Norovirus - The Perfect Human Pathogen

7/29/2019 Norovirus - The Perfect Human Pathogen

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PATHOGENPATHOGEN

Perfect Human

Highly

ContagiousDiarrhea

The Norovirus alters

the intestinal lining,

causing cells to dump

fluid, which gets

washed out of the bodyalong with many, many,

many noroviruses.

http://phenomena.nationalgeographic.com/2013/01/02/the-norovirus-a-study-in-puked-perfection/

http://jid.oxfordjournals.org/content/205/11/1622.full

http://www.ncbi.nlm.nih.gov/pubmed/21876931

Highly

ContagiousVomit

Noroviruses hijack

our nervous system to

slow down the passage

of food from the

stomach into the

intestines.

http://www.mdpi.com/1999-4915/2/3/748

Easily

SpreadAirborne

Noroviruses easilyfloat through the air

and settle on

surfaces like food,

countertops, sinks ortoilets.

http://jcm.asm.org/content/48/7/2552

Tougher Than

Bear GryllsFreeze, Cook or Clean

noroviruses survive

both freezing and

heating and resist

many common chemicaldisinfectants.

http://phenomena.nationalgeographic.com/2013/01/02/the-norovirus-a-study-in-puked-perfection/

http://blogs.scientificamerican.com/artful-amoeba/2012/01/17/misery-in ducing-norovirus-can-survive-for-months-perhaps-years-in-drinking-water/

http://www.sciencedirect.com/science/article/pii/S0168160505005854

RapidEvolution

Limited Immunity

noroviruses are genetically diverse andevolve rapidly. That means we’ve only

got a few months of immunity, and then

we’re fair game for another brutal bout

of projectile puking and diarrhea.

http://www.ncbi.nlm.nih.gov/pubmed/16343580?dopt=Abstract

What Doesn’tKill You...

Moderate Virulencenoroviruses are only moderately virulent

allowing a large pool of potential hosts

to survive...and be reinfected.

again.

and again.

and again...

Recipe for an Outbreak

1cardealership

1Infectedtoddler1babychangingstation

SeveralBillionNoroviruses2bigpacksofdrypapertowels

16employees(12sick)

Ingredients:

http://www.micro-blog.info/2013/07/this-is-what-happens-when-norovirus-sprays-from-a-toddler/

http://www.salahqutaishat.com/1/post/2013/07/the-st-hit-the-fan-at-an-auto-dealer-in-oregon.html

http://www.ncbi.nlm.nih.gov/pubmed/23559462

Directions:

1. Bringaninfectedtoddlerto

cardealershipandliberallyspraybabychangingstationwithfeces.Leavethemessforadealershipemployeestocleanup.

Directions:

2. Cleanupthebabychangingstationusingonly

drypapertowels.Leavesomeinfectedfeces(withbillionsofnoroviruses)visibleonthebabychangingstation.Foradditionaloutbreaksleavethefecesvisibleforweeks.

Directions:

3. Returntothemeeting,touchsurfaces,handlefoodandinfect75%ofyourco-workers

Treatment

NOTHING!

antiviral drugs•vaccine

•time

•plenty of fluids

Dehydration is the mostcommon complication and

in severe cases can

require IV fluids.

http://www.cdc.gov/norovirus/about/treatment.html

Prevention

The best way to help

prevent norovirus isto practice proper

hand washing and

general cleanliness.

http://www.cdc.gov/norovirus/preventing-infection.html

Wash Your Hands

Prevention

Remove vomit or diarrhea

right away!

Use soapy water to wash

surfaces that contacted

vomit or diarrhea and allnearby surfaces, such as

door knobs and toilet

handles

http://www.disinfect-for-health.org/wp-content/themes/disinfect/pdfs/NorovirusIncident_8.5x11_Eng_Color.pdf

Clean contaminatedsurfaces

Prevention

Rinse thoroughly withplain water

Wipe dry with paper towels

http://www.epa.gov/oppad001/list_g_norovirus.pdf

Clean contaminatedsurfaces

Prevention

Disinfect surfaces by

applying a chlorine bleach

solution or EPA approved

disinfectant

Disinfect Surfaces

Prevention

Prepare a chlorine bleach

solution (or disinfectant)

Allow disinfectant to airdry for surfaces unlikely

to have food or mouth

contact

Rinse all surfaces

intended for food or mouth

contact with plain water

before use

Disinfect Surfaces

Cleaning and

Disinfection Resources• Restroom Cleaning Procedures

• EPA Approved Disinfectants

• Baby Changing Station Sanitation

Instructions

• Industry Cleaning Tips

More CommonThan theCold?No. But...

Norovirus is the most

common cause of acute

gastroenteritis in

the United States

https://www.osha.gov/Publications/norovirus-factsheet.pdf

So What’s

the BigDeal?

It’s expensive!

•21 million illnesses

•2 million outpatient visits

•400,000 emergency department visits•70,000 hospitalizations

•800 deaths each year

http://www.cdc.gov/norovirus/php/illness-outbreaks.html

It’s more

commonthan youthinkA.G.E.(acute gastroenteritis)

•179 million episodes occur annually

•50% caused by norovirus•NORS started tracking in 2009

•Most illnesses are not tied to a

reported outbreak (1/3000)

http://wwwnc.cdc.gov/eid/article/19/8/13-0482_article.htm

http://en.wikipedia.org/wiki/Norovirus

Discovery

The 1968 outbreak of

gastroenteritis at Bronson

Elementary school inNorwalk Ohio prompted a

lot of scientific study.

But it wasn’t until 1972

that Dr Albert Kapikiandiscovered the virus

behind that outbreak.

http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lid/epidemiologysection/Pages/kapikian.aspx

Dr. Albert Kapikian

What Can

YOU do?Report unclean

conditions

•Report unclean restrooms to management

•Wash your hands regularly•Stay home when you’re sick (really, no need to

be a hero, let someone else finish those TPS reports.)

http://www.salahqutaishat.com/

Photo Attributes• Photo Credit: <a href="http://www.flickr.com/photos/28634332@N05/5654415647/">NASA's Marshall Space Flight Center</a> via <a href="http://compfight.com">Compfight</a> <a href="http://

creativecommons.org/licenses/by-nc/2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/47353092@N00/8102307987/">AJC1</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-sa/

2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/24315793@N02/3010888802/">Reggie Rachuba</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/

by-nc-nd/2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/70591690@N00/2693551009/">ZeroOne</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-sa/

2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/34864797@N07/3473249591/">parkydoodles</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-

nc-sa/2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/10819063@N06/3654276952/">tbSMITH</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/ by-nc-nd/

2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/37129284@N02/5093910979/">greg westfall.</a> via <a href="http://compfight.com">Compfight</a> <a href="http:// creativecommons.org/licenses/by/

2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/35703177@N00/3095149875/">The U.S. Army</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by/

2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/93247490@N00/441858611/">Mark Lobo .</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc-

nd/2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/95492938@N00/81671961/">Kaptain Kobold</a> via <a href="http://co

• mpfight.com">Compfight</a><a href="http: //creativecommons.org/licenses/by-nc-sa/2.0/">cc</a>

• Photo Credit: <a href="http://www.flickr.com/photos/34838158@N00/3370167184/">alexkess</a> via <a href="http://compfight.com">Compfight< /a> <a href="http://creativecommons.org/licenses/by-nc-nd/

2.0/">cc</a>

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Norovirus - The Perfect Human Pathogen

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