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 Prof.Dr. Mustafa ALTINDIS            

Güncelleme: 14.01.2009

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Norovirus Noroviruses are estimated to cause 23 million cases of acute gastroenteritis (commonly called the "stomach flu") in the U.S. each year, and are the leading cause of gastroenteritis. Of viruses, only the common cold is reported more often than viral gastroenteritis (norovirus).

Noroviruses may cause more outbreaks of foodborne illness than all bacteria and parasites. They can cause extended outbreaks because of their high infectivity, persistence in the environment, resistance to common disinfectants, and difficulty in controlling their transmission through routine sanitary measures.

The norovirus is transmitted primarily through the fecal-oral route and fewer than 100 norovirus particles are said to be needed to cause infection. Transmission occurs either person-to-person or through contamination of food or water. Transmission can occur by touching surfaces or objects contaminated with norovirus and then placing that hand in your mouth; having direct contact with another person who is infected and showing symptoms; sharing foods or eating utensils with someone who is ill; exposure to aerosolized vomit; and consuming food contaminated by an infected food handler.

The virus is shed in large numbers in the vomit and stool of infected individuals, most commonly while they are ill. Some individuals may continue to shed norovirus up to two weeks after they have recovered from the illness.

Symptoms of Norovirus infection

Usual symptoms of norovirus infections include nausea, vomiting, diarrhea, and abdominal pain. Headache and low-grade fever may also accompany this infection. The illness is usually mild and brief. It will develop 24 to 48 hours after exposure and lasts for 24 to 60 hours. Recovery usually occurs in two to three days without serious or long-term health effects. Immunity is not permanent and reinfection can occur.

Diagnosis and treatment for Norovirus

Laboratory diagnosis is difficult. Diagnosis is often based on the combination of symptoms, particularly the prominence of vomiting, little fever, and the short duration of illness. Actual proof of infection requires research laboratory techniques in which norovirus particles are identified by electron microscopy from samples of stool or vomitus.

No specific treatment is available. Persons who are severely dehydrated might need rehydration therapy.

Preventing Norovirus infection

The good news about norovirus is that it does not multiply in foods as many bacteria do. In addition, thorough cooking destroys this virus. To avoid this illness, make sure the food you eat is cooked completely. Shellfish (oysters, clams, mussels) pose the greatest risk and any particular serving may be contaminated; there is no way to detect a contaminated oyster from a safe oyster. With shellfish, only complete cooking offers reliable protection.

Wash raw vegetables thoroughly before eating or preparing salads. If you are travelling in an area that appears to have polluted water, drink only boiled drinks or carbonated bottled beverages without ice.

Wash hands with soap and warm water after using the toilet, before preparing or eating food; and after caring for the sick; exclude persons with gastroenteritis from the kitchen; and always dispose of sewage in a sanitary manner.
http://www.noroblog.com/2007/01/articles/norovirus-information/about-norovirus/print.html 

Is this a new outbreak?

Current situation in UK (December 2008)

Over the last few weeks we have seen an increase in reports of norovirus cases which is typical for this time of the year. In comparison to the same time last year the numbers are slightly lower.Numbers of norovirus fluctuate each year with laboratory reported cases representing only a small fraction of the number of cases that actually occur. This self-limiting infection usually only lasts a few days hence the majority of cases are not reported to the clinician.Norovirus is highly contagious, however, one of the ways to protect against the infection and to help prevent yourself or others becoming infected, is by practicing good hygiene. This includes thorough hand washing after using the toilet and before eating or preparing foods.  All contaminated surfaces should be thoroughly disinfected after any episode of illness. Food preparation should also be avoided by those who have been ill until 48 hours after symptoms have disappeared.Unfortunately there is no specific treatment for norovirus apart from letting the illness run its course, therefore it is important to drink plenty of fluids to prevent dehydration especially in the very young or elderly.It is not unusual to see outbreaks occurring in hospitals, because the virus spreads quickly in confined environments. When an outbreak occurs in a hospital, an incident control team will manage the incident and will implement specific procedures to try and limit the spread of the infection. A study by the Health Protection Agency has shown that outbreaks of norovirus are shortened when control measures at healthcare settings are implemented quickly, such as closing wards to new admissions within 4 days of the beginning of the outbreak and implementing strict hygiene measures.Last reviewed: 12 December 2008.  


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