38 outbreaks of Norovirus confirmed in Maine

Photo: Maine Center for Disease Control and Prevention

Norovirus outbreaks by type of facility, Maine, 2008-2011

What are the symptoms of norovirus?

The symptoms of norovirus usually include nausea, vomiting, diarrhea, and some stomach cramping. Low-grade fever, chills, headache, muscle aches, and tiredness, may also occur.

When do symptoms appear?

Symptoms of norovirus usually begin about 24 to 48 hours after ingestion of the virus, but they can appear as early as 10 hours after exposure.

How can norovirus be prevented?

• Frequently wash your hands, especially after toilet visits and changing diapers, and before eating or preparing food.

• Carefully wash fruits and vegetables.

• Thoroughly clean and disinfect contaminated surfaces immediately after an episode of illness by using a bleach-based household cleaner.

• Immediately remove and wash clothing or linens that may be contaminated  after an episode of illness.

• Flush or discard any vomit and/or stool in the toilet and make sure that the surrounding area is kept clean.

What treatment is available?

Currently, there is no medication that works against norovirus, nor is there a vaccine to prevent infection.

*More information is available through the Maine Center for Disease Control and Prevention: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/disease/norovirus.shtml

STATE — Maine has been hit by 38 separate outbreaks of noroviruses, a group of viruses that cause acute gastroenteritis, reported Dr. Stephen Sears, state epidemiologist with the Maine Center for Disease Control and Prevention (MECDC).

The virus is also known as the "winter vomiting disease." Symptoms include intense bouts of vomiting, diarrhea and cramping, and it typically lasts 24 to 72 hours, said Sears.

"It is one of the most prevalent viral illnesses in the United States," he said, "typically more in the winter months. It lasts two to three days, and it is terrible when you get it."

While people often associate the virus with the "stomach flu," Sears said that norovirus is, in fact, not the flu.

While influenza is a respiratory illness, norovirus, said Sears, can be transmitted through eating food or drinking liquids contaminated with norovirus, touching surfaces or objects contaminated with norovirus, or having direct contact with another person.

And, said Sears, the virus can spread fairly quickly. Once a person is exposed, they usually become sick within 24 hours, he said.

"That's what is so insidious about it," he said. "It's highly contagious. ... It can be a foodborne illness as well as person to person."

Sears said that there are nearly 23 million cases of norovirus per year throughout the United States.

Because norovirus is so common, particularly during the winter months, MECDC only investigates outbreaks of norovirus, as opposed to individual cases, said Sears. Outbreaks are most common in nursing homes, schools and other community settings, like weddings, he said.

Ann Johnson, school nurse at Oxford Hills Comprehensive High School, said that she encourages students to wash their hands regularly and not share things, like food.

"Like anything, the bugs always win," she said. "We do what we can to encourage kids to be as healthy as possible, so their bodies can naturally fight anything."

According to John Martins, director of employee and public communications for MECDC, only one norovirus outbreak has been confirmed in Oxford County this year.

However, Martins said he was unable to provide the number of people it had actually affected.

"It's not really telling the whole story," he said, "because a lot of people will get these types of illnesses, put themselves in bed for a couple of days to work it out, and they won't report it," said Martins.

Martins also said that he could not say where the outbreak had occurred.

"One of the things we do with our data is, if we drill down too far, typically it exposes the people; Maine is such a small community, so we usually just report countywide data," he explained.

Nearby Androscoggin County had two confirmed outbreaks of norovirus; Penobscot County had seven, and Kennebec County had eight – the highest number of cases reported in one area statewide, said Martins.

"It's probably far more widespread than the numbers tell us," he said. "They are probable, but we don't always get the test to confirm it. The only data that we log in our system are confirmed outbreaks."

Sears said that MECDC works with the affected organizations to help prevent the illness from continuing to spread. He said that nursing homes tend to be the places hit hardest by the virus.

Oftentimes, said Sears, nursing homes will put up a sign advising visitors to stay away until the outbreak subsides.

According to Dr. Sheila Pinette, director of MECDC, the number of flu cases in Maine has subsided this year, and because of this, MECDC is diverting its attention to norovirus and how it can be prevented.

Only 11 cases of the flu have been reported to MECDC this year, said Pinette, far below the hundreds that are usually reported in a year.

Sears said that while norovirus is not necessarily more common this year, more people are aware of how to avoid it. So far this winter, he said that 38 norovirus outbreaks have been confirmed statewide since the beginning of January.

In 2011, 77 total outbreaks were confirmed in Maine, according to MECDC.

"It occurs usually in clusters," said Sears. "Once it gets into a closed environment, a lot of people get sick really fast, because it's so contagious. By the time you see the first case, you are going to see two, three, four, or five."

But according to Sears, there is currently no treatment or vaccine for norovirus, nor can it be treated with antibiotics. This is because antibiotics work to fight bacteria and not viruses.

"Using good hygiene, like good hand-washing, and avoiding people who are ill, is the only really good prevention," he said.

More than 80 percent of norovirus outbreaks occur between November and April. In Maine, outbreaks are typically seen from late fall through early spring, according to a MECDC epidemiology report.

Other ways to avoid the virus, said Sears, includes thoroughly cleaning and disinfecting contaminated surfaces, by using a bleach-based household cleaner, or by immediately removing and washing clothing or linens that may be contaminated. He also advises that those with symptoms stay home to avoid spreading it to others.

"There have been outbreaks all over the state," said Sears, "but every few years, there is a year that is more intense." And while this year is not the worst, he said, "it's still pretty bad ... and it's still a problem."