Over 240 students in Taiwan ill with Norovirus

There’s a lot of Norovirus going around Taiwan resulting in hotel closures, waivers and according to the Want China Times, the latest group hit by the vomit-inducing pathogen are students on graduation trips.

About 140 students and teachers out of a 285-person group from New Taipei Municipal An Kang High School reported diarrhea and vomiting during their trip to southern Taiwan, according to the CDC.10849902_719581291471357_3442145704847569295_n1-300x300

The symptoms appeared after the group ate breakfast at their hotel in the scenic Kenting area on Thursday morning and again after eating dinner at another restaurant on Thursday night, the agency said.

The patients were sent to numerous hospitals and most of them have been discharged, the agency said.

Likewise, 100 students from Ming Hu Elementary School in Taipei have reported vomiting during their trip to Chiayi county since Thursday morning.

The CDC said it is investigating if any staff members of the hotels and restaurants the group visited have contracted the disease.

A real headline: Health Officials React To An Outbreak Of Stomach Yuck

I don’t know what Stomach Yuck is, but health department folks in Florida are reacting to it, according to WUWF radio.Wooden-Mannequin-Vomiting-300x198

An outbreak of a nasty stomach bug (Stomachus yuckii? – ben)  has health officials getting the word out about basic hygiene. Dr. John Lanza, the Director of the Florida Department of Health in Escambia County, recently issued a release about a spike in the number of gastrointestinal infections reported in Escambia County.

Lanza says thirty plus people have come down with the illness causing vomiting, diarrhea and fever.  They are all part of the same outbreak, which involved children and workers at day care centers in the county. While you might expect the chilly weather keeping people inside as the cause, Dr. Lanza says it’s not so much the time of year but an event or circumstance that exposes a lot of people to a bug at once that can cause an outbreak like this. He says the classic case is the spring wedding where a sick caterer can cause illness in more than half a wedding party within a few days.

Bird feeders can spread Salmonella

My grandparents were all about birds; they had Audubon field guides and binoculars in multiple spots in their house. Whenever I visited them in Campbellford, Ontario (that’s in Canada) I always helped fill up their bird feeder with seed.

Who knows how much Salmonella I was exposed to.

According to the Press Democrat, backyard bird feeders are a source of Salmonella for  and sharing the seed is probably leading to the demise of some song birds. The pathogen spreads from the bird-to-bird – or the seed itself.blue-jay-dec08

Andrienne Faulkner loves feeding birds.

The 69-year-old Montgomery Village area resident spends about $700 a year on birdseed for the various feeders in the yard.

So when she spotted two dead songbirds in her yard last week — a finch near a garbage can and a pine siskin on her patio — she first thought West Nile virus might be to blame.

She made some inquiries, and was surprised to learn that it wasn’t West Nile that was killing the birds — it was her.

Well, not exactly. The direct cause is likely a salmonella outbreak sweeping through several Bay Area counties.

But by providing birds a place to eat and congregate, Faulkner and other backyard birders may be unwittingly helping spread avian diseases, like the salmonella outbreak now spreading through finch populations in the region.

“I want to feed them, but I don’t want to kill them,” said Faulkner, who said she plans to remove her feeders and clean them as recommended.

The outbreak started about a month ago with a sharp increase in the number of people reporting dead or lethargic songbirds, said Veronica Bowers, founder and director of Native Songbird Care & Conservation in Sebastopol, a rescue center focused on songbirds.

One of the birds taken to her center has since tested positive for salmonella, she said. State Department of Fish and Wildlife officials have alerted her and other rescue centers of outbreaks in Sonoma, Sacramento, Alameda and other Bay Area counties, she said.

In a somewhat related story, a bunch of parrots at the San Diego Zoo have been vaccinated for Salmonella, according to San Diego 6.

About one-third of the small parrots that reside in the San Diego Zoo Safari Park’s aviary have been vaccinated to protect against salmonella, which killed some of the flock, zoo officials said today.

“We recently lost some birds to salmonella,” said Bruce Rideout, director of the Wildlife Disease Laboratories for San Diego Zoo Global. “Although unfortunate, we were able to use this loss to take biological samples necessary for isolating the bacteria. These samples became the basis for the vaccine.”

Twenty out of the flock of 60 birds received both an oral and injectable vaccine at the park’s hospital over the past couple of days. The rest will be vaccinated soon, zoo officials said.

Salmonella outbreak linked to TX steakhouse

Salmonella sucks. In complex full service restaurants there are lots of possibilities for contamination. Sometimes the source is improper cooking procedures. Sometimes illnesses are linked to asymptomatic food handlers. Often the actual source is never identified.

According to myhighplains.com, 30 patrons of a Dalhart, TX restaurant, X-10 Woodfire Steakhouse have salmonellosis. That’s about all the info that’s out there.10868011_1537591776489189_8491316100590439212_n

The Texas Department of State Health Services tells KAMR Local 4 News the X-10 Woodfire Steakhouse in Dalhart has been connected to the salmonella cases.

Last week, that restaurant voluntarily closed.

Officials say since then, the restaurant was cleaned and sanitized and has been cleared for reopening.

Officials say they have not identified the original source inside the restaurant. 

All environmental and food samples tested negative for salmonella.

Hepatitis A in Nanna’s berries; seen and heard

As companies and consumers check their freezers, past menus and, receipts, health officials anticipate that confirmed cases will continue to grow (The Age):

The number of cases of Hepatitis A linked to the consumption of frozen berries imported from China has climbed to at least 14.

Thirty-four government schools have advised the Victorian Education Department that some of their students have consumed berries that have been recalled because of the hepatitis A imported frozen berry outbreak.1424036630491

The number of schools affected suggests that potentially hundreds of students ate berries from one of four lines of frozen berries before they were recalled in recent days by Bairnsdale-based food company Patties Foods.


Another example of questioning the world of epidemiology; gotta be tough to be an epi (Business Insider Australia):

On its website, Patties Foods says “The link between our products and the reported illnesses has not yet been confirmed,” in response to its own question about meeting medical costs.

“This makes it too early to comment,” the company said.

The local-food-is-safer contingent is out – without data (Sunshine Coast Daily):

Long-time Chevallum strawberry farmer Rick Twist, co-owner of Twist Brothers, said he could not understand why people continued to risk purchasing overseas products to save a few dollars when the integrity of local produce was so much higher.

“Why the hell do people buy this stuff from those countries when their standards are so low and ours are so high?” Mr Twist said.

“Australian berries… our regulations are so tight and so strong, I think they’re the best in the world.”

And the outbreak has hit rugby (Yahoo News):

The Tigers confirmed on Tuesday that three senior players had approached club management on Monday with concerns that berries they ate may have been contaminated.

Captain Robbie Farah and veteran winger Pat Richards were later named in news reports as two players who underwent precautionary blood tests for the virus.

[Coach Jason] Taylor declined to name the trio of players but said they had shown no symptoms and the club had no confirmed cases of infection.

“It’s really simple. A couple of guys have eaten some of the berries that have been recalled, and that’s the end of the story,” Taylor said.

“We’re not overly concerned about it. We’re just being really cautious. It’s a smart move to make sure we are ticking all the boxes and all the guys are OK.

“We don’t feel that is going to come to that point (of infection) but we are doing due diligence on it.”

Some good amateur medical assessment there, Coach Taylor.

N.C. State ’stomach flu’ outbreak linked to fraternity/sorority event

The amount of norovirus-related news is overwhelming this week. A college in Virginia was closed. A cruise ship returned to port. Outbreaks at Minnesota and U.K. elementary schools.

And, maybe, possibly, an outbreak at N.C. State associated with a fraternity and sorority.

According to The Technician, there are up to 20 students experiencing nasty gastrointestinal illness symptoms following a social function between chapters of the Alpha Delta Pi sorority and the Kappa Alpha Order fraternity.10849902_719581291471357_3442145704847569295_n1-300x300

Fred Hartman, the director of public relations at NC State, said the students are exhibiting symptoms that are consistent with the stomach flu, including nausea, vomiting and diarrhea.

The sorority hosted an event Sunday night, and the university became aware that students had developed stomach ailments by Monday night, according to Hartman. No new cases were reported as of 5 p.m. Wednedsay.

The severity of the symptoms varied on a case-to-case basis, and many of the students sought treatment off campus.

The Student Health Center posted a notification to its website indicating the stomach flu had appeared on NC State’s campus on Tuesday (what is stomach flu? -ben). According to the post, symptoms of the virus (the stomach flu virus? -ben) include nausea, vomiting, diarrhea, abdominal pain/cramping, fever and/or headaches.

The virus is spread by touching contaminated surfaces before touching the mouth, consuming contaminated foods and drinks and coming in direct contact with the stool or vomit of an infected person, according to the post.

Brian Peters, the community director of the Honors Village, made a post in the NCSU Quad/Honors Village Facebook page indicating that there are reports of gastrointestinal illness going around campus, particularly in the Greek community, that is “potentially norovirus.”

Although the word norovirus never appeared in the post from the Student Health Center, the URL link to the page is: healthcenter.ncsu.edu/2015/02/norovirus-campus/.

Leah Arnett, the director of Student Health Services at NC State, deferred comments about the stomach flu outbreak to University Communications.

Justin Hammond, the director of marketing and communications in the office of the Vice Chancellor and Dean of Academic and Student Affairs, said in an email that University Communications is handling all inquiries on this information and deferred comment to Hartman.

Laine Gladstone, the president of NC State’s chapter of AD Pi also declined to comment.

Michael Wallace, the president of NC State’s chapter of Kappa Alpha Order, did not respond to multiple requests for comment by press time.

The Office of Greek Life declined to comment about the situation.

“The university is taking steps to try and help those students and to try and prevent the illness from spreading,” Hartman said.

Encouraging handwashing is a great message. If this outbreak is suspected to be norovirus, based on exposure/symptom timing and other factors, other good messages include: talking about the limitation of popular alcohol-based hand sanitizers (they don’t do much against the non-enveloped virus); keeping ill folks away from food preparation; the limitation of quaternary ammonia-based sanitizers (only chlorine is really effective); and, that the spread potential from a vomit event is about a 25 radius.

Norovirus is kind of special.


Norovirus on NC State campus?

There’s for sure some norovirus in the Jaykus/NoroCORE lab, but NC State Student Health Center has a message on their website suggesting that there may be be some community illnesses as well. It’s even got it’s own Twitter handle, @WolfPackNoro.
The stomach bug or stomach flu (norovirus -ben), is on campus.
Symptoms include nausea, vomiting, diarrhea, abdominal pain/cramping, fever and / or headache. 10849902_719581291471357_3442145704847569295_n1-300x300
If you are experiencing these symptoms call 919-515-7107. 
The virus is spread by touching contaminated surfaces or objects and then touching your mouth, eating contaminated foods or drinks, and direct contact with stool or vomit while caring for a sick person. If you become sick, take care of yourself with:
▪Medications. This may include fever reducing, anti-nausea, and/or anti-diarrhea medicines.
▪Oral Rehydration. Sip only clear non caffeinated liquids, such as ginger ale, water, ice chips, sport drinks, broth soups.
▪Diet. Once liquids are tolerated eat a bland diet.  This would include crackers, noodles, rice, and toast, and limit dairy.  Advance your diet as tolerated.
▪IV Fluids, as needed. Prevention is key to staying well.  
Washing hands is the most important thing to do to prevent getting or spreading the infection.  Also, decontaminate surfaces and objects, such a computer keyboards, door handles, and steering wheels.
I’d add that alcohol-based hand sanitizer, a favorite tool in outbreaks, isn’t effective against human norovirus unless it’s (VF481) and to decontaminate with chlorine-based compounds (quaternary ammonia sanitizers also aren’t all that effective against noro.
Here are some infosheets about the virus.

Another Virginia college with a norovirus outbreak

Farmville, VA has a norovirus problem. After Hampden-Sydney college closed Sunday for an outbreak-inspired deep clean, four students from neighboring Longwood University have also come down with noro, according to CBS6.

Longwood University reported that over the weekend, there were four cases of students with gastrointestinal issues.

In each case, cleaning crews disinfected the reported area with bleach. The university is continuing to monitor the situation and cleaning crews are standing by.

Risk management decision: Norovirus outbreak closes Hampden-Sydney College

Norovirus kind of sucks, unless you are a virologist. The perfect human pathogen (a term coined by my NoroCORE colleague and all-around good guy, Aron Hall) is shed at a crazy high rate of virus particles per gram of vomit or feces and sticks around in the environment for a long time. So outbreaks tend to persist.10849902_719581291471357_3442145704847569295_n1-300x300

Risk managers are faced with a  tough decision – shut down a place (school, amusement park, hotel, restaurant) for a deep clean/sanitize (with high concentrations of chlorine) or risk the chance that an outbreak stretches out over weeks. According to NBC 12, a Virginia college chose the former and will be closed until Wednesday as sanitation staff do their thing, while ill students stay isolated (and out of the classroom).

Hampden-Sydney College announced Sunday that it will remain closed through Wednesday, Feb. 4.

An update on the college’s website reads, “The Virginia Department of Health has determined that the illness on campus is norovirus. Norovirus spreads quickly person to person and causes nausea, vomiting, diarrhea, and a low grade fever. The virus is contracted by contact with infected persons or contaminated surfaces and items. The virus can remain vital for as long as two weeks.

Classes are suspended until Wednesday, February 4.

Athletic practices and competitions, extracurricular activities, and fraternity social events are suspended until Wednesday, February 4.

Administrative departments will resume normal hours on Tuesday, February 3.

It may have taken three days, but sophomore Tre Briggs just got over the norovirus. He is one of more than 300 students who fell ill after the outbreak on campus last week. “I just knew something was wrong and then that night I went to sleep and I was just vomiting all night,” Briggs said.

Managing behavior through messaging doesn’t always work, as we saw 7 years ago at Guelph:

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD

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.