Reasonable Rascal
12-20-02, 22:51
VIRAL GASTROENTERITIS UPDATE 2002 (02)
****************************************
A ProMED-mail post
In these updates:
[1] Nursing home (USA - Michigan)
[2] Nursing home (Canada - British Columbia)
[3] Aircraft Carrier (USS Theodore Roosevelt)
[4] Hospital (USA - New York, Long Island)
[5] Widespread infection (USA - Minnesota)
[6] Widespread infection (USA -Alaska)
[7] Nursing home (USA - New Hampshire)
[8] Hospitals (Canada - Ontario)
******
[1]
Date: Wed 18 Dec 2002
Source: Lansing State Journal, Wed 18 Dec 2002 [edited]
<http://www.lsj.com/news/local/021218_virus_1b-2b.html>
More than 100 Suspected Norovirus Cases at Nursing Home
--------------------------------------------------
Norwalk virus or [a similar norovirus] is what sickened more than 100 nursing home residents and staffers here, public health investigators said on Tue 17 Dec 2002. Results came back from samples taken at the Sparrow Dimondale Nursing Center, where about 80 of the 170 residents have been suffering from diarrhea, stomach pain, and vomiting this past week. Also, 67 out of 245 staffers were affected.
New cases at the center have slowed, but health officials continue to monitor the facility and are hearing reports of the virus elsewhere in the area, said Dean Sienko, medical director of the Barry-Eaton District Health Department. "Things are slowing down, and we hope to continue to see that trend," Sienko said. "But my sense, based on anecdotal reports, is that here is a fair amount of norovirus-like activity in the community at this time." Sienko said the virus may have surfaced in some area schools, where administrators report more kids staying home with gastrointestinal symptoms. The illness, although uncomfortable, isn't considered serious and doesn't have to be reported to health officials.
The first case of the illness at the Dimondale center surfaced early last week. It reached its peak at about 15 new cases a day late last week, Sienko said. There have been only 2 new cases in the last couple of days. Sparrow spokesman Russ Leonard-Whitman said the nursing center continues to restrict visitors' access. Officials also are maintaining strengthened hand-washing measures at the Dimondale facility and requiring workers to change into work clothes when they arrive and change back before they leave.
[Byline: Adam Emerson]
******
[2]
Date: Wed 18 Dec 2002
Source: The Columbian, Tue 17 Dec 2002 [edited]
<http://www.columbian.com/12172002/clark_co/344496.html>
British Columbia: Norovirus Infection May Be Moving to Battle Ground
--------------------------------------------------
Southwest Washington Health District officials said 2 residents of Parkway North Care Center were experiencing vomiting, diarrhea and other symptoms indicative of norovirus-like virus infection on Mon 16 Dec 2002. The health district is working with Parkway North to deal with the illness as well as conducting a full inspection of its food preparation facilities.
A similar sickness has sprinted through four Vancouver assisted living centers since before Thanksgiving. The Health District has tallied 328 cases of [suspected norovirus illness] at the 4 centers since the first sick call. The good news: The Vancouver portion of the outbreak has slowed considerably. Just one resident and 2 staff at Bridgewood at Four Seasons Retirement and Assisted Living Community were added to the sick list over the weekend. Only one additional resident at Rose Vista Nursing Center has contracted the illness since Friday.
Both the Van Mall Retirement Community and Hampton Alzheimer's Community, meanwhile, escaped the weekend with no additional cases. Each dealt with close to 100 norovirus infection sufferers among staff and residents earlier in the outbreak.
[Byline: Ken Olsen]
******
[3]
Date: Thu 19 Dec 2002
Source: CNN News online, Thu 19 Dec 2002 [edited]
<http://www.cnn.com/2002/US/12/19/flu.carrier/>
Viral Gastroenteritis Outbreak On Board Aircraft Carrier
--------------------------------------------------
Hundreds of sailors on board the [aircraft carrier] USS Theodore Roosevelt [have contracted viral gastroeneteritis] during exercises in the Atlantic, U.S. Navy officials said. When the virus [infection] peaked about 4 days ago, it affected at least 300 of the more than 5000 crew members stationed aboard the ship. Navy officials said they were initially puzzled as to the cause of the widespread sickness, but the answer came after blood samples were flown for testing at the U.S. naval base in Norfolk, Virginia. The samples showed the crew had a [viral gastroenteritis]. At no time was the ship quarantined, Navy officials said.
Medical teams aboard the carrier treated the cases with the usual rest and plenty of fluids, and those not afflicted were told to wash their hands to prevent spreading the outbreak. Officials said that the outbreak seems to be under control and that many of the stricken sailors are back at work. The spreading of viruses aboard ships is common because of the close quarters the sailors keep, though it is not known why this outbreak was so widespread, a Navy official said.
--
Dan Moynihan
Staff Engineer
VIMS Operations
University of Arizona
Tucson, AZ
******
[4]
Date: Thu 19 Dec 2002
Source: Newsday online, Thu 19 Dec 2002 [edited]
http://www.newsday.com/news/local/longisland/ny-livirus1218,0,6067474.story?coll=ny-linews-headlines
Norovirus Infection Hits 2 Long Island Hospitals
--------------------------------------------------
The virus responsible for ruining the vacations of hundreds of cruise ship passengers in recent months is now believed to be sickening patients at 2 Long Island hospitals. Several wards at Nassau University Medical Center (NUMC) and St. Charles Hospital have been closed off to new patients to prevent the spread of what may be a norovirus infection. "Just like the cruise ship where people came to the cruise ship with the virus, we believe the same situation is occurring here," said registered nurse Maria Ninivaggi, director of NUMC's infection control division. "It's a unit with a confined space with a confined number of patients and it has spread among them."
Doctors suspected something was wrong at NUMC in East Meadow on Tuesday after noticing several patients in the 14th floor psychiatric unit vomiting or experiencing diarrhea. Ninivaggi said 19 patients are now believed to have the virus. Its source is unknown.
The genesis of the outbreak is similar at St. Charles Hospital in Port Jefferson, where patients in 2 rehabilitation wards came down with a gastrointestinal illness on Friday, and officials soon closed the wards off to new patients. So far 21 people have fallen ill, but since those with the virus usually recuperate within 2 to 3 days, all have recovered but one, said Kim Kubasek, vice president of administration at St. Charles. One ward reopened yesterday, and the other is still closed since that patient is considered infectious. It should reopen by the weekend, Kubasek said.
Norovirus infection is no stranger to hospitals, day care centers, nursing homes, restaurants or cruise ships. Each year, it affects 23 million people, requiring hospitalizations for 50 000 of them, according to the Centers for Disease Control and Prevention. Although most of the time there are no long-term health consequences, there are 310 deaths annually, according to the CDC.
Officials from both Long Island hospitals stressed that their cases are all mild, and that the wards are being scrubbed down and sterilized to prevent further transmission. "Obviously someone from the community introduced it to the hospital," said Dr. Patricia Dillon, medical director of epidemiology and disease control at the Suffolk County Department of Health. "It could have been a disaster that spread to the whole hospital. But their infection control measures were effective."
Dillon said no other hospitals in Suffolk reported a similar outbreak, and this is the first outbreak this year in the county of what is believed to be a norovirus infection. Nassau County health officials said they couldn't comment and deferred questions to the state Department of Health, which did not return several calls.
[Byline: Dawn MacKeen]
******
[5]
Date: Thu 19 Dec 2002
Source: Star Tribune online, Thu 19 Dec 2002 [edited]
<http://www.startribune.com/stories/1556/3542258.html>
Norovirus Infection Widespread in Minnesota
-------------------------------------------
State health officials said an unprecedented 25 outbreaks of illness afflicting as many as 1000 people have been attributed to norovirus infection since 1 Nov 2002. The illness causes intense vomiting, cramps and diarrhea usually for one or 2 days. Around the state, doctors say clinic waiting rooms are filled with people suffering from these symptoms. The illness has struck hundreds of students at Mounds View High School and members of 2 professional sports teams. About half of the Minnesota Wild developed norovirus infection symptoms last weekend, said spokesman Aaron Sickman.
"[The infection] is everywhere," said Dr. Brad Benson, an internist and pediatrician at the University of Minnesota Primary Care Center in Minneapolis. Health officials said noroviruses typically make the rounds in winter. The illness also has sickened people in Canada and other Midwestern states and on cruise ships; a sign that the virus outbreaks are widespread. Health officials say it's not clear why this is a bad year for these viruses, but they added that cruise-ship outbreaks probably are the result, not the cause, of increases in norovirus-associated illnesses everywhere. The U.S. Centers for Disease Control and Prevention estimate that noroviruses cause 23 million cases of stomach illness each year.
[Byline: Jill Burcum]
******
[6]
Date: Thu 19 Dec 2002
Source: Anchorage Daily News online, Thu 19 Dec 2002 [edited]
<http://www.adn.com/front/story/2346589p-2402346c.html>
Norovirus Infection Has Become widespread in Alaska
--------------------------------------------------
The outbreak of gastroenteritis reported last week in Ketchikan is being reported in other Alaska cities, including Anchorage, and health officials think more outbreaks are possible as people spread the virus through their holiday travels. As of Wed 18 Dec 2002, similar outbreaks infecting hundreds of Alaskans have cropped up at a U.S. Navy camp near Ketchikan, among members of a dance troupe in Juneau, as well as students in Craig and children attending a day care center in Anchorage, according to the state Section of Epidemiology. All of the outbreaks are probably caused by a norovirus, which is thought to be the most common cause of gastrointestinal illness in the United States, epidemiologists said.
So far, state medical authorities have confirmed only 2 cases of norovirus infection , in samples taken from children connected to the Anchorage day care center. Stool samples from Ketchikan and Juneau have been sent to the Centers for Disease Control and Prevention in Atlanta, but results are not available yet, Alaska epidemiologists said. The 2 positive cases from Anchorage are similar to the virus strains detected on recent cruises, the state epidemiology office said. Dr. Joe McLaughlin, who helped investigate the cases in Ketchikan, said medical investigators working there didn't identify anyone who had been on the ships or had known someone who had.
In Alaska's outbreaks, 2 people were hospitalized in Ketchikan, but no deaths were reported, epidemiologists said. People do not have to be traveling on ships to get the virus, however. Sue Anne Jenkerson, state nurse epidemiologist, said people can get the virus through food, water and possibly through air. It's passed person to person -- the route likely to blame for the recent outbreaks in Alaska, she said. The current round can be traced to back to early October, when more than 20 children and staffers at an Anchorage day care became ill, epidemiologists said.
A public health nurse reported that more than 75 elementary students missed school in November due to similar symptoms in Craig, a small community northwest of Ketchikan. During the same month, the first case of gastroenteritis was reported in the Southeast Alaska Acoustic Measurement Facility, which is a naval camp near Ketchikan. Within days, more people connected with the camp came down with the illness. Someone connected with the base is also a teacher at a Ketchikan school where there was a high absentee rate connected to related illnesses. That person may have helped spread the virus into the school, McLaughlin said. To date, at least 225 people living near Ketchikan have come down with symptoms typical of Norwalk-like virus. 18 dancers or chaperones with a Juneau troupe became ill between 6 and 10 Dec 2002. They had traveled by ferry to Wrangell and may have been exposed to the virus on board, epidemiologists said. As a result, the state Department of Environmental Conservation got involved.
Food safety and sanitation inspectors contacted the Wrangell hotel where the troupe stayed and the school where they performed.
[Byline: Ann Potempa]
******
[7]
Date: Thu 19 Dec 2002
Source: The Union Leader online, Thu 19 Dec 2002 [edited]
<http://www.theunionleader.com/articles_show.html?article=16677>
New Hampshire: Norovirus Outbreak Affects Nursing Home
--------------------------------------------------
An epidemic of what is believed to be norovirus infection has caused nearly 50 residents and workers at a local nursing home to become ill. The first symptoms were reported on 10 Dec 2002. Since then, about 48 people associated with Integrated Health Services, Peabody Road, have reported cases of stomach cramps, diarrhea, loose stool and vomiting. "We have had some cases of mild gastrointestinal illness," said Jose Montero, chief of New Hampshire's Office of Disease Control. "Preliminary reports show that it is a norovirus infection." By last Saturday, about 10 residents and workers each day were experiencing different symptoms at the 112-bed nursing home. The incident was reported to state health officials last week by the nursing home's administrator, Gary DiPietro.
The preliminary test results revealing norovirus infection are now in the process of being confirmed by the Centers for Disease Control and Prevention. Noroviruses spread quickly in closed areas such as nursing homes, according to Montero, who said the Derry nursing home is one of "several" elderly-care facilities in the state currently experiencing this epidemic. He would not say how many other facilities or what state
organizations are dealing with the illness, but did say the virus often appears at this time of year. While it is still not clear what caused the epidemic in the local nursing home, Montero said the infection was most likely carried into the facility by a visitor who may have contaminated the surface of food or other items. Some employees at the nursing home have suffered symptoms of the virus, and have been asked to stay home for at least 48 hours after their symptoms disappear, according to Montero.
The home is not taking any admissions because of the epidemic, Morris said. All group activities at the nursing home have been suspended, meals are being served in individual rooms, and common areas are not being used. "Residents are being kept isolated," Montero said. As people become healthy again, the nursing home staff will allow some residents to visit with other residents in their rooms if both individuals are showing no symptoms. At this point, no residents have been hospitalized because of the epidemic, said Morris.
[Byline: Kimberly Houghton]
*****
[8]
Date: Thu 19 Dec 2002
Source: Toronto Star online, Thu 19 Dec 2002 [edited]
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Arti
cle_Type1&c=Article&cid=1035775742888&call_pageid=968332188774&col=968350116467>
Hospitals in Ontario Affected by Confirmed Norovirus Infection
--------------------------------------------------
Health Minister Tony Clement is advising many Ontarians to call the province's nursing hotline if they suspect they have [a norovirus infection] rather than going to hospitals, which are struggling with outbreaks of norovirus-related disease. He made the plea yesterday at a news conference where he was marking the one-year anniversary of the Telehealth Ontario service. "Our best advice is that if you have the
standard symptoms of norovirus infection and you are a person of average health, then certainly, at least in the first instance, phone Telehealth Ontario," he said. The nursing hotline offers free medical advice around the clock and can be reached by phoning 1-866-797-0000.
There are currently 11 Ontario hospitals with confirmed cases of the virus and 42 more with suspected cases, according to the health ministry. The Scarborough Hospital, Grace site, has been forced to close its critical care and palliative care units because of the virus. The Bloorview McMillan Centre has also closed a unit. Humber River Regional and Salvation Army Grace are the only other hospitals in the GTA with confirmed cases of norovirus infection .
[Byline: Theresa Boyle]
--
ProMED-mail
[It is now the turn of the USA to experience -- report? -- widespread norovirus infection in hospitals, health-care facilities, and nursing homes. This second "Viral gastroenteritis update" is posted early to accommodate this developing situation. Please note that these reports are edited to replace "flu-like", "Norwalk-like", "bug" with the ICTV approved designation "Norovirus" for the agent responsible for this form of viral gastroenteritis. - Mod.CP]
****************************************
A ProMED-mail post
In these updates:
[1] Nursing home (USA - Michigan)
[2] Nursing home (Canada - British Columbia)
[3] Aircraft Carrier (USS Theodore Roosevelt)
[4] Hospital (USA - New York, Long Island)
[5] Widespread infection (USA - Minnesota)
[6] Widespread infection (USA -Alaska)
[7] Nursing home (USA - New Hampshire)
[8] Hospitals (Canada - Ontario)
******
[1]
Date: Wed 18 Dec 2002
Source: Lansing State Journal, Wed 18 Dec 2002 [edited]
<http://www.lsj.com/news/local/021218_virus_1b-2b.html>
More than 100 Suspected Norovirus Cases at Nursing Home
--------------------------------------------------
Norwalk virus or [a similar norovirus] is what sickened more than 100 nursing home residents and staffers here, public health investigators said on Tue 17 Dec 2002. Results came back from samples taken at the Sparrow Dimondale Nursing Center, where about 80 of the 170 residents have been suffering from diarrhea, stomach pain, and vomiting this past week. Also, 67 out of 245 staffers were affected.
New cases at the center have slowed, but health officials continue to monitor the facility and are hearing reports of the virus elsewhere in the area, said Dean Sienko, medical director of the Barry-Eaton District Health Department. "Things are slowing down, and we hope to continue to see that trend," Sienko said. "But my sense, based on anecdotal reports, is that here is a fair amount of norovirus-like activity in the community at this time." Sienko said the virus may have surfaced in some area schools, where administrators report more kids staying home with gastrointestinal symptoms. The illness, although uncomfortable, isn't considered serious and doesn't have to be reported to health officials.
The first case of the illness at the Dimondale center surfaced early last week. It reached its peak at about 15 new cases a day late last week, Sienko said. There have been only 2 new cases in the last couple of days. Sparrow spokesman Russ Leonard-Whitman said the nursing center continues to restrict visitors' access. Officials also are maintaining strengthened hand-washing measures at the Dimondale facility and requiring workers to change into work clothes when they arrive and change back before they leave.
[Byline: Adam Emerson]
******
[2]
Date: Wed 18 Dec 2002
Source: The Columbian, Tue 17 Dec 2002 [edited]
<http://www.columbian.com/12172002/clark_co/344496.html>
British Columbia: Norovirus Infection May Be Moving to Battle Ground
--------------------------------------------------
Southwest Washington Health District officials said 2 residents of Parkway North Care Center were experiencing vomiting, diarrhea and other symptoms indicative of norovirus-like virus infection on Mon 16 Dec 2002. The health district is working with Parkway North to deal with the illness as well as conducting a full inspection of its food preparation facilities.
A similar sickness has sprinted through four Vancouver assisted living centers since before Thanksgiving. The Health District has tallied 328 cases of [suspected norovirus illness] at the 4 centers since the first sick call. The good news: The Vancouver portion of the outbreak has slowed considerably. Just one resident and 2 staff at Bridgewood at Four Seasons Retirement and Assisted Living Community were added to the sick list over the weekend. Only one additional resident at Rose Vista Nursing Center has contracted the illness since Friday.
Both the Van Mall Retirement Community and Hampton Alzheimer's Community, meanwhile, escaped the weekend with no additional cases. Each dealt with close to 100 norovirus infection sufferers among staff and residents earlier in the outbreak.
[Byline: Ken Olsen]
******
[3]
Date: Thu 19 Dec 2002
Source: CNN News online, Thu 19 Dec 2002 [edited]
<http://www.cnn.com/2002/US/12/19/flu.carrier/>
Viral Gastroenteritis Outbreak On Board Aircraft Carrier
--------------------------------------------------
Hundreds of sailors on board the [aircraft carrier] USS Theodore Roosevelt [have contracted viral gastroeneteritis] during exercises in the Atlantic, U.S. Navy officials said. When the virus [infection] peaked about 4 days ago, it affected at least 300 of the more than 5000 crew members stationed aboard the ship. Navy officials said they were initially puzzled as to the cause of the widespread sickness, but the answer came after blood samples were flown for testing at the U.S. naval base in Norfolk, Virginia. The samples showed the crew had a [viral gastroenteritis]. At no time was the ship quarantined, Navy officials said.
Medical teams aboard the carrier treated the cases with the usual rest and plenty of fluids, and those not afflicted were told to wash their hands to prevent spreading the outbreak. Officials said that the outbreak seems to be under control and that many of the stricken sailors are back at work. The spreading of viruses aboard ships is common because of the close quarters the sailors keep, though it is not known why this outbreak was so widespread, a Navy official said.
--
Dan Moynihan
Staff Engineer
VIMS Operations
University of Arizona
Tucson, AZ
******
[4]
Date: Thu 19 Dec 2002
Source: Newsday online, Thu 19 Dec 2002 [edited]
http://www.newsday.com/news/local/longisland/ny-livirus1218,0,6067474.story?coll=ny-linews-headlines
Norovirus Infection Hits 2 Long Island Hospitals
--------------------------------------------------
The virus responsible for ruining the vacations of hundreds of cruise ship passengers in recent months is now believed to be sickening patients at 2 Long Island hospitals. Several wards at Nassau University Medical Center (NUMC) and St. Charles Hospital have been closed off to new patients to prevent the spread of what may be a norovirus infection. "Just like the cruise ship where people came to the cruise ship with the virus, we believe the same situation is occurring here," said registered nurse Maria Ninivaggi, director of NUMC's infection control division. "It's a unit with a confined space with a confined number of patients and it has spread among them."
Doctors suspected something was wrong at NUMC in East Meadow on Tuesday after noticing several patients in the 14th floor psychiatric unit vomiting or experiencing diarrhea. Ninivaggi said 19 patients are now believed to have the virus. Its source is unknown.
The genesis of the outbreak is similar at St. Charles Hospital in Port Jefferson, where patients in 2 rehabilitation wards came down with a gastrointestinal illness on Friday, and officials soon closed the wards off to new patients. So far 21 people have fallen ill, but since those with the virus usually recuperate within 2 to 3 days, all have recovered but one, said Kim Kubasek, vice president of administration at St. Charles. One ward reopened yesterday, and the other is still closed since that patient is considered infectious. It should reopen by the weekend, Kubasek said.
Norovirus infection is no stranger to hospitals, day care centers, nursing homes, restaurants or cruise ships. Each year, it affects 23 million people, requiring hospitalizations for 50 000 of them, according to the Centers for Disease Control and Prevention. Although most of the time there are no long-term health consequences, there are 310 deaths annually, according to the CDC.
Officials from both Long Island hospitals stressed that their cases are all mild, and that the wards are being scrubbed down and sterilized to prevent further transmission. "Obviously someone from the community introduced it to the hospital," said Dr. Patricia Dillon, medical director of epidemiology and disease control at the Suffolk County Department of Health. "It could have been a disaster that spread to the whole hospital. But their infection control measures were effective."
Dillon said no other hospitals in Suffolk reported a similar outbreak, and this is the first outbreak this year in the county of what is believed to be a norovirus infection. Nassau County health officials said they couldn't comment and deferred questions to the state Department of Health, which did not return several calls.
[Byline: Dawn MacKeen]
******
[5]
Date: Thu 19 Dec 2002
Source: Star Tribune online, Thu 19 Dec 2002 [edited]
<http://www.startribune.com/stories/1556/3542258.html>
Norovirus Infection Widespread in Minnesota
-------------------------------------------
State health officials said an unprecedented 25 outbreaks of illness afflicting as many as 1000 people have been attributed to norovirus infection since 1 Nov 2002. The illness causes intense vomiting, cramps and diarrhea usually for one or 2 days. Around the state, doctors say clinic waiting rooms are filled with people suffering from these symptoms. The illness has struck hundreds of students at Mounds View High School and members of 2 professional sports teams. About half of the Minnesota Wild developed norovirus infection symptoms last weekend, said spokesman Aaron Sickman.
"[The infection] is everywhere," said Dr. Brad Benson, an internist and pediatrician at the University of Minnesota Primary Care Center in Minneapolis. Health officials said noroviruses typically make the rounds in winter. The illness also has sickened people in Canada and other Midwestern states and on cruise ships; a sign that the virus outbreaks are widespread. Health officials say it's not clear why this is a bad year for these viruses, but they added that cruise-ship outbreaks probably are the result, not the cause, of increases in norovirus-associated illnesses everywhere. The U.S. Centers for Disease Control and Prevention estimate that noroviruses cause 23 million cases of stomach illness each year.
[Byline: Jill Burcum]
******
[6]
Date: Thu 19 Dec 2002
Source: Anchorage Daily News online, Thu 19 Dec 2002 [edited]
<http://www.adn.com/front/story/2346589p-2402346c.html>
Norovirus Infection Has Become widespread in Alaska
--------------------------------------------------
The outbreak of gastroenteritis reported last week in Ketchikan is being reported in other Alaska cities, including Anchorage, and health officials think more outbreaks are possible as people spread the virus through their holiday travels. As of Wed 18 Dec 2002, similar outbreaks infecting hundreds of Alaskans have cropped up at a U.S. Navy camp near Ketchikan, among members of a dance troupe in Juneau, as well as students in Craig and children attending a day care center in Anchorage, according to the state Section of Epidemiology. All of the outbreaks are probably caused by a norovirus, which is thought to be the most common cause of gastrointestinal illness in the United States, epidemiologists said.
So far, state medical authorities have confirmed only 2 cases of norovirus infection , in samples taken from children connected to the Anchorage day care center. Stool samples from Ketchikan and Juneau have been sent to the Centers for Disease Control and Prevention in Atlanta, but results are not available yet, Alaska epidemiologists said. The 2 positive cases from Anchorage are similar to the virus strains detected on recent cruises, the state epidemiology office said. Dr. Joe McLaughlin, who helped investigate the cases in Ketchikan, said medical investigators working there didn't identify anyone who had been on the ships or had known someone who had.
In Alaska's outbreaks, 2 people were hospitalized in Ketchikan, but no deaths were reported, epidemiologists said. People do not have to be traveling on ships to get the virus, however. Sue Anne Jenkerson, state nurse epidemiologist, said people can get the virus through food, water and possibly through air. It's passed person to person -- the route likely to blame for the recent outbreaks in Alaska, she said. The current round can be traced to back to early October, when more than 20 children and staffers at an Anchorage day care became ill, epidemiologists said.
A public health nurse reported that more than 75 elementary students missed school in November due to similar symptoms in Craig, a small community northwest of Ketchikan. During the same month, the first case of gastroenteritis was reported in the Southeast Alaska Acoustic Measurement Facility, which is a naval camp near Ketchikan. Within days, more people connected with the camp came down with the illness. Someone connected with the base is also a teacher at a Ketchikan school where there was a high absentee rate connected to related illnesses. That person may have helped spread the virus into the school, McLaughlin said. To date, at least 225 people living near Ketchikan have come down with symptoms typical of Norwalk-like virus. 18 dancers or chaperones with a Juneau troupe became ill between 6 and 10 Dec 2002. They had traveled by ferry to Wrangell and may have been exposed to the virus on board, epidemiologists said. As a result, the state Department of Environmental Conservation got involved.
Food safety and sanitation inspectors contacted the Wrangell hotel where the troupe stayed and the school where they performed.
[Byline: Ann Potempa]
******
[7]
Date: Thu 19 Dec 2002
Source: The Union Leader online, Thu 19 Dec 2002 [edited]
<http://www.theunionleader.com/articles_show.html?article=16677>
New Hampshire: Norovirus Outbreak Affects Nursing Home
--------------------------------------------------
An epidemic of what is believed to be norovirus infection has caused nearly 50 residents and workers at a local nursing home to become ill. The first symptoms were reported on 10 Dec 2002. Since then, about 48 people associated with Integrated Health Services, Peabody Road, have reported cases of stomach cramps, diarrhea, loose stool and vomiting. "We have had some cases of mild gastrointestinal illness," said Jose Montero, chief of New Hampshire's Office of Disease Control. "Preliminary reports show that it is a norovirus infection." By last Saturday, about 10 residents and workers each day were experiencing different symptoms at the 112-bed nursing home. The incident was reported to state health officials last week by the nursing home's administrator, Gary DiPietro.
The preliminary test results revealing norovirus infection are now in the process of being confirmed by the Centers for Disease Control and Prevention. Noroviruses spread quickly in closed areas such as nursing homes, according to Montero, who said the Derry nursing home is one of "several" elderly-care facilities in the state currently experiencing this epidemic. He would not say how many other facilities or what state
organizations are dealing with the illness, but did say the virus often appears at this time of year. While it is still not clear what caused the epidemic in the local nursing home, Montero said the infection was most likely carried into the facility by a visitor who may have contaminated the surface of food or other items. Some employees at the nursing home have suffered symptoms of the virus, and have been asked to stay home for at least 48 hours after their symptoms disappear, according to Montero.
The home is not taking any admissions because of the epidemic, Morris said. All group activities at the nursing home have been suspended, meals are being served in individual rooms, and common areas are not being used. "Residents are being kept isolated," Montero said. As people become healthy again, the nursing home staff will allow some residents to visit with other residents in their rooms if both individuals are showing no symptoms. At this point, no residents have been hospitalized because of the epidemic, said Morris.
[Byline: Kimberly Houghton]
*****
[8]
Date: Thu 19 Dec 2002
Source: Toronto Star online, Thu 19 Dec 2002 [edited]
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Arti
cle_Type1&c=Article&cid=1035775742888&call_pageid=968332188774&col=968350116467>
Hospitals in Ontario Affected by Confirmed Norovirus Infection
--------------------------------------------------
Health Minister Tony Clement is advising many Ontarians to call the province's nursing hotline if they suspect they have [a norovirus infection] rather than going to hospitals, which are struggling with outbreaks of norovirus-related disease. He made the plea yesterday at a news conference where he was marking the one-year anniversary of the Telehealth Ontario service. "Our best advice is that if you have the
standard symptoms of norovirus infection and you are a person of average health, then certainly, at least in the first instance, phone Telehealth Ontario," he said. The nursing hotline offers free medical advice around the clock and can be reached by phoning 1-866-797-0000.
There are currently 11 Ontario hospitals with confirmed cases of the virus and 42 more with suspected cases, according to the health ministry. The Scarborough Hospital, Grace site, has been forced to close its critical care and palliative care units because of the virus. The Bloorview McMillan Centre has also closed a unit. Humber River Regional and Salvation Army Grace are the only other hospitals in the GTA with confirmed cases of norovirus infection .
[Byline: Theresa Boyle]
--
ProMED-mail
[It is now the turn of the USA to experience -- report? -- widespread norovirus infection in hospitals, health-care facilities, and nursing homes. This second "Viral gastroenteritis update" is posted early to accommodate this developing situation. Please note that these reports are edited to replace "flu-like", "Norwalk-like", "bug" with the ICTV approved designation "Norovirus" for the agent responsible for this form of viral gastroenteritis. - Mod.CP]