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Published Date: 2005-01-15 23:50:00
Subject: PRO/EDR> Viral gastroenteritis update 2005 (02)
Archive Number: 20050115.0126

VIRAL GASTROENTERITIS UPDATE 2005 (02)
**************************************
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] & [2] Japan - outbreak at Fukuyama nursing home now attributed to
norovirus, not rotavirus
[3] & [4] Japan - suspected norovirus outbreaks at nursing homes in 6 other
prefectures
[5] Japan - nationwide suspected norovirus outbreaks affect 4100 with 15
deaths
[6] Japan - all nursing homes to be surveyed following norovirus infection
deaths
[7] Canada - outbreaks at homes for elderly in Central Alberta
******
[1]
Date: Mon 10 Jan 2005
From: ProMED-mail <promed@promedmail.org>
Source: Yomiuri Shimbun, Mon 10 Jan 2005 [edited]
<http://www.yomiuri.co.jp/newse/20050108wo23.htm>

Japan: 6 deaths in nursing home in Fukuyama, Hiroshima Prefecture
--------------------------------------------
6 elderly residents have died and 36 fallen ill with vomiting, diarrhea,
and high fever since 30 Dec 2004 at a nursing home in Fukuyama, Hiroshima
Prefecture, the city's public health center announced on Fri 7 Jan 2005.
The health center is seeking to identify whether the outbreak was caused by
food poisoning or an infectious disease. On Friday afternoon the center
ordered the Fukuyama Fukujuen nursing home to cease using its kitchen for
the time being.
The health center learned of the outbreak at about 1:40 pm on Fri 7 Jan
2005, when an anonymous call asked whether an incident related to food
poisoning had occurred at a nursing home in the city, according to a
spokesman for the center. The nursing home had failed to report the
outbreak to the center. A nursing home official said that they planned to
notify the center after studying the condition of residents taken ill.
The center said one nursing home resident died on 31 Dec 2004, 2 died on 2
Jan 2005 and one each died on 3, 4, and 5 Jan 2005. The dead are one man
and 5 women, aged in their 80s and 90s. 5 of the residents moved into the
nursing home between 1996 and June 2004, were bedridden, and required
nasogastric feeding.
It is not clear when the other residents who died moved into the home, but
they ate the same meal as the others. Health, Labor and Welfare Ministry
instructions stipulate that a nursing home and other facilities are
required to report promptly any case of food poisoning or suspected
infectious disease to the local municipal government and other related
public bodies.
[This report refers to the outbreak reported in ProMED-mail post "Viral
gastroenteritis update 2005 (01) 20050109.0070", which was attributed to
rotavirus infection. The update reproduced below clearly indicates that the
outbreak was due to norovirus infection and not rotavirus infection. - Mod.CP]
******
[2]
Date: Mon 10 Jan 2005
From: ProMED-mail <promed@promedmail.org>
Source: Yomiuri Shimbun, Mon 10 Jan 2005 (translated from Japanese by an
anonymous correspondent in Japan) [edited]
<http://www.yomiuri.co.jp/national/news/20050109i214.htm>

Japan: norovirus infection confirmed as cause of outbreak in Fukuyama
---------------------------------------------------------------------
The Fukuyama city health office confirmed the presence of norovirus in 9
specimens tested on Sat 8 Jan 2005. An expert stated that it was the 1st
occasion in Japan when so many deaths could be attributed to norovirus
infection.
It has been reported that there were 576 cases of viral gastroenteritis in
9 prefectures in recent days. The Fukuyama outbreak case total has risen to
43 with 7 deaths.
******
[3]
Date: Mon 10 Jan 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Japan Times, Mon 10 Jan 2005 [edited]
<http://www.japantimes.co.jp/cgi-bin/getarticle.pl5?nn20050110a2.htm>

Japan: suspected norovirus outbreaks in nursing homes in 7 prefectures
-----------------------------------------------------
More than 250 people have suffered diarrhea and vomiting at homes for the
elderly from late December 2004 to early January 2005 in 7 prefectures,
including a woman who died in Kanagawa Prefecture, in addition to the 7
deaths already reported in Hiroshima Prefecture, officials said.
A woman in her 80s died on Wed 5 Jan 2005 at a nursing home in Yamato,
Kanagawa Prefecture, after 46 residents and staff at the facility began
suffering from diarrhea and vomiting on 28 Dec 2005, the prefectural
government said. The other 45 people are recovering, it said. Kanagawa
authorities said 30 residents and 16 staff members developed the symptoms
between 28 Dec 2004 and Sat 8 Jan 2005. On Monday, the woman was suffering
from diarrhea and vomiting. She died at a hospital 2 days later.
Elsewhere, 51 elderly people developed similar symptoms in Hokkaido, along
with 21 in Kitakyushu, 37 in the city of Miyazaki, 15 in northern Yamaguchi
Prefecture, 35 in the city of Wakayama and 54 in Akita Prefecture,
according to tallies released by prefectural authorities through Sun 9 Jan
2005.
The revelation comes after the death of 7 people from diarrhea and vomiting
at a nursing home in Fukuyama, Hiroshima Prefecture. Health officials in
Fukuyama announced on Sun 9 Jan 2005 that they have found evidence of
norovirus infection, symptoms of which include vomiting, diarrhea and
fever, in the feces of 9 of the residents at Fukuyama Fukujuen nursing
home. They said 62 residents and staff at 2 nursing homes in Fukuyama other
than Fukujuen have also suffered similar symptoms since Wednesday,
including 4 who are still hospitalized. Fukujuen officials held a meeting
with family members of the residents Sunday, but they couldn't say how the
residents and staff were infected with the virus.
******
[4]
Date: Tue 11 Jan 2005
Source: ProMED-mail <promed@promedmail.org>
Source: NHK (Japan Broadcasting Corporation), Tue 11 Jan 2005 (translated
by a Japanese correspondent) [edited]
<http://www.nhk.or.jp/news/2005/01/11/d20050111000154.html>

Japan: viral gastroenteritis now affects 17 prefectures
-------------------------------------------------------
According to a study of Ministry of Welfare and Labor, as of Tue 11 Jan
2005, [cases of] gastroenteritis have spread to 17 prefectures, 58
facilities and 2214 patients. These include Hokkaido Profecture (4
facilities, 399 patients); Osaka Prefecture (8 facilities, 340 patients);
and and Akita Prefecture (10 facilities, 297 patients). [In addition to]
the above facilities [with confirmed?] norovirus infections, there are 13
other prefectures [with 1652 suspected cases]. Death totals were 9 in
Hiroshima, 7 in Chiba and 1 in Kanagawa.
The Ministry stated the study was ongoing and numbers were expected to
increase.
[Notes provided by the translator: Norovirus outbreaks appear to be
increasing in Japan. There are reported to be at least 6000 cases a year.
In November 2004, the Ministry of Education and Science alerted all
elementary schools, junior high schools, and high schools to the threat of
norovirus infection. - Mod.CP]
******
[5]
Date: Tue 11 Jan 2005
From: ProMED-mail <promed@promedmail.org>
Source: Kyodo online, EDS: Updating, Tue 11 Jan 2005 [edited]
<http://home.kyodo.co.jp/all/display.jsp?an=20050111234>

Japan: suspected norovirus cases reach 4100 with 15 deaths nationwide
-------------------------------------------------
A total of 4114 people, mainly in homes for the elderly, have shown
symptoms of "stomach flu" in Japan since December 2004, and 15 others have
died after suffering diarrhea, vomiting and other symptoms of
gastroenteritis, according to a Kyodo News tally released on Tue 11 Jan 2005.
Noroviruses, known to cause stomach flu or viral gastroenteritis in humans,
have been detected in 591 people, or 14 per cent of the total [tested]. The
outbreak of the illness, which involves inflammation of the stomach and
intestine, is not limited to homes for the elderly, with 1735 suspected
cases reported in schools, kindergartens, and hospitals.
Kyodo News compiled the tally based on reports from the nation's 47
prefectural governments and other authorities about suspected group
infections or food poisoning cases, following reports earlier this month
that at least 7 elderly people in a public care home died after developing
similar symptoms in Hiroshima Prefecture.
Noroviruses are a group of viruses known to cause [gastroenteritis] in
winter. Nausea, vomiting, diarrhea, light fever, and stomach cramps are
among the known symptoms that appear after one or 2 days of infection. The
virus is mainly contracted orally. The illness is usually brief, with
symptoms lasting only one or 2 days. The Kyodo survey showed that suspected
group infections at homes for the elderly were reported in 34 prefectures
with more than 100 people infected in 13 prefectures.
In Hokkaido, a total of 226 people at 6 homes developed symptoms, and
noroviruses were found in each of the homes. In addition to 7 deaths at a
home in Hiroshima, 2 deaths were reported in Akita, while one death each
was reported at homes for the elderly in 5 other prefectures. One death was
also reported at a hospital in Yamagata Prefecture.
******
[6]
Date: Sat 15 Jan 2005
From: Dr Alfonso J Rodriguez <ajrm_msds@yahoo.es>
Source: Yahoo News, UK, Sat 14 2005 [edited]
<http://uk.news.yahoo.com/050114/323/fab3p.html>

Japan: all nursing homes to be surveyed following gastroenteritis deaths
-------------------------------------------------
Japan will survey conditions at all of its 5000 nursing homes after 7
elderly residents at one institution died of stomach flu [viral
gastroenteritis] caused by a highly contagious virus [norovirus], the
health ministry said. "We take the outbreak very seriously and have decided
to survey all the nursing homes to see whether they are properly following
health guidelines," a ministry official said.
The survey, in which nursing home operators will have to answer questions,
followed the outbreak of a virus at a nursing home in Hiroshima which
killed 7 people earlier this month. The Ministry is investigating the
source of the outbreak. News reports said that [norovirus infection] may
have spread when care workers mixed old and new diapers and neglected to
wash their hands. Noroviruses can easily spread through consuming
contaminated food or liquids, or by touching contaminated objects and
placing that hand in the mouth, according to the US Centers for Disease
Control and Prevention. Norovirus infection is usually not serious, as most
people can recover within one or 2 days with no long-term health effects.
But the illness can be deadly for elderly people or others with weak immune
systems and low mobility.
According to Kyodo News, 42 residents and 20 staff members fell ill at the
Hiroshima nursing home, including the 7 who died.
Japan has one of the world's oldest populations, with more than 23 000
people aged 100 or more.
--
Alfonso Rodriguez, MD
<ajrm_msds@yahoo.es>
******
[7]
Date: Fri 14 Jan 2005
From: ProMED-mail <promed@promedmail.org>
Source: Canadian Press online, Edmmonton Press, Reuters report, Wed 12 Jan
2005 [edited]
<http://www.canada.com/search/story.html?id=780775a7-9ae5-4808-91b7-63e5229b1e8c>

Canada: outbreaks of norovirus infection affect nursing homes in Alberta
-----------------------------------------------
A major outbreak of norovirus infection, which causes severe vomiting and
diarrhea, has infected dozens of seniors in central Alberta lodges and
nursing homes. "It's a really active year for the virus and it's the same
in many provinces," said Dr Martin Lavoie, medical health officer for the
David Thompson Health Region.
Outbreaks of norovirus infection have been reported at 12 facilities in the
health region in the last month. There are about 7 outbreaks at the moment,
he said. In Red Deer, visitors are advised to stay away from the Parkvale
and Pines seniors lodges because of the contagious virus. 8-10 seniors in
each lodge are battling the bug, said Dale Aasen, executive director of the
Piper Creek Foundation, which runs the lodges. Signs at the doors warn
visitors about the outbreak and suggest they return at a better time. Other
outbreaks have been reported at Heart Haven Lodge in Stettler, Innisfail
Country Lodge and facilities in Ponoka, Castor and as far south as Drumheller.
Lavoie said seniors aren't the only ones getting sick. The virus, which is
sometimes referred to as "stomach flu", has hit people of all ages. "If you
are frail and elderly it would be harder on you, but it is still pretty
violent at a younger age," said Lavoie. Symptoms include vomiting, diarrhea
and muscle aches that last for 24 to 48 hours. The virus can spread quickly
through close contact with infected people or by eating food prepared by an
infected person. Large outbreaks were also reported in late 2002 and early
2003.
--
ProMED-mail
<promed@promedmail.org>

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