PATHOGENPATHOGENThePerfect Human

Highly Contagious

DiarrheaThe Norovirus alters

the intestinal lining, causing cells to dump

fluid, which gets washed out of the body along with many, many,

many noroviruses.

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

each GRAM of feces contains around 5 BILLION noroviruses ready to INFECT a new host.

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

but it only takes about 20 VIRUSES to establish an infection.

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

Highly ContagiousVomitNoroviruses 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

when that STORED FOOD comes flying out of the mouth, it provides a vehicle for noroviruses to SPREAD.

EasilySpread

AirborneNoroviruses easily

float through the air and settle on

surfaces like food, countertops, sinks or

toilets.

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

Tougher ThanBear GryllsFreeze, Cook or Clean

noroviruses survive both freezing and heating and resist many common chemical disinfectants.

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

noroviruses can SURVIVE on surfaces for up to 2 WEEKS.Maybe even years in still water

http://blogs.scientificamerican.com/artful-amoeba/2012/01/17/misery-inducing-norovirus-can-survive-for-months-perhaps-years-in-drinking-water/http://www.sciencedirect.com/science/article/pii/S0168160505005854

RapidEvolution

Limited Immunitynoroviruses are genetically diverse and evolve 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’t Kill 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

1 car dealership1 Infected toddler

1 baby changing stationSeveral Billion Noroviruses

2 big packs of dry paper towels 16 employees (12 sick)

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

Recipe for an Outbreak

Directions:

1. Bring an infected toddler to car dealership and liberally spray baby changing station with feces. Leave the mess for a dealership employees to cleanup.

Recipe for an Outbreak

Directions:

2. Clean up the baby changing station using only dry paper towels. Leave some infected feces (with billions of noroviruses) visible on the baby changing station. For additional outbreaks leave the feces visible for weeks.

Recipe for an Outbreak

Directions:

3. Return to the meeting, touch surfaces, handle food and infect 75% of your co-workers

Treatment

NOTHING!•antiviral drugs•vaccine•time •plenty of fluids

Dehydration is the most common complication and in severe cases can require IV fluids.

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

But it is possible to PREVENT Norovirus outbreaks.

Prevention

The best way to help prevent norovirus is

to 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 all nearby 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 contaminated surfaces

Prevention

Rinse thoroughly with plain water

Wipe dry with paper towels

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

Clean contaminated surfaces

But DON’T STOP here. Norovirus can survive on surfaces after cleaning

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 air dry 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

Norovirus BREAKS BAD millions of times each year

More CommonThan the Cold?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 Big Deal?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 common than you thinkA.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

The first identified OUTBREAK was in 1968 at Bronson Elementary school in NORWALK Ohio

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

That’s why it’s sometimes called NORWALK VIRUS.

Norwalk virus is the species, where as norovirus is the genus (but there’s only one known species in the genus anyways).

Discovery

The 1968 outbreak of gastroenteritis at Bronson Elementary school in Norwalk Ohio prompted a lot of scientific study. But it wasn’t until 1972 that Dr Albert Kapikian discovered 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/

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