After battling the Covid-19 pandemic for almost two years, a new virus outbreak has been reported in the UK, which is spreading like wildfire. Referred to as the vomiting bug, Norovirus is highly infectious and causes vomiting and diarrhoea.
Arushi Bidhuri of The Health Site writes Public Health England issued a warning about this nasty virus after routine surveillance reported that there has been a massive jump in cases of norovirus. According to reports, 154 outbreaks have been recorded in England since May. This is roughly three times the previous five-year average of 53 outbreaks over the same time period. According to PHE, while small children have been affected, there has also been an increase in infection across all age categories.
As we continue to take precautionary measures against Covid-19, here are some precautions you should take to avoid the contraction of the highly infectious, norovirus. Again, the most important thing is to pay close attention to hygiene.
Quarantine yourself in case you experience any symptoms of norovirus.
Wash your hands frequently and thoroughly, using soap and water. Unlike COVID-19, alcohol sanitisers do not kill norovirus, therefore soap and water are the best options.
To disinfect contaminated household surfaces, use a bleach-based household cleaner or a mixture of bleach and hot water.
Avoid cooking or eating with others at least 48 hours after recovering from the infection.
Any contaminated clothes or bedding should be washed with detergent and at 60 C, and contaminated objects should be handled with disposable gloves if feasible.
People infected with the virus should take rest and stay hydrated.
Seek medical attention if symptoms persist for more than 24 hours.
Since young children and the elderly are more prone to rapid dehydration, take extra care and be cautious.
Canine norovirus (CNV) is a diarrhea-causing pathogen in canines. In this study, 268 canine diarrheic fecal samples were collected from 13 pet hospitals across three provinces in China between March 2017 and May 2019, and 7.8% (21/268) samples were detected as CNV-positive by RT-PCR. Phylogenetic analysis of twenty-one CNV RdRp fragments showed that eighteen of the strains clustered in GVI.2, two clustered in GVI.1 and one clustered in GIV.2. The complete RdRp, VP1, and VP2 genes of four GVI.2 strains obtained from three provinces were successfully sequenced.
Phylogenetic analyses based on the RdRp, VP1, and VP2 genes showed that the GVI.2 strains from this study were closely related to USA GVI.2 strains. The complete genome of GVI.2 strain Dog/M9/18/CH was successfully sequenced, it was 7905 nucleotides (nt) in length and shared 95.9% nt identity with the sole available, nearly full-length genome of GVI.2 strain genome. To our knowledge, this is first description of the molecular prevalence of CNV in mainland China, and the first report of a complete GVI.2 genome. These findings will extend our understanding of epidemics and the genetic evolution of CNV.
First detection of canine norovirus in dogs and a complete GVI.2 genome in mainland China
We report a norovirus GIV outbreak in the United States, 15 years after the last reported outbreak. During May 2016 in Wisconsin, 53 persons, including 4 food handlers, reported being ill. The outbreak was linked to individually prepared fruit consumed as a fruit salad. The virus was phylogenetically classified as a novel GIV genotype.
Rare norovirus GIV foodborne outbreak, Wisconsin, USA
School officials said on Thursday, schools reported an abrupt increase in students reporting symptoms of vomiting.
“At first, it appeared to be at our middle school, but as the day went on, we began to see similar symptoms in other buildings. Our school health professionals immediately notified county and state health professionals, and are working very closely with them through this situation,” Superintendent Dr. Michelle Havenstrite said.
Havenstrite said health officials believe the illnesses are likely due to norovirus.
The Centers for Disease Control and Prevention lists norovirus as a very contagious virus that causes vomiting and diarrhea. People easily contract the virus by having direct contact with infected people, consuming contaminated food or water or touching contaminated surfaces.
The meal dates at the origin of these toxi-infections are between 02/11/2021 and 02/25/2021 with a majority of meals reported on 02/14 (21 TIAC, 46%). All these TIACs took place in the context of a family meal with between 2 and 8 patients. A total of 164 patients were recorded and two people were hospitalized.
Shellfish collected from individuals who were sick after consuming oysters as well as from suppliers were analyzed by reference laboratories and laboratories approved by the Ministry of Agriculture and Food: noroviruses were identified. Noroviruses have also been detected in several production areas of consumed oysters.
The Yilan County Public Health Bureau said Aug. 12 that several customers and employees in the mass food poisoning case at Hotel Royal Chiaohsi (礁溪老爺酒店) had tested positive for norovirus, though it has not been confirmed as the official cause.
Earlier this month, news broke out that 164 people who dined at the Hotel Royal Chiaohsi’s buffet restaurant had experienced symptoms of food poisoning, including a group of Chailease Finance Co. employees that were on a company retreat. Of all the afflicted individuals, 92 have sought medical assistance, according to the health bureau.
The bureau said that a few customers and hotel staff members, including two restaurant workers, have received a positive result for the norovirus test, but no traces of the virus have been found on any of the kitchenware so far. Since the investigation results will determine the hotel’s responsibility and its follow-up settlement, the bureau said more clarification is needed on the true cause of the incident.
To establish the agent responsible for a gastroenteritis outbreak in a hotel in Menorca (Spain) in September 2016.
The study included epidemiological and laboratory analysis. Environmental and stool samples were examined for bacterial and viral pathogens.
One hundred and fifty-one cases were detected, 123 among the tourists staying in the hotel and 28 affecting the staff. The presence of genotype 2 norovirus was discovered in the microbiological studies of patient’s faeces, as well as in the surface samples of rooms and common areas. The control plan implemented allowed for control of the outbreak.
This study on a genotype 2 norovirus outbreak reveals the importance of a rapid response for controlling these types of outbreaks.
Norovirus outbreak causing gastroenteritis in a hotel in Menorca, Spain
Human norovirus (HuNoV) is one of the leading causes of acute gastroenteritis globally. HuNoV outbreaks have been recently reported during air travels. Contaminated surfaces are known as a critical transmission route at various settings. The aim of this study was to provide key information about the survival and the decontamination of HuNoV on three commonly touched airplane cabin surfaces.
In this study, we monitored the survival of HuNoV on seat leather, plastic tray table, and seatbelt for 30 days, with and without additional organic load (simulated gastric fluid). The efficacy of two EPA registered anti-norovirus disinfectants were also evaluated. Results showed that HuNoV was detected at high titers (>4 log10 genomic copy number) for up to 30 days when additional organic load was present. Both tested disinfectants were found highly ineffective against HuNoV when the surface was soiled. The study showed that when the organic load was present, HuNoV was highly stable and resistant against disinfectants.
Findings from this study indicated that appropriate procedures should be developed by airline companies with the help of public health authorities to decrease passengers’ exposure risk to HuNoV.
Survival and inactivation of human norovirus GII.4 Sydney on commonly touched airplane cabin surfaces
Public Health 29 July 2020
Dorra Djebbi-Simmons, Mohammed Alhejaili, Marlene Janes, Joan King and Wenqing Xu*
Chipotle Mexican Grill Inc. will, according to Edvard Pettersson of Bloomberg, pay a $25 million criminal fine to resolve allegations by federal prosecutors that its food sickened more than 1,100 people across the U.S. from 2015 to 2018.
It’s the largest fine ever imposed in a food-safety case, according to a statement by the U.S. attorney’s office in Los Angeles.
The criminal charges pertain in part to norovirus outbreaks at Chipotle restaurants. The highly contagious virus can be transmitted by infected food workers handling ready-to-eat foods and their ingredients, according to the statement. It can cause severe symptoms, including diarrhea, vomiting and abdominal cramping.
“Chipotle failed to ensure that its employees both understood and complied with its food safety protocols, resulting in hundreds of customers across the country getting sick,” U.S. Attorney Nick Hanna said in the statement announcing the deferred-prosecution agreement.
The Newport Beach, California-based company said that, as part of the agreement, it will its strengthen its food-safety polices and practices.
“This settlement represents an acknowledgment of how seriously Chipotle takes food safety every day and is an opportunity to definitively turn the page on past events and focus on serving our customers real food made with real ingredients that they can enjoy with confidence,” Brian Niccol, chairman and chief executive officer of the company, said in a statement.
Prosecutors alleged that four norovirus outbreaks were caused by employees showing up to work sick, in violation of company policy, and by food products being stored at the wrong temperatures.
A fifth outbreak — which sickened about 647 people in July 2018 who dined at a Chipotle in Ohio — was from Clostridium perfringens, a bacterium found in raw meat and poultry that is one of the most common types of foodborne illness in the U.S. People who get ill from it usually recover in 24 hours and it’s not contagious.
Managers at the company’s restaurants failed on a number of occasions to notify Chipotle’s safety group at its headquarters when an employee had been vomiting at work, according to prosecutors. Instead, the safety analysts would find out only after contacting the restaurant because it had received a complaint from a sick customer. As a result, there were days of delay before the restaurants were sanitized.
The U.S. Centers for Disease Control reports that from July to September 2019, cruise line X experienced sudden, unexplained outbreaks (>3% of the passenger population) of acute gastroenteritis (AGE) among passengers on 10 cruise ships sailing in Europe. The rapid onset of vomiting and diarrhea followed by recovery within 24 hours were consistent with norovirus infection. Investigations by the cruise line throughout the summer yielded no clear source of the outbreaks even after extensive food testing.
On September 18, 2019, CDC’s Vessel Sanitation Program (VSP) was notified of an outbreak of AGE on cruise ship A of cruise line X, sailing into U.S. jurisdiction (defined as passenger vessels carrying ≥13 passengers sailing to the United States from a foreign port) from Germany to New York City (1). By the end of the 19-day voyage on September 23, a total of 117 of 2,046 (5.7%) passengers and eight of 610 (1.3%) crew members met the case definition for AGE (three or more loose stools within a 24-hour period or more than normal for the patient, or vomiting plus one other sign or symptom including fever, diarrhea, bloody stool, myalgia, abdominal cramps, or headache).
Four stool specimens were collected and tested for norovirus at CDC’s National Calicivirus Laboratory; three tested positive for norovirus by quantitative reverse transcription–polymerase chain reaction (RT-PCR). No outbreak source was determined after a field investigation by a VSP team on September 22.
The following month, on October 7, CDC’s VSP was notified of two more outbreaks in U.S. jurisdiction. The first outbreak occurred on another ship (ship B) of cruise line X sailing to and from New York City along the eastern seaboard and affected 85 (3.9%) of 2,166 passengers and 10 (1.6%) of 612 crew members; the second outbreak occurred on ship A sailing from Montreal to New York City and affected 83 (3.7%) of 2,251 passengers and 10 (1.6%) of 610 crew members. VSP again conducted outbreak investigations on October 12 (ship B) and October 13 (ship A). Five stool specimens from ship B and two from ship A were collected for laboratory testing. During the field investigations, cruise line X’s public health officials reported to VSP that after reviewing food questionnaires completed by ill passengers on ship B, nearly 80% of completed questionnaires implicated a smoothie made from frozen fruits and berries. Because of the epidemiologic link and because berries have been implicated in past outbreaks (2,3), CDC requested assistance from the Food and Drug Administration (FDA) to collect frozen fruit and berry items from ship B for norovirus testing. Food item lot numbers from ship B matched those from the same frozen fruit and berry items on ship A.
Overall, nine of 11 stool samples from the three outbreak voyages on ships A and B tested positive for norovirus by quantitative RT-PCR at CDC; these included three of four from ship A’s first voyage, four of five from ship B, and two of two from ship A’s second voyage. The samples were typed as GII.2[P16]. FDA tested 16 frozen fruit and berry items, and three items tested positive for norovirus: raspberries (norovirus genogroup II), tropical fruit cocktail (norovirus genogroup I), and berry mix (norovirus genogroup I). Norovirus sequences from the stool samples and from raspberries were 97.5% similar. After removal of the fruit items, no further outbreaks were reported on cruise line X.
Upon further review of food provisioning, cruise line X determined that its food vendor had purchased several containers (nearly 22,000 pounds) of frozen raspberries of the same lot from a supplier in China beginning the end of June 2019. These raspberries had been supplied to the entire fleet of cruise line X. Both the epidemiologic and laboratory data implicated the raspberries as the cause of the outbreaks. As a result of these findings, on November 11, the World Health Organization issued a recall notice* for frozen raspberries traced back to China. This investigation highlights the importance of AGE surveillance at sea to prevent transmission of AGE illness through U.S. ports and to identify contaminated foods at sea that had not yet been implicated on land.
Notes from the field: Multiple cruise ship outbreaks of norovirus associated with frozen fruits and berries—United States, 2019, 24 April 2020
Morbidity and Mortality Weekly Report pg. 501-502
Jared R. Rispens, MD1,2; Amy Freeland, PhD2; Beth Wittry, MPH2; Adam Kramer, ScD2; Leslie Barclay, MPH3; Jan Vinjé, PhD3; Aimee Treffiletti, MPH2; Keisha Houston, DrPH2