There’s a lot of norovirus in Nevada schools

Posted on October 26, 2015 by Ben Chapman

The famed winter vomiting virus appears to be making life miserable for Nevada school kids. According to the Reno Gazette Journal over 1700 students in 20 schools have had the virus over the past 5 weeks and the outbreak appears to be spreading.

The case count might be real or it might be inflated due to self reporting (kids who want to stay home) or protective parents who don’t want noro in their house (keeping their kids home).

An outbreak of norovirus has reached such heights in local public schools that health officials stopped counting the number of people infected by the highly contagious illness, which causes days of diarrhea and vomiting.

But the Washoe County Health District estimates – based on schools’ absenteeism and reported illnesses – that 1,760 students and staff have been afflicted at 20 schools and a few daycare centers, quadrupling the number of infections since the outbreak started at half as many schools on Oct. 1.

“We were hopeful it wouldn’t get to this point,” said county Director of Epidemiology Randall Todd, noting the virus’ rapid spread to a new school every few days.

The health district has advised the Washoe County School District and families to do three things at outbreak schools, which are concentrated in northern Reno, Spanish Springs and Sparks. The health district isn’t identifying the affected daycare centers.

Disinfect high-traffic areas of the school where surfaces are repeatedly touched, such as railings, desks, chairs and doors. Thoroughly clean and disinfect the area around a vomiting incident up to a 25-foot radius.

Wash hands frequently with soap and water — antibacterial hand-sanitizer does not kill the virus.

Sick students and staff must stay out of school for 72 hours after their last symptoms.

Such a “substantial outbreak” wouldn’t be possible if parents and staff were following all three protocols advised for outbreak schools, said Todd, positing that at least one recommendation isn’t being followed.

The health district hasn’t recommended closing any schools, and school officials said they don’t want to go there either for the sake of academics.

But they’re in luck. The week-long fall break starts Monday.

“We’re keeping our fingers crossed that fall break will give us the boost we need to put this behind us,” said Todd.

Norovirus hospitalizes thousands of Canadians annually

Posted on October 24, 2015 by Ben Chapman

Most people get over a bout of norovirus relatively quickly and without a visit to a health care provider. In extreme cases, a couple of days worth of vomit and painful stomach cramps can send folks to the hospital, especially if they become severely dehydrated.

Our hoser colleagues have estimated that between 4000 and 11,000 people are hospitalized as a result of Norovirus annually in Canada, resulting in a cost burden of over $21 million CAD (or about 5 million Timbits).

Estimated hospitalizations attributed to norovirus and rotavirus infection in Canada, 2006–2010
V.K. Morton, M.K. Thomas and S. A McEwen
Epidemiology and Infection / Volume 143 / Issue 16 / December 2015, pp 3528-3537

Enteric viruses including norovirus and rotavirus are leading causes of gastroenteritis in Canada. However, only a small number of clinical cases are actually tested for these pathogens leading to systematic underestimation of attributed hospitalizations in administrative databases. The objective of this analysis was to estimate the number of hospitalizations due to norovirus and rotavirus in Canada. Hospitalization records for acute gastroenteritis-associated discharges at all acute-care hospitals in Canada between 2006 and 2011 were analysed. Cause-unspecified gastroenteritis hospitalizations were modelled using age-specific negative binomial models with cause-specified gastroenteritis admissions as predictors. The coefficients from the models were used to estimate the number of norovirus and rotavirus admissions. The total annual hospitalizations for rotavirus were estimated to be between 4500 and 10 000. Total annual hospitalizations for norovirus were estimated to be between 4000 and 11 000. The mean total annual cost associated with these hospitalizations was estimated to be at least $16 million for rotavirus and $21 million for norovirus (all figures in Canadian dollars). This study is the first comprehensive analysis of norovirus and rotavirus hospitalizations in Canada. These estimates provide a more complete assessment of the burden and economic costs of these pathogens to the Canadian healthcare system.

Katie’s Norovirus Nightmare

Posted on October 22, 2015 by Ben Chapman

The NoroCORE Collaborative is running a series of posts for Halloween on norovirus nightmares. The first post comes from one of my graduate students, Katie Overbey.

During Spring Break of 2014 I was spent the week with my boyfriend in New Orleans and we stayed with my aunt. As one does in New Orleans, we ate lots of tasty food and tried lots of drinks. On the Saturday of our trip, after eating at my aunt’s favorite Mexican restaurant (side note: who eats Mexican food when they visit New Orleans?) she decided to take us on what has since been deemed the ‘drinking tour of the French Quarter.’ After about three hours I started to feel queasy right in the middle of the iconic Pat O’Briens Bar. We thought maybe I was hungry from our day of activities so we headed to get dinner. The place was packed and while waiting for our food, it hit me. I weaved through the crowd to get to the bathroom, just to discover that one stall was broken, the other was occupied and there was a line. I apologized to the people in line for what was about to happen and then proceeded to throw up in the sink, because as anyone who’s had norovirus knows – when it decides to hit, there’s not much you can do.

After cleaning up as best I could (though after my master’s research I now know that bathroom was doomed because of all my aerosolized vomit) we headed back to my aunt’s as fast as possible. I proceeded to get sick all night long, which ironically put a damper on the rest of my relaxing vacation.

At first, my aunt and boyfriend thought I had enjoyed the drinking tour too much, but I knew that what I had was way worse. I suspect that it had something to do with the Mexican food because after my aunt ate some of my leftovers, she got sick too.

Katie Overbey is an MS student in Food Science at NC State studying how to better communicate with schools having norovirus outbreaks and environmental detection of norovirus

40 sick in Norovirus outbreak at Brisbane camp

Posted on October 21, 2015 by Douglas Powell

Looks like I picked the wrong week to send the kid to camp (I didn’t).

Queensland health is trying to identify the cause of a suspected norovirus outbreak.

A highly contagious stomach bug is suspected to have hit about 40 primary school pupils after a Year 4 camp at the weekend.

In an email to parents yesterday, Grovely’s St William’s School principal Anthony Lucey said one family had a confirmed diagnosis of norovirus.

Brisbane Catholic Education communications manager John Phelan said about 40 children had been affected since symptoms were first reported last weekend after children returned from Camp Warrawee at Joyner.

“Once students began reporting as ill, we immediately contacted both the camp and Queensland Heath,” Mr Phelan said.

Losing my religion.

Foodborne viruses in fresh produce

Posted on October 10, 2015 by Douglas Powell

Norovirus (NoV) and hepatitis A virus (HAV) are the most important foodborne viruses. Fresh produce has been identified as an important vehicle for their transmission.

In order to supply a basis to identify possible prevention and control strategies, this review intends to demonstrate the fate of foodborne viruses in the farm to fork chain of fresh produce, which include the introduction routes (contamination sources), the viral survival abilities at different stages, and the reactions of foodborne viruses towards the treatments used in food processing of fresh produce. In general, the preharvest contamination comes mainly from soli fertilizer or irrigation water, while the harvest and postharvest contaminations come mainly from food handlers, which can be both symptomatic and asymptomatic. Foodborne viruses show high stabilities in all the stages of fresh produce production and processing. Low-temperature storage and other currently used preservation techniques, as well as washing by water have shown limited added value for reducing the virus load on fresh produce. Chemical sanitizers, although with limitations, are strongly recommended to be applied in the wash water in order to minimize cross-contamination. Alternatively, radiation strategies have shown promising inactivating effects on foodborne viruses. For high-pressure processing and thermal treatment, efforts have to be made on setting up treatment parameters to induce sufficient viral inactivation within a food matrix and to protect the sensory and nutritional qualities of fresh produce to the largest extent.

Comprehensive Reviews in Food Science and Food Safety

Dan Li, Ann De Keuckelaere and Mieke Uyttendaele

Norovirus surrogates are tough to inactivate in cotton and polyester

Posted on October 7, 2015 by Ben Chapman

A couple of years ago Sam, the almost-5-year-old yacked all over the backseat of the van on a car trip. The polyester carpeting and cotton fabric-covered seats smelled for weeks. We even tried to hose the van out, leaving the doors open for a couple of days (and then a frog set up shop in there).

It was most likely motion sickness that led to Sam’s vomit event, but people with noro puke on all sorts of surfaces. My friend Angie Fraser and colleagues at Clemson just published what happens when you try to inactivate norovirus surrogates on different surfaces including polyester and glass.

From the discussion:

Our results indicated that surface and virus type had a significant influence on RE (that’s recovery efficiency – ben). We found that both FCV and MNV exhibited higher RE when inoculated onto glass than either polyester or cotton. In addition, the recovery of both viruses from cotton was significantly lower than that of polyester. Compared with FCV, MNV exhibited a higher recovery from soft porous surfaces; however, it was only significant for cotton. Previous studies have also document- ed the ability of HuNoV surrogates to be recovered with greater efficiency from hard nonporous surfaces than from soft porous surfaces. Viruses may become more tightly bound to soft porous surfaces due to their ability to absorb the virus-containing media and trap viruses in the subsurface.

Recovery and Disinfection of Two Human Norovirus Surrogates, Feline Calicivirus and Murine Norovirus, from Hard Nonporous and Soft Porous Surfaces

Journal of Food Protection, Number 10, October 2015, pp. 1776-1924, pp. 1842-1850(9)

Yeargin, Thomas; Fraser, Angela; Huang, Guohui; Jiang, Xiuping

Abstract:

Human norovirus is a leading cause of foodborne disease and can be transmitted through many routes, including environmental exposure to fomites. In this study, both the recovery and inactivation of two human norovirus surrogates, feline calicivirus (FCV) and murine norovirus (MNV), on hard nonporous surfaces (glass) and soft porous surfaces (polyester and cotton) were evaluated by both plaque assay and reverse transcription quantitative PCR method. Two disinfectants, sodium hypochlorite (8.25%) and accelerated hydrogen peroxide (AHP, at 4.25%) were evaluated for disinfection efficacy. Five coupons per surface type were used to evaluate the recovery of FCV and MNV by sonication and stomaching and the disinfection of each surface type by using 5 ml of disinfectant for a contact time of 5 min. FCV at an initial titer of ca. 7 log PFU/ml was recovered from glass, cotton, and polyester at 6.2, 5.4, and 3.8 log PFU/ml, respectively, compared with 5.5, 5.2, and 4.1 log PFU/ml, respectively, for MNV with an initial titer of ca. 6 log PFU/ml. The use of sodium hypochlorite (5,000 ppm) was able to inactivate both FCV and MNV (3.1 to 5.5 log PFU/ml) below the limit of detection on all three surface types. AHP (2,656 ppm) inactivated FCV (3.1 to 5.5 log PFU/ml) below the limit of detection for all three surface types but achieved minimal inactivation of MNV (0.17 to 1.37 log PFU/ml). Reduction of viral RNA by sodium hypochlorite corresponded to 2.72 to 4.06 log reduction for FCV and 2.07 to 3.04 log reduction for MNV on all three surface types. Reduction of viral RNA by AHP corresponded to 1.89 to 3.4 log reduction for FCV and 0.54 to 0.85 log reduction for MNV. Our results clearly indicate that both virus and surface types significantly influence recovery efficiency and disinfection efficacy. Based on the performance of our proposed testing method, an improvement in virus recovery will be needed to effectively validate virus disinfection of soft porous surfaces.

Food Safety Talk 81: Food safety matters every week

Posted on October 7, 2015 by Ben Chapman

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour. They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.

After a brief discussion about Quadrophenia, the guys thankfully decide to not sing this episode.

Ben mentions that the last video store in the Raleigh area is closing. This led to some discussion about the job security of academic careers where Don stated, ‘prediction is very difficult especially about the future.’

Spurred by Ben’s short visit to Baltimore, the guys then discuss how awesome The Wire is. Don mentions a perspective by David Simon, the Wire’s creator, on the real life situation in Baltimore. Ben was recently in Baltimore for the Food Safety Summit. A nod goes out to Brian Saunders for doing a good job of boots on the ground coverage of what’s going on in Baltimore during the Food Safety Summit.

Don recommends Acorn TV for anyone interested in British TV. This subscription service has British programming not typically shown on US TV. At the Acorn website Ben spotted Time Team an archeology reality series that he thinks his kids would love.

This week Ben talks about media interviews and a focus on multiple food safety stories all hitting at the same time. He talked a cutting boards post on barfblog that garnered some attention. He also fielded inquires regarding the Blue Bell Listeria outbreak . Ben noted that Blue Bell announced they are recalling all the ice cream.

A tragic botulism outbreak linked to a church potluck in Ohio was also a topic in multiple media outlets. The potluck outbreak was linked to home-canned potatoes but the coverage prompted a side conversation about bot and foil-wrapped baked potatoes.

Looking ahead to future food outbreaks Ben mentions that a bill was introduced in North Carolina to legalize raw milk. This bill would allow consumers to legally acquire raw milk via a cow share mechanism. In this article Ben is quoted challenging an inappropriate comparison of raw milk outbreak data by the bill’s sponsor.

In After Dark Don shames Ben for not listening to Roderick on the Line. Again.

– 30 –

‘Elementary school kids, younger kids probably aren’t the best when it comes to hygiene’

Posted on October 3, 2015 by Ben Chapman

We’ve successfully made it through a couple of months of school in our house without any illnesses. I’m not sure if my kids’ recent obsession with handwashing is a factor (I suspect it is) or whether we’ve just been lucky.

Kids and norovirus are a common pair. Last month an estimated 700 students missed school in Person County, NC with the virus (or stayed home to avoid it; only two cases were confirmed). Today, AP reports that 400 kids in northern Nevada at 11 schools likely have noro.

The Washoe County Health District said it believes the norovirus outbreak first started on Sept. 16 at a Reno elementary school, where 150 students and 11 staff members have reported symptoms, including nausea, vomiting, diarrhea and abdominal cramping.

As of Friday, the Washoe County School District reported that the outbreak had spread to 9 other elementary schools, a high school and some associated daycare centers. It has been centered in Reno, with one Sparks elementary school.

Most of the nearly 400 people affected have been elementary school children. The high school teachers who were sickened also traced their illnesses to the affected elementary school kids, whom they were related to.

“Elementary school kids, younger kids probably aren’t the best when it comes to hygiene,” said Phil Ulibarri, a county health department spokesman.

The school district has also been advised to thoroughly clean schools, which Ulibarri said means sanitizing a 25-foot radius where there is vomiting or diarrhea, including going as high as six feet up along walls.

Awesome, the Nevada folks are using the best available science.

Ice fingered but epi can be ‘squishy’ 61 sickened by Norovirus at journalists’ conference

Posted on October 1, 2015 by Douglas Powell

Two months after a norovirus outbreak at Bali Hai restaurant, county health officials have fingered ice as the foodborne source that sickened at least 61 people — including three in a wedding party.

“We’re certain it had something to do with the ice” served at the annual awards banquet of the local Society of Professional Journalists, said county spokesman Michael Workman. “We’re not certain how it got in the ice.”

In its final report to the San Diego SPJ, the county said 84 of the 172 people at the July 29 banquet returned surveys on what they ate and other issues. Fifty were sickened by norovirus type GI.1. (Eight others also reported getting ill.)

Three diners elsewhere in Bali Hai also got GI.1 — part of a wedding party of 140.

“We have to [classify it as] food poisoning,” Workman said, rather than a sick person spreading the gastrointestinal disease.

A Sept. 4 report said, “We did not link any food service workers with the illness,” but Workman on Tuesday told Times of San Diego that “we can’t say yes or no” to whether an employee caused the outbreak.

Workman stressed that Bali Hai remains “rated for high” for hygiene. “Everyone involved — from the people who attended [the banquet] and from the restaurant … did the right thing.”

County spokesman Workman saluted Bali Hai management.

“The restaurant had a great hygiene procedure, really good,” he said. “They are on the up-and-up on what they do and what they teach their employees. The employees have been there a long time. So they get it.”

But Workman acknowleged the county’s findings can be “squishy” and “it’s not an exact science.”

But: “We’re confident it’s been taken care of.”

The quasi-daily probe E1: The okra of the sea

Posted on September 24, 2015 by Ben Chapman

My friend Mike Batz of University of Florida’s Emerging Pathogen Institute and I were chatting a while back and thought it would be cool to connect for short podcasts when there was something fun going on. Here’s the first episode (and maybe the last) in it’s raw, unedited, short format.

Today we talked about oysters, raw and steamed, Vibrio, norovirus, burden and risk-based messaging.

The article that prompted the probe was from Lifezette where oysters are referred to as those scary shellfish.

Heads up, raw oyster lovers. New research from China shows the bivalves not only transmit human norovirus, they also serve as a reservoir for the harmful and highly contagious virus.

In an expansive study published recently in Applied and Environmental Microbiology, a journal of the American Society for Microbiology, scientists discovered that more than 80 percent of the known noroviruses matched those found in oysters.

Even common recommendations for reducing the risks of illness, such as avoiding them from warm-water sources, aren’t a guarantee you won’t get sick, food safety expert Ben Chapman told LifeZette.

“Considering where they’re from, and not eating them at a certain time of year, may reduce the risk, though risk is always there,” said Chapman, a researcher at North Carolina State University. Chapman also notes that cooking oysters may lower risk, but that steaming — a popular way to prepare them — isn’t likely to get them above 140 degrees.

Listen to the episode here.

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Category Archives: Norovirus