Dale Bass of Kamloops This Week (that’s in British Columbia, Canada) writes that when norovirus hit customers at one Greek restaurant in the city, there were headlines with the name of the Victoria Street eatery — and it was shut down for days.

medzedesWhen norovirus struck another Greek restaurant just 16 months later, there was nothing in media releases identifying the eatery and it was not ordered closed.

Doug Dick was one of several people who became sick with the virus after eating at Minos restaurant on Tranquille Road in North Kamloops earlier this month. He asked KTW why Minos was not closed, since Dorian’s Greek House in downtown Kamloops was closed in December 2013.

Dick wondered if the reaction to Dorian’s situation came as a result of it being Royal Inland Hospital medical staff becoming ill there, something Joyce Michaud, the Interior Health Authority’s environmental-health officer — and the person who oversees inspections of places like restaurants — said is incorrect.

She said when her team is advised of a suspicious health outbreak, it doesn’t consider the occupations of those who are sick unless there is a direct link.

The focus, Michaud said, is identifying the bug, figuring out where it came from and, if possible, where it is, and helping the facility take steps to eradicate it.

Part of that is ensuring people who need to have medical tests get them done and often, which means delivering the test kits to sick people, Michaud said, rather than asking them to leave their homes.

Dick also wondered why IHA didn’t issue a press release warning people about about Minos.

Michaud noted the IHA didn’t issue a press release about Dorian’s, either. Because RIH operating-room staff becoming ill, a release was sent out advising the public surgeries were being cancelled.

Because the medical staff had not eaten at the restaurant — Dorian’s catered an event for them — the first task was to identify where the virus had come from, Michaud said. Soon there were many more people contacting the IHA with norovirus symptoms and, when it became apparent there was a public-health risk linked to Dorian’s, the restaurant was identified.

With Minos, there was one report on May 4 of someone becoming ill after eating there on May 2. An inspector was sent to the restaurant and, in the absence of any leftover food from that date, reviewed food-safety practices with the staff and told them the facility had to be thoroughly cleaned because the virus could linger on surfaces.

“The next day, we got another call and we called the restaurant again,” Michaud said, noting the IHA did not see it as an ongoing risk to the public since the restaurant had undergone a thorough cleaning.

“With Dorian’s, there was an order issued [to close until it was given permission from IHA to reopen] ,but there was no need for an order at Minos,” Michaud said.

Orders like that issued to Dorian are also posted on the authority’s website at interiorhealth.ca.

While it did confirm the name of the restaurant to people calling the authority to report illness, Michaud said a decision to release a name “is typically done on the basis of ongoing risk to the community and/or where it would aid ongoing investigation by having those at risk contact IH.

“The situation at Minos was not one where it appeared the restaurant was contributing to ongoing illness,” she said.

UK Naval base hit with norovirus

There are a bunch of things in this story that grabbed my attention. As Stefon says, this one has everything: the Navy, vomit, diarrhea, isolation, quarantine, a ship and Raleigh.

According to BBC, approximately 70 Royal Navy personnel have been hit with norovirus (or winter vomiting sickness as the British call it) leading to intense cleaning and sanitation.

The Navy said people had started falling ill at HMS Raleigh in Torpoint about 10 days ago.

Those affected were placed in quarantine in an attempt to stem the spread of the contagious virus.

A Royal Navy spokesman said control measures included “intense cleaning and isolating those with symptoms”.

He added: “The virus started about 10 days ago. It peaked towards the end of last week at about 70 and numbers fell rapidly after that.”

HMS Raleigh provides training for the Royal Navy, Royal Marines, Royal Fleet Auxiliary and the Royal Navy Reserve.

 

 

Norovirus from swimming in a lake

In July, 2014 a norovirus outbreak linked to a lake near Portland, Oregon sickened 70 people. Those who swam in the lake were 2.3 times more likely to develop vomiting or diarrhea than those who visited the park but didn’t go in the water.

kids.cottage.00More than half of those who got ill were children between 4–10 years old. Experts believe the outbreak began after a swimmer infected with norovirus had diarrhea or vomited in the water and other swimmers swallowed the contaminated water. To prevent other people from getting sick, park officials closed the lake to swimmers for 10 days.

“Children are prime targets for norovirus and other germs that can live in lakes and swimming pools because they’re so much more likely to get the water in their mouths,” said Michael Beach, Ph.D, CDC’s associate director for healthy water. “Keeping germs out of the water in the first place is key to keeping everyone healthy and helping to keep the places we swim open all summer.”

 Norovirus Outbreak Associated with a Natural Lake Used for Recreation — Oregon, 2014

15.may.15

Morbidity and Mortality Weekly Report

Amy Zlot, MPH, Maayan Simckes, MPH, Jennifer Vines, MD, Laura Reynolds, MPH, Amy Sullivan PhD, Magdalena Kendall Scott, MPH, J. Michael McLuckie, Dan Kromer, MPA, Vincent R. Hill, PhD, Jonathan S. Yoder, MPH, Michele C. Hlavsa, MPH

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6418a2.htm?s_cid=mm6418a2_e

 

Why I now boil all frozen berries: Norovirus source in Sweden

Norovirus struck the care home in Ljungby a week ago, initially causing the deaths of two people, with another guest dying later in the week.

raspberrySweden’s national food agency (Livsmedelsverket) said in a statement on Monday that tests had confirmed that imported frozen fruits were the source of the sickness outbreak.

It is suspected that the raspberries became contaminated during the packing process, when boxes of berries were hand-packed by a worker who was carrying the virus.

“It is not uncommon for imported frozen raspberries to be contaminated with Norovirus,” Livsmedelsverket said in a statement on its website.

‘They should have been boiled’ 2 dead, 60 sick from Norovirus in frozen raspberries in Swedish retirement homes

I didn’t think about it much until a couple of years ago, but now I boil all frozen berries.

frozen_raspberries(1)(1)Apparently that’s a good idea.

But sad that consumers have to be the critical control point.

Two people have died of suspected food poisoning and another hospitalized. Some 60 people have suffered food poisoning on several retirement homes in Ljungby municipality. The cause is believed to be the raspberries in a dessert.

The raspberries served at several retirement homes in Ljungby municipality boiled never – contrary to the recommendations contained.

One should always boil the frozen foreign raspberries, says Elsie Castro, a molecular biologist at the National Public Health Agency.”

Mariana Axelsson, nutrition manager in Ljungby municipality, admits that the infected raspberries that caused an outbreak of Norwalk virus should have been cooked. The procedures have failed and will now be reviewed.

Hallonparfaiten served on several retirement homes in Ljungby and caused 60 people fell ill with Norwalk virus. Two elderly also have died , probably as a result of the disease.

British hotel linked to 100 noro illnesses

As Schaffner and a bunch of other food safety folks enjoy the Welsh weather as part of the IAFP European Symposium, a British resort at Cooden Beach is according to the Daily Mail, dealing with a bunch of norovirus.

The owner of a British seaside hotel has apologised after nearly 100 holidaymakers were struck down by what health officials have described as a norovirus outbreak.

Almost everyone who has visited the Cooden Beach Hotel in the last two weeks has come down with vomiting, diarrhoea and other symptoms of the highly-contagious airborne bug.

A Rother District Council spokesperson said it is believed that 100 people have been affected by the so-called ‘winter vomiting bug’ at the hotel in Eastbourne, East Sussex.

Owner James Kimber has issued an apology to guests and staff, and has vowed to steam clean the entire guest house to prevent additional cases.

A sign posted on the door of the hotel, where guests enjoy sweeping views of the English Channel, warns visitors about an ‘airborne virus’ at the premises.
Airborne? Sort of. Spread through the air, definitely (see the vomit modeling machine from Grace Tung, below). Steam cleaning might not do much. CDC suggests using chlorine-based sanitizers.

Gross: Family encounters vomit on a plane

Illness happens on planes, and when it does it’s miserable.

In 2009 I dealt with campylobacteriosis over a day of travel from Manhattan (Kansas) to Raleigh. In 2013, then four-year-old Jack yacked on a flight which led to a fascinating approach by Delta Airlines involving plastic bags to contain the risk and coffee pods to manage the smell. The flight crew let us off the plane first (although we were in the second-to-last row) as we potentially inoculated the plane and passengers with norovirus.6a00d834e06b8c69e200e54f7819da8834-800wi

According to MyFoxOrlando, the Shirley family encountered a bunch of vomit on a United flight to DC – and maybe their own norovirus inoculation event.

Scott Shirley had boarded a United Airlines flight with his wife and son when the trio noticed an unusual smell after placing their carry-on bags underneath their seats. After realizing their bags were damp, the family recognized the odor as vomit.

“She [Shirley’s wife] reached down and rubbed the ground and goes “the whole ground is wet,” and then she put it to her nose and goes “Oh my god! This is throw up,” Shirley explained to WUSA9.

Shirley says his wife (who ironically, works for FDA -ben) suffers from mysophobia – fear of germs– and she immediately began crying she was so upset. The airline did acknowledge that a passenger seated in that area had become sick on an earlier flight but the family was told it had been cleaned by the cabin crew.

“It was clear that no one had cleaned the area where we were sitting, because there was no evidence of any chemical smell what so ever. This was purely that distinct smell of vomit on our hands and backpacks,” Shirley told the Daily Mail.

CDC recommends using a chlorine bleach solution with a concentration of 1000–5000 ppm to clean and disinfect an area where someone has vomited. Hard to do that on a plane with all the carpet.

Ohio high school prom linked to norovirus outbreak

In 1997, Dani and I went to prom (below, exactly as shown). The theme was a classic: ‘Under the Sea.’ The venue was filled with bubble decorations, fish and blue streamers.

But no norovirus.FullSizeRender

According to the Chillicothe Gazette, students attending the Zane Trace High School prom last weekend weren’t that lucky; 22 have symptoms consistent with norovirus.

According to Health District spokesman Rami Yoakum, calls began coming into the health district Monday from parents reporting sick children. Thus far, 22 illnesses are believed to be part of the same outbreak, 18 of whom are Zane Trace students.

Kathy Wakefield, director of Public Health Nursing at the health district, said officials believe a norovirus is the culprit.

The health district has been working with the school, advising officials to clean school surfaces, and has also sent letters home to parents describing symptoms and asking them to keep sick children at home and away from sporting events.

Specimens were collected and sent to the state lab in Reynoldsburg. If the results in each case come back all looking similar, the Health District will likely be able to trace back to the source of the contamination, Yoakum said. Presently, health officials feel they have a good idea where the illness may have originated, but don’t want to publicly speculate until until the results from the tests come back and they are sure.

 

From the rerun files: norovirus hits cruise ships

I’ve never been on a cruise. Sometimes we talk about taking one, hopping from island to island and relaxing on the open seas.

And then comes another round of norovirus outbreaks. Lots of news coverage, throwbacks to the poop cruises and pictures of the CDC Vessel Sanitation program officials boarding ships.

Restaurants are linked to 64 per cent of norovirus outbreaks. CDC says that cruise ships get a lot of the attention but onlyaccount for only about 1 per cent of norovirus outbreaks. But not everyone goes on a cruise. In 2013, according to the Florida-Carribean Cruise Association 11.7 million North Americans (out of a total of ~530 million residents) went on cruises.Screen Shot 2015-04-14 at 10.46.44 PM

It’s a numbers game: one per cent of the outbreaks happen in a setting that just two per cent of the population visit. Like Schaffner says, what’s the Crusies ?

But norovirus is everywhere. But being stuck on a ship with projectile vomiting doesn’t sound fun. According to the Guardian, two separate Royal Caribbean ships are experiencing outbreaks and are on their way back to San Diego.

Health officials are investigating what caused the outbreaks aboard the ships bound for California, both owned by Royal Caribbean Cruises Limited. The ships docked on Monday and Tuesday in San Diego.

Celebrity Cruises reported 106 sick passengers on board the Celebrity Infinity, which arrived on Monday in California. The ill vacationers accounted for 5% of the 2,117 travelers on board. Six of the more than 900 crew members were also sick.

Epidemiologists from the Centers for Disease Control are investigating the outbreak, and collected eight stool samples on board. Crews are tightening sanitation and disinfection procedures. 

Crew members are planning a “staged disembarkation” to avoid exposing healthy passengers to sick ones, potentially contaminating them with the infectious stomach virus.

100 sick onboard Celebrity cruise ship

Up to 100 passengers have are being reported as sick from a possible Norovirus outbreak onboard the Celebrity Infinity.

vomit cruiseAccording to the Centre for Disease Control (CDC) 95 out of 2,117 passengers along with 5 crew members have been reported sick from gastrointestinal illness. The CDC has not yet confirmed that it’s Norovirus but in most outbreaks onboard it usually is. Passengers and crew have been having vomiting and diarrhea.

The CDC has also stated that 8 stool specimens from passenger and crew have been collected for testing. A CDC Vessel Sanitation Program environmental health officer and one epidemiologist are to board the 91,000 gross ton ship once it arrives in San Diego, CA on April 13. The Celebrity Infinity began the voyage on March 29th from Fort Lauderdale, Florida on a 15 night Panama Canal cruise.