmas Day, while the other guests
carried on as usual. But, by Boxing Day evening, more and more of the
visitors staying at the hotel began falling ill. A further 32 cases
were diagnosed, and the health authority was called in to give advice
about how to stop the airborne virus spreading. It is believed the
virus was brought into the hotel by a party of guests from Kent. A
spokesman for the hotel said, "It's very contagious. A number of
guests and team members have contracted the virus. The hotel will
remain closed while the rooms are steam-cleaned. It will be
re-opened when we get the all-clear from the health authority."

--
ProMED-mail
<promed@promedmail.org>

******
[6] USA (New York)
Date: Thu30 Dec 2004
From: ProMED-mail <promed@promedmail.org>
Source: Mid-Hudson News Network online, Thu 30 Dec 2004 [edited]
<http://www.midhudsonnews.com/News/gastro_virus-30Dec04.htm>

New York: Gastrointestinal Illness on Rise
------------------------------------------
If you've got the stomach bug this winter, you're not alone. The
Putnam County Department of Health has recently seen an increase in
gastrointestinal illness throughout the county. The illness is
usually caused by a virus that is spread by exposure to infected
people or contaminated food or water. The virus is generally spread
person-to-person by direct contact, or touching surfaces or objects
contaminated with a virus and then placing unwashed hands in the
mouth. Some medical reports suggest that some viruses can be spread
through the air during vomiting.

Although these viruses are easy to spread, serious illness rarely
occurs. The most common symptoms include nausea, vomiting and stomach
cramps. Diarrhea may occasionally accompany vomiting. Fever is
usually low-grade or absent. The good news is that infected people
generally recover in one to 2 days.

No specific treatment is available. Persons who are ill with vomiting
and diarrhea should drink plenty of fluids to prevent dehydration,
Putnam Health officials suggest. Dehydration among young children,
the elderly and the sick can be common and is the most serious health
effect of this illness. By drinking fluids, persons can reduce their
chance of becoming dehydrated. Occasionally some individuals may need
to be hospitalized to receive intravenous fluids to reverse
dehydration.

--
ProMED-mail
<promed@promedmail.org>

[The description of the disease indicates that the viral
gastroenteritis outbreaks spreading in New York State are caused by
noroviruses. - Mod.CP]

See Also