• Reusable grocery bag carried nasty norovirus, scientists say

    featurepics.com

    A resuable grocery bag was traced to an outbreak of norovirus that sickened members of a girls' soccer team in Oregon.

    By JoNel Aleccia

    Oregon public health officials have traced a nasty outbreak of norovirus infections in a group of soccer players to an unlikely source: a reusable grocery bag contaminated with what some experts are calling “the perfect pathogens.”

    The incident is raising questions, once again, about the cleanliness of the portable shopping bags that many consumers use to avoid the paper vs. plastic impact on the environment.

    “We wash our clothes when they’re dirty; we should wash our bags, too,” said Kimberly K. Repp, an epidemiologist with the Washington County Department of Health and Human Services in Hillsboro, Ore. Her work is published this week in the Journal of Infectious Diseases.

    Repp was an intern with the Oregon Health and Science University in October 2010 when she and other experts were asked to help unravel the mystery of sick soccer players and their chaperones. They had traveled north from Beaverton and Tigard, Ore., to Washington state on a Friday for a weekend tournament.

    Less than 48 hours later, nine people were ill with unpleasant symptoms including vomiting and diarrhea. The question was: How did they get it?

    One of the soccer players --  all 13- and 14-year-old girls -- had fallen ill on Saturday night and moved into the room of one of the parent chaperones. The pair went home early Sunday, with no further contact with other players.

    Even so, seven other people became ill within days, stumping scientists momentarily.

    CDC

    Noroviruses are a group of viruses responsible for some 21 million cases of gastrointestinal illness a year, including 70,000 hospitalizations and 800 deaths.

    “It involved really thinking outside the bag, so to speak,” Repp said.

    Eventually, interviews revealed that most of those who became ill ate packaged cookies at a Sunday lunch. Where did the cookies come from? Turns out, the culprit was a reusable grocery bag of snacks left in the empty hotel room occupied by the first girl who got sick.

    Quickly, the puzzle fell into place. The girl had been very ill in the hotel bathroom, spreading an aerosol of norovirus that landed everywhere, including on the reusable grocery bag hanging in the room.

    When scientists checked the bag, it tested positive for the bug, even two weeks later.

    “It was a knock out of the park,” said Repp. “We demonstrated norovirus transmission without person-to-person contact. That’s why this is different.”

    The trouble with noroviruses -- which cause an estimated 21 million cases of gastroenteritis a year, some 70,000 hospitalizations and 800 deaths -- is that they’re tough bugs that can live for prolonged periods on objects and surfaces, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University Medical Center in Nashville.

    “Norovirus does have the vexing capacity to persist in the environment,” he said.

    While the risk of contracting an illness from any particular reusable bag is low, Schaffner said, the Oregon study follows a 2010 paper by researchers at the University of Arizona and Loma Linda University that found large numbers of bacteria in reusable grocery bags, including 12 percent that were contaminated with E. coli.

    When scientists stored the bags in the trunks of cars for two hours, the number of bacteria jumped 10-fold.

    Some critics dismissed that study, which was funded in part by the American Chemistry Council, which supports the makers of some disposable plastic bags.

    But few have debated the study’s conclusion, which found that washing the reusable shopping bags regularly decreased contamination by 99.9 percent.

    “You could just wipe it down with Lysol or Clorox,” said Repp.

    Schaffner agrees. The most important tool to prevent norovirus, which spreads rapidly and infects quickly, is good hygiene, including careful hand-washing and thorough cleaning of the contaminated environment.

    “You could wash the bag,” Schaffner said. “Or you could start over with a new bag."

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  • Mystery sapovirus strikes nursing homes, new tests reveal

    Dr. Charles Humphrey, CDC

    Sapovirus, previously regarded as rare, is showing up more often as the nasty culprit between outbreaks gastrointestinal illness in nursing homes.

    By JoNel Aleccia

    For sheer misery, few germs can cause the chaos of norovirus in a nursing home.  The gut bug can spread rapidly through food, on surfaces or person-to-person, afflicting victims with violent diarrhea, vomiting and stomach pain.

    About 20 million people suffer from acute norovirus infections in the U.S. each year, health officials say, but new research suggests that the nasty germ has an equally cruddy but little-known cousin: sapovirus.

    Health researchers in Oregon and Minnesota have discovered that once-rare sapovirus may be more common than thought and, worse, on the rise, particularly in nursing homes and long-term care centers.

    “It’s an up-and-coming bug,” said Lore Elizabeth Lee, an Oregon public health epidemiologist and author of a new study on sapovirus in the journal Emerging Infectious Diseases.

    A review of2,161 gastrointestinal outbreaks in the two states yielded some surprising results. Sure, more than half of the outbreaks were caused by norovirus, and nearly a quarter were caused by bacteria, parasites or other agents, as expected.

    But among 142 non-norovirus outbreaks that remained a mystery, scientists tested samples from 93 and found that nearly a quarter were caused by the new culprit,sapovirus, Lee said.

    “It means we have another virus circulating that we need to study,” she explained.

    The virus operates about the same as norovirus, mostly causing diarrhea, vomiting and, in some cases, fever. It appears to spread in the same ways: person-to-person, on surfaces and through food.

    Of the 21 sapovirus outbreaks detected by Lee and her colleagues, 66 percent occurred in long-term care centers, another 10 percent occurred in schools and the rest occurred in familiar norovirus venues: a prison, a large psychiatric hospital, a restaurant and a cruise ship.

    That means that sapovirus, once regarded as a sporadic illness in children, may be spreading its gastrointestinal misery in a similar pattern as norovirus, including in nursing homes and beyond. “It’s probably circulating in a lot of other settings as well,” Lee said.

    Part of the same family of Caliciviridae viruses, norovirus and sapovirus are separate bugs. Sapovirus was first detected in 1977 at a home for infants in Sapporo, Japan, where it got its name.

    It appeared mostly to lie low for a quarter-century, until 2002, when scientists developed a new test for the virus and suddenly found it showing up in more places. “The reason we’re seeing it now is we’re actively testing for it,” Lee said.

    All of that is important because of the potential harm of a gut bug like this. Norovirus is the leading cause of foodborne disease outbreaks in the United States, and a similar bug could be responsible for more of those illnesses as well.

    In most people, it’s a miserable but brief bout. But in children, the elderly or people with weakened immune systems, it can lead to hospitalization or even death.

    Being able to identify the virus behind disabling outbreaks is important, Lee said.

    Minnesota is testing for sapovirus and Oregon will soon begin, Lee said, with other states following in the future, perhaps.

    In the meantime, the same steps that prevent norovirus will knock down sapovirus as well. That means good hand hygiene, careful food preparation and scrupulous attention to environmental cleanliness.

    “Bleach,” said Lee. “Strong bleach.”

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  • Norovirus vaccine showing promise

    By Rachael Rettner
    MyHealthNewsDaily

    VANCOUVER, Canada — Scientists are getting closer to producing a vaccine against norovirus — the number one cause of foodborne illness in the United States.

    Researchers have now tested norovirus vaccines in a limited number of human trials, said Charles Arntzen, co-director of the Center for Infectious Diseases and Vaccinology at Arizona State University. But more studies need to be done in people to garner how effective it is, Arntzen said.

    If all goes well, a norovirus vaccine could come to market in the next four to five years, Arntzen said, speaking to reporters here today at the annual meeting of the American Association for the Advancement of Science.

    Norovirus causes about 5.5 million cases of foodborne illness in the United States each year, or 58 percent of all foodborne illness, according to the Centers for Disease Control and Prevention. Salmonella, on the other hand, causes just 11 percent of cases, the CDC says. The virus can also spread from person to person, and through water. Symptoms include vomiting, diarrhea and stomach cramping.

    Although the virus is perhaps best known for causing illnesses that spread on cruise ships, most cases, around 60 percent, occur in long-term care facilities, such as homes for the elderly, said Jan Vinjé, of the CDC.

    The vaccine will likely be delivered as a nasal spray, which studies have shown induces a much stronger immune reaction against norovirus than an oral vaccine, Arntzen said. It would contain virus-like particles that resemble the two main strains of norovirus, but do not cause disease. Arntzen is collaborating with several companies to develop a vaccine, and receives funding from the company BioVaxx, Inc.

    The company Ligocyte Pharmaceuticals is in the lead with testing their vaccine in people, Arntzen said. In a study published in the New England Journal of Medicine in December, researchers from Ligocyte showed a vaccine administered a few weeks before exposure to norovirus was about 60 percent effective in preventing illness (37 percent of participants who received the vaccine became ill, compared with 69 percent of participants who received a placebo). Before a vaccine can come to market, it needs to be about 80 to 90 percent effective, Arntzen said.

    Because norovirus evolves rapidly, it may need to be administered every year, like the flu vaccine, Arntzen said. At first, it would likely be targeted toward at-risk populations, including the young, the elderly, kids in daycare and travelers, Arntzen said.

    Currently, the best way to prevent norovirus infection is to wash your hands with soap and water before eating or preparing food, according to the CDC. Hand sanitizers can also be used if soap and water are not available, but these may not be as affective as hand washing at preventing infection, said Natalie Prystajecky, of the University of British Columbia.

    Those who fall ill should not prepare food for at least three days until after they recover from their illness, the CDC says.

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  • Nearly 200 sick at cheerleading competition

    By Msnbc.com staff and wire

    Nearly 200 people reported getting sick after attending the Salute to Spirit and State Cheerleading Championships at the Comcast Arena in Everett, Wash., last weekend, according to KING 5 News.

    Washington state health officials said they were investigating and that people who'd attended the weekend high school cheerleading competition began reporting vomiting or diarrhea on Sunday and Monday.

    "At least 19 squads are reporting high numbers of illnesses," Kate Lynch, a spokeswoman for the Washington State Department of Health, told Reuters. She said 1,200 cheerleaders from 45 high schools participated in the event about 30 miles northeast of Seattle.

    Health officials said they learned of the outbreak, which has flu-like symptoms similar to those found in the illnesses norovirus, rotavirus or a food-borne illness, on Tuesday.

    More than 3,000 people attended the event, the Washington Interscholastic Activities Association said in a statement. "Our immediate concerns are for those who have been affected by this illness and our thoughts are with them," Mike Colbrese, the association's executive director, said in a statement.

    Cheerleaders at Seattle's Ballard High School said nearly half their squad became sick.

    Ballard cheerleader Summer Gnoinski told KING 5, "I threw up every hour on the hour." Her sister, Karly, who did not get sick, calls herself "one of the lucky ones."

    Assistant cheerleading coach Michelle Whelan says until they know what's going on, she's taking extra precautions. "I'm not letting the girls use pom-poms, signs, flags or anything else that was at the competition until we can disinfect them."

  • Cruise ship departs after norovirus outbreak

    For the second time in less than two weeks, a cruise ship has had to return to port early because passengers and crew were hit with what federal health officials suspect is an outbreak of a norovirus. NBC's Kerry Sanders reports.

    By Dan Askin, Cruise Critic

    Updated Feb. 12, 9 a.m. EST: Crown Princess departed Port Everglades Saturday afternoon after a two-day intensive cleaning. According to Princess, 226 passengers (7.34 percent out of 3,078) and 63 crew (5.35 percent of 1,178) reported gastrointestinal illness during the shortened cruise.

    Crown Princess will end its current cruise two days early following a spike in cases of gastrointestinal illness for the second straight week.

    In a statement, Princess Cruises said the 113,000-ton, 3,080-passenger ship will return to its Fort Lauderdale, Fla., homeport on Thursday instead of Saturday, where it will undergo two days of sanitization in consultation with the U.S. Centers for Disease Control and Prevention (CDC).


    Impacted passengers will receive full refunds for the cruise, flights home, coverage of change fees if air was not booked through Princess, hotel accommodation if necessary and a 25 percent future cruise credit.

    A total of 364 of 3,103 passengers and 30 of 1,168 crew were infected on last week's cruise, after which Princess undertook what it describes as "rigorous sanitization measures ... [including] a comprehensive disinfection of all cabins and public areas." The sanitization, which delayed the ship's Feb. 4 departure by some six hours, was overseen by the CDC together with the line's public health, medical and onboard departments.

    Norovirus is the second most common illness next to the common cold, and is highly contagious, spreading easily in confined spaces such as hospitals, hotels, dormitories and cruise ships. Symptoms include vomiting and diarrhea, and millions are infected each year.

    Cruise lines participating in the CDC's Vessel Sanitation Program -- and every major operator does -- are required to report the total number of G.I. cases evaluated by the medical staff before the ship arrives at a U.S. port when sailing from a foreign port. A separate notification is required when the count exceeds 2 percent of the total number of passengers or crew onboard.

    The Crown Princess will return to port two days early after 114 passengers on the latest voyage have reported gastrointestinal illness.

    Princess said the upcoming two-day disinfection will include "bringing aboard additional cleaning crew to assist with a thorough sanitization of all public spaces and surfaces including soft furnishing and carpets, railings, door handles and the like. Additionally, once all of the passengers have disembarked on Thursday morning, all bed linens and towels will be removed from every stateroom. The staterooms will be sanitized multiple times before making up the rooms with fresh linens and towels on Saturday morning, just prior to passenger embarkation."

    The line said it expects the next cruise to depart on Feb. 11 as scheduled.

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