Contagious virus hits Europe

Just when you thought you beat the winter flu season, another virus blows across the continent causing more than runny noses and watery eyes. The norovirus is currently causing concern in some parts of Germany.

While the Robert Koch Institute of Germany reported over 24,000 cases of the norovirus between Dec. 19, 2006 and Jan. 18, 2007, Army hospitals and clinics in Germany are not reporting high numbers.

“We have seen a slight increase of patient’s with diarrhea in Landstuhl Regional Medical Center’s Emergency Room, but nothing significant in the school community or other outpatient clinics in the Kaiserslautern area,” said Dr. (Lt. Col.) William Corr, preventive medicine consultant for the Europe Regional Medical Command.

The norovirus made the news in the U.S. in December when Indiana health officials blamed the norovirus for an outbreak of illness among nearly 400 patrons of an Olive Garden restaurant outside Indianapolis. More than 380 passengers and crew members aboard Royal Caribbean’s “Freedom of the Seas” were sickened by the norovirus during a November Caribbean cruise. In Montreal, Canadian newspapers reported that an epidemic of viral gastroenteritis spread to at least 29 health-care institutions across Montreal, making it the worst of its kind in a decade. In late January, more than 300 hundred British army recruits came down with a severe form of gastroenteritis.

The U.S. Army Center for Health Promotion and Preventive Medicine-Europe uses a computerized tracking system for early notification of community-acquired outbreaks. The system showed a spike Jan. 16, with 23 visits to clinics in the Heidelberg and Bavarian areas. Since Jan. 16, the rates dropped to normal. The relatively low numbers may be attributed to the fact Soldiers and family members live and work in gated communities, said Dr. Corr.

Norovirus is a group of viruses that cause flu-like symptoms, according to the U.S. Centers for Disease Control and Prevention. It spreads through contaminated food or liquids, contaminated surfaces, or direct contact with someone who is infected. Viruses are very different from bacteria and parasites, some of which can cause illnesses similar to norovirus infection. Like all viral infections, antibiotic medication does not cure patients affected by noroviruses.

Norovirus symptoms usually include nausea, vomiting, diarrhea and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people, the illness is self-limiting with symptom lasting for about one or two days. In general, children experience more vomiting than adults do. Most people with norovirus illness have both of these symptoms.

Noroviruses are found in the stool or vomit of infected people. People can become infected with the virus in several ways, including:
• Eating food or drinking liquids that are contaminated with norovirus
• Touching surfaces or objects contaminated with norovirus, and then placing their hand in their mouth
• Having direct contact with another person who is infected and showing symptoms (for example, when caring for someone with illness, or sharing foods or eating utensils with someone who is ill)

Persons working in day-care centers, barracks, or dining facilities should pay special attention to children, employees, Soldiers, and patrons who have norovirus illness. This virus is very contagious and can spread rapidly throughout such environments.

Noroviruses are very contagious and can spread easily from person to person. Both stool and vomit are infectious. Particular care should be taken with young children in diapers who may have diarrhea.

People infected with norovirus are contagious from the moment they begin feeling ill to at least three days after recovery.  Some people may be contagious for as long as two weeks after recovery. Therefore, it is particularly important for people to use good hand washing and other hygienic practices after they have recently recovered from norovirus illness.

People may feel very sick and vomit many times a day, but most people get better within one or two days, and they have no long-term health effects related to their illness. However, sometimes people are unable to drink enough liquids to replace the liquids they lost because of vomiting and diarrhea.  These persons can become dehydrated and may need special medical attention.  This problem with dehydration is usually only seen among the very young, the elderly, and persons with weakened immune systems.
“The best thing to do to stop the spread of norovirus is to wash your hands.  Hand washing is the best way to keep from getting sick,” said Dr. Corr.

(Courtesy of Europe Regional Medical Command Public Affairs; information courtesy of the CDC Web site, and the U.S. Army Center for Health Promotion and Preventive Medicine Health Information Operations Weekly Update.)