The discovery, reported June 10, 2019, in the journal Proceedings of the National Academy of Sciences, overturns nearly two decades of conventional wisdom about norovirus. Until now, the only structural data about the virus that scientists had came from a single, not particularly prevalent, strain.
“Everyone thought that all the strains would look about the same – like the one that was solved 20 years ago,” says Howard Hughes Medical Institute Investigator Leemor Joshua-Tor. “It turns out that they don’t!”
Joshua-Tor’s team used a microscopy technique called cryo-electron microscopy (cryo-EM) to visualize the shells of four viral strains, including one responsible for up to roughly 80 percent of norovirus outbreaks. That strain was 71 percent larger (by volume) than the one previously reported. Its shell was also decorated with a different pattern of molecular spikes.
Those structural details will be crucial for scientists working on vaccines or antiviral therapies to treat norovirus infection, says Joshua-Tor, a structural biologist at Cold Spring Harbor Laboratory (CSHL). Though norovirus causes about 21 million cases of foodborne illness in the United States every year, there are currently no approved therapies.
At least one vaccine candidate is working its way through clinical trials now. But CSHL study coauthor James Jung says scientists will need to take the virus’s newfound variation into account – so any new vaccine protects against a broad array of strains.
The traditional oyster-tasting feast in March has been canceled and fears are mounting of huge financial losses to the local community that harvests about 3 million oysters each year.
Experts are pointing their fingers at the outdated sewage system in the area that has seen a rise in the numbers of tourists flocking to Croatia’s stunning Adriatic coast.
“I am really sorry but people themselves are to blame that something like this happened,” explained Vlado Onofri from the Institute for Marine and Coastal Research in nearby Dubrovnik. “It’s something that has to be solved in the future.”
While some stomach bugs can be eliminated with cooking, norovirus survives at relatively high temperatures.
Navigating the oyster fields in their small boats, the farmers proudly show visitors rows and rows of oyster-filled underwater farm beds spreading through the bay.
Top municipal official Vedran Antunica questioned the assumption that the local sewage system was to blame for the outbreak.
“Viruses are everywhere, now as we speak, the air is full of viruses,” Antunica said. “We had the same sewage system in the past, so why wasn’t it (norovirus) recorded? What has changed?”
Do not bring raw anything into a hospital full of immunocompromised people (those NZ mussels are cooked).
And I’m still looking at you, Brisbane Private Hospital, for continuing to serve raw sprouts on everything.
The Bailiwick Express reports that an outbreak of the winter vomiting bug (we call it Norovirus) which forced hospital bosses to ban visitors from wards was caused by someone bringing mussels in for a patient, it has emerged.
Over Christmas, Northumbria Healthcare NHS Trust will partially lift the restriction on visitors, introduced after norovirus spread across a number of sites.
Officials have traced its spread to a visitor bringing in mussels for an inpatient at Wansbeck General Hospital in Ashington, Northumberland.
It is thought to have affected at least 180 people.
Between December 2011 and June 2016, children aged 14 days to 11 years with AGE were enrolled at 1 of 7 hospitals or emergency departments as part of the New Vaccine Surveillance Network. Parental interviews, medical and vaccination records, and stool specimens were collected at enrollment. Stool was tested for rotavirus by an enzyme immunoassay and confirmed by real-time or conventional reverse transcription-polymerase chain reaction assay or repeated enzyme immunoassay. Follow-up telephone interviews were conducted to assess AGE in HHCs the week after the enrolled child’s illness. A mixed-effects multivariate model was used to calculate odds ratios.
Overall, 829 rotavirus-positive subjects and 8858 rotavirus-negative subjects were enrolled. Households of rotavirus-positive subjects were more likely to report AGE illness in ≥1 HHC than were rotavirus-negative households (35% vs 20%, respectively; P < .0001). A total of 466 (16%) HHCs of rotavirus-positive subjects reported AGE illness. Of the 466 ill HHCs, 107 (23%) sought healthcare; 6 (6%) of these encounters resulted in hospitalization. HHCs who were <5 years old (odds ratio, 2.2 [P = .004]) were more likely to report AGE illness than those in other age groups. In addition, 144 households reported out-of-pocket expenses (median, $20; range, $2–$640) necessary to care for an ill HHC.
Rotavirus-associated AGE in children can lead to significant disease burden in HHCs, especially in children aged <5 years. Prevention of pediatric rotavirus illness, notably through vaccination, can prevent additional illnesses in HHCs.
Evidence for household transmission of rotavirus in the United States, 2011-2016
Stool tests performed on those who are ill haven’t confirmed this diagnosis, but Director of Health Services Dr. Goldstein said that norovirus is “likely” the culprit of the students’ symptoms, which include vomiting, diarrhea and stomach pain. Resident Advisors on campus have reported 103 cases of students having contracted the debilitating stomach bug as of Wednesday evening, according to Goldstein, Director of Health Services.
Goldstein first notified the campus community about the virus in a campus-wide email sent Monday, Feb. 4 at 2:40 p.m., but didn’t name the illness as norovirus at that time.
Some students, however, felt this email did not come soon enough. Haley Matthes ‘19 voiced her frustrations and warned students to be aware of its spreading in a post in the Lafayette College Class of 2019 Facebook group on Feb. 2.
“I’m just tired of the school waiting for a campus-wide sickness to escalate to a point where they need to send out a bulletin [or] cancel classes,” Matthes said in a follow-up email.
Matthes was also upset that extended hours weren’t offered at Bailey Health Center.
Several students in the Phi Kappa Psi fraternity have also had the virus. According to Mikey Burke ‘21, approximately 12 to 15 members of the fraternity had contracted the virus as of Tuesday, although he said he expected that number to grow.
“I think it just spread really quickly throughout the house, it originated there and spread to a lot of the brotherhood, I live in McKeen and only hung out at the [Phi Psi] house for a couple hours…and got sick,” Burke said in an email.
Bobby Longo ‘21, another Phi Psi fraternity member to have the virus, said he believed the email warning on Monday was “too late.”
“Norovirus is an extremely contagious stomach virus that spreads like wildfire. After the first or second case on campus we should have been notified… it ramps up as people go from class to class spreading it,” Longo said in an email.
According to Goldstein, his level of concern about the virus was raised when the health center began receiving phone calls and emails from concerned students and parents, as the health center was “not overwhelmed” by the number of students coming to Bailey about the virus.
Goldstein said he wanted to find a “sweet spot” of not raising a level of hysteria but also communicating with the students. He decided to send the campus-wide email more based on “the feedback from students,” Goldstein said.
“I think what’s happening is students are self-treating and getting through this without needing to see a provider, but the numbers are pretty significant on campus. The students communicating with me was a good thing,” he said.
According to Goldstein, reports from Resident Advisors and Bailey total a little over 150, but Goldstein said there may be overlap among these reports, if for example, a student both went to Bailey and reported their illness to their RA.
While Goldstein said that the discussion of the school closing “hasn’t happened yet,” he believes certain social gatherings will be cancelled if the virus continues spreading rapidly. One event, the Lunar New Year dumpling making party hosted by ISA and ACA, was cancelled on Tuesday as a result of the spreading sickness.
Abstract Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.
To acquire data on contamination with Norovirus in berry fruit and salad vegetables in the United Kingdom, 1,152 samples of fresh produce sold at retail in the UK were analysed for Norovirus.
Of 568 samples of lettuce, 30 (5.3%) were Norovirus-positive. Most (24/30) lettuce samples which tested positive for Norovirus were grown in the UK and 19 of those 24 samples contained NoV GI. Seven/310 (2.3%) samples of fresh raspberries were Norovirus-positive. Most (6/7) of the positively-testing fresh raspberry samples were imported, but no predominance of a genogroup, or any seasonality, was observed. Ten/274 (3.6%) samples of frozen raspberries were Norovirus-positive. The country of origin of the positively-testing frozen raspberry samples was not identified in most (7/10) instances.
The collected data add to the currently limited body of prevalence information on Norovirus in fresh produce, and indicate the need for implementation of effective food safety management of foodborne viruses.
Norovirus in produce sold at retail in the United Kingdom
Cook, N., Williams, L., & Dagostino, M. (2019). Prevalence of . Food Microbiology, 79, 85-89. doi:10.1016/j.fm.2018.12.003
Dr. Matt Willis, Marin County’s public health officer, said the closure was issued on Jan. 3. and on the following day the state health department issued a recall order on Tomales Bay oysters that had been sold to 34 restaurants by Hog Island Oyster Co., based in Marshall.
“There were 44 confirmed cases of norovirus between Dec. 29 and Jan. 5 across the Bay Area,” Willis said. “Only seven of those 44 cases were Marin cases.”
Willis said there is no concern in this case that the outbreak is related to food handling, cultivation or harvesting practices.
“It’s likely this represents contamination of the water itself,” he said. “The water testing showed high levels of bacterial and viral contamination, which is normal following high rainfall over a long interval.”
Willis said it is unusual for a norovirus outbreak to be linked to oysters. He said there are typically about 20 norovirus outbreaks every year in Marin County, and they usually occur in places where people congregate in close quarters such as schools or nursing homes.
There are plenty of Norovirus-related raw oyster outbreaks throughout the world weekly.
Maybe not in Marin County, Matt, but globally, yes.
I’m married and not looking for anything like that.
I like smart women, long walks on the beach (with Ted the Wonder Dog — that’s him about 5:30 a.m. on Yaroomba Beach with me — and Amy and Sorenne, which I’ve been doing the last four days), and have never been on a cruise.
All the passengers will be offered a refund as a result of the outbreak, Royal Caribbean has said.
This is an unusual move on the part of Royal Caribbean. Costs for the seven-night Western Caribbean voyage on the Oasis of the Seas start at $626 (£487) per person before taxes and fees for an interior stateroom.
Cruise companies are not under obligation to provide a refund in such situations as this.
“Cruise lines look at this sort of thing on a case by case basis and how disruptive this was to passengers,” Colleen McDaniel, executive editor at Cruise Critic, told Market Watch.
CBS News reports one of the world’s biggest cruise ships, Royal Caribbean’s Oasis of the Seas, is returning to a Florida port a day early and giving passengers full refunds of their fare after 277 guests and crew members were hit with an outbreak of norovirus as it sailed to Jamaica.
Cruise line spokesman Owen Torres told The Associated Press, “We think the right thing to do is get everyone home early rather than have guests worry about their health.”
He says the ship will return to Port Canaveral on Saturday. It sailed from there Sunday on a seven-day Caribbean cruise.
Passengers took to social media on Wednesday, tweeting they were forced to stay onboard after docking in Falmouth, Jamaica, for what was supposed to be a day of excursions.
Torres said returning a day early gives the cruise line “more time to completely clean and sanitize the ship” before it sails again.
Brae Surgeoner, Doug and I had a paper published in the September 2009 Journal of Environmental Health about some research we conducted in the Winter of 2006. The study came about because a whole bunch of kids in the University of Guelph’s residence system started puking from an apparent norovirus outbreak. There were lots of handwashing signs up and we wanted to know whether they changed hygiene behavior (especially if kids were using the tools available when entering the cafeteria). Turns out that the kids weren’t doing as good of a job at hand hygiene as they reported to us.
NC State’s press release is below (the Kansas State release is here):
As public health experts warn of potential widespread outbreaks of H1N1 flu this school year, a new study from North Carolina State University shows that students do not comply with basic preventative measures as much as they think do. In other words, the kids aren’t washing their hands.
“Hand washing is a significant preventative measure for many communicable diseases, from respiratory diseases like H1N1 to foodborne illness agents, such as norovirus,” says Dr. Ben Chapman, assistant professor of family and consumer sciences and food safety extension specialist at NC State. The new study, which examined student compliance with hand hygiene recommendations during an outbreak of norovirus at a university in Ontario, finds that only 17 percent of students followed posted hand hygiene recommendations – but that 83 percent of students reported that they had been in compliance. Norovirus causes gastrointestinal problems, including vomiting and diarrhea. Every year there are 30 to 40 outbreaks of norovirus on university campuses, affecting thousands of students.
Chapman, who co-authored the research, says this is the first study to observe student hygiene behavior in the midst of an outbreak. Previous studies examined self-reporting data after an outbreak – and the new research shows that the self-reporting data may be inaccurate.
“Typically, health officials put up posters and signs and rely on self-reporting to determine whether these methods are effective,” Chapman says. “And people say they are washing their hands more. But, as it turns out, that’s not true.
“The study shows that while health authorities may give people the tools we think they need to limit the spread of an outbreak, the information we’re giving them is not compelling enough to change their behavior. Basically, it doesn’t work. But we do it again with every outbreak, and we’re doing it now with H1N1.”
Chapman says the study shows that health officials need to target specific audiences, such as students in a particular dorm or who eat at a particular cafeteria, and tailor their information to those audiences. For example, telling them where the nearest washrooms are, or pointing out where hand sanitizer units are located. “The more specific the information is for an audience, the better off you are,” Chapman says.
Chapman adds that health authorities also need to use language appropriate to their target audience. “For example, don’t refer to something as a ‘gastrointestinal illness,’” he says, “instead, tell them ‘this could make you puke’ or ‘dude, wash your hands.’ The idea is to craft compelling messages that create discussion in that audience. Make them talk about it.”
Chapman also says that health officials should take advantage of social media, such as text messaging and Facebook, to raise awareness. “If your audience consists of students,” he explains, “you should use media that students use.
“Campuses need to expect outbreaks will happen and plan accordingly. Have the response tools in hand.”
Illness contributes to a decrease in student class attendance which can lead to increased academic stress. Decreasing the spread of illness among those living in residence halls is essential to academic success. The purpose of this systematic review was to identify interventions implemented in residence halls on college campuses to reduce the spread of illness. The PICO question directing the research for this study asks, “How do interventions affect the spread of illness in university residence hall populations?”. The research conducted was completed by means of a systematic review of literature including 20 peer reviewed articles published between 1999-2017 from the databases CINAHL Plus, PsychInfo, and PubMed. Findings from this review revealed a focus on three interventions used to decrease illness among college students living in residence halls: (1) hand washing, (2) lifestyle initiatives, and (3) education. Of the three, hand washing and educational measures were found to decrease the spread of illness, while lifestyle initiatives were found to have no direct correlation to the spread of illness.