Threats Unseen: Beware of Norovirus During an Emergency

Woman clutches her stomach as if feeling nauseous

Natural disasters are unpredictable. Often, we don’t know when or where they will happen or if we will have to leave our homes because of them. Evacuations for hurricanes and wildfires can force people into emergency shelters, where close quarters, shared spaces, and high-touch surfaces can make it easy for norovirus to spread.Graphic that defines norovirus. Text also in body of article.

Norovirus outbreaks occurred in most evacuation shelters in Butte and Glenn counties, Calif., during the Camp Fire in November 2018. Public-health officials identified 292 people ill with acute gastroenteritis caused by norovirus.(1)

A norovirus outbreak among evacuees from Hurricane Katrina in 2005 was also reported in CDC’s Morbidity and Mortality Weekly Report. That outbreak might have affected approximately 1,000 evacuees and relief workers.(2)

What is Norovirus?

Norovirus is a very contagious virus that causes vomiting and diarrhea. Most “stomach bugs” are likely norovirus infections because it’s a relatively common virus. Anyone can catch norovirus from direct contact with an infected person, touching a contaminated surface, or eating contaminated food. It only takes a very small amount of virus particles to make
you sick. The number of particles that could fit on the head of a pin is enough to infect more than 1,000 people.

A person infected with norovirus usually starts to feel ill 12 to 48 hours after they’ve been exposed. The most common symptoms of norovirus infection are diarrhea, vomiting, nausea, and stomach pain. But it can cause fever, headache, and body aches, too.

Be Prepared

Follow the guidance of local officials when going to an emergency shelter during the COVID-19 pandemic. They will tell you when and where to take shelter and what to bring with you.

Act now to prepare “go kits” for family members. Include everyday personal items you cannot do without and other personal protective supplies, such as hand sanitizer with at least 60% alcohol, bar or liquid soap, disinfectant wipes and spray, and at least two masks per person age 2 or older in your household.

If your Emergency Action Plan is to go to a shelter in an evacuation, your kit might also include plenty of nonperishable food, mess kits (e.g., reusable cups, plates, bowls utensils). Also, pack paper towels and disposable plastic gloves to clean up after a sick family member. If you are cleaning up after someone vomits or has diarrhea, use a bleach-based cleaner to prevent the spread of norovirus.

Wash Your Hands

Clean hands are essential to health, whether in an emergency or day-to-day life. Handwashing can keep you healthy and prevent the spread of respiratory and diarrheal infections, like norovirus, from one person to the next. Unseen woman washing her hands with soap in a sink.

Wash your hands thoroughly with soap and water especially after using the toilet or changing diapers; always before eating, preparing, or handling food; and before giving yourself or someone else medicine. Here’s how:

  • Wet your hands with clean, running water (warm or cold) and apply soap.
  • Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under the water.
  • Dry your hands using a clean towel or air dry them.

You can use alcohol-based hand sanitizers in addition to hand washing. But you should not use hand sanitizer as a substitute for washing your hands with soap and water. Hand sanitizers aren’t as effective at removing norovirus particles as washing hands with soap and water.

If you start to feel sick, continue to wash your hands often with soap and water and try to avoid direct contact with others. You should not prepare food for others or provide health care while you are sick, and for at least 2 days after symptoms stop.

Learn More

CDC and state and local health departments help to raise awareness among healthcare providers and the public about norovirus and how to prevent it. Learn more about how they work to prevent and stop norovirus outbreaks.

For more suggestions on how to prepare your health for emergencies, visit https://www.cdc.gov/prepyourhealth/.

Resources

References

  1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6920a1.htm
  2. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a3.htm


Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Anatomy of an outbreak

For Reuters, Manas Sharma and Simon Scarr animated a coronavirus outbreak in Singapore between January and April, going with the force-directed bubble view. It starts small, then there’s the spread, and clusters form.

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New Lab Matters: The promise and challenge of newborn screening in 2019

New Lab Matters cover depicts a newborn baby

Newborn screening is a public health success story, ongoing for 56 years. On the one hand, new treatment and laboratory testing options open up the possibility of expanded screening panels. On the other hand, testing laboratories and follow-up providers are generally under-resourced and straining to keep pace with growing workloads. But as our feature article shows, scientists are working diligently to improve the accuracy and precision of existing tests and to bring on new disorders, even as they continue the high-stakes work of screening tens of thousands of infants a year.

Here are just a few of this issue’s highlights:

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The post New Lab Matters: The promise and challenge of newborn screening in 2019 appeared first on APHL Lab Blog.

3 Reasons Why Handwashing Should Matter to You

Unseen woman washing her hands with soap in a sink.

Most of us are familiar with the parental-like voice in the back of our minds that helps guide our decision-making—asking us questions like, “Have you called your grandmother lately?” For many that voice serves as a gentle, yet constant reminder to wash our hands.

Handwashing with soap and water is one of the most important steps you can take to avoid getting sick and spreading germs to loved ones. Many diseases are spread by not cleaning your hands properly after touching contaminated objects or surfaces. And although not all germs are bad, illness can occur when harmful germs enter our bodies through the eyes, nose, and mouth. That’s why it is critical to wash hands at key times, such as after a flood or during a flu pandemic, when germs can be passed from person to person and make others sick.

Washing hands with soap and water is the best way to reduce the number of germs on them, however during a disaster clean, running water may not be available. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Here are three key reasons why you should always care about handwashing:Your hands carry germs you can't see. Wash your hands.

  1. Handwashing can keep children healthy and in school. Handwashing education can reduce the number of young children who get sick and help prevent school absenteeism.
  2. Handwashing can help prevent illness. Getting a yearly flu vaccine is the most important action you can take to protect yourself from flu. Besides getting a flu vaccine, CDC recommends everyday preventive actions including frequent handwashing with soap and water.
  3. Handwashing is easy! Effective handwashing is a practical skill that you can easily learn, teach to others, and practice every day to prepare for an emergency. It takes around 20 seconds, and can be done in five simple steps:
    1. Wet your hands with clean, running water, turn off the tap, and apply soap
    2. Lather your hands by rubbing them together with the soap
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice
    4. Rinse your hands well under clean, running water
    5. Dry your hands using a clean towel or air-dry them

Promote Handwashing in Your Community

Global Handwashing Day is celebrated annually on October 15 to promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world. This year’s theme, “Clean Hands—A Recipe for Health,” calls attention to the importance of handwashing at key times, such as before eating or feeding others, and before, during, and after preparing food.

Learn how you can get involved and promote handwashing at home, your child’s school or daycare, and your local community:

Pursuing Preprints, Preventing Pandemics: How pre-peer-review posting can accelerate outbreak science | PLOS Research News

0000-0002-8715-2896 Preprints – scientific papers posted online prior to peer review – offer opportunities to share and discuss research rapidly and openly, and Michael Johansson, infectious disease expert and founder of the nonprofit Outbreak Science,

When Preparation Meets Opportunity: Cameroon Gets a Jump on Outbreak Response

 Buea-Regional-Hospital-at-the-foot-of-Mt-Cameroon

When Dr. Aristide Abah stepped off the plane that brought him from Atlanta back to his home in Cameroon, there was no time to waste. An outbreak of H5N1 flu threatened the country, and it was up to Dr. Abah to lead the response.

Fortunately, he was prepared.

Dr. Abah had just spent four months at CDC headquarters as part of CDC’s Public Health Emergency Management Fellowship, which invites public health experts from all over the world to learn how to organize an emergency response in their country.

A deadly threat

In Cameroon, H5N1 was raging in poultry, putting people at risk. The virus can spread to people who come into contact with infected birds, and the result can be devastating. An estimated 60% of people who get the disease, die.

A swarm of activity took place around Cameroon’s response: culling chickens, contact tracing, delivering Tamiflu to people who needed it, providing personal protective equipment (PPE) to workers, and more. The country faced challenges; with over 500 sets of PPE needed each day, animal health workers ran out and had to repurpose supplies that were never used for the 2014 Ebola outbreak.

If they were to stop the deadly virus from spreading to humans, the country needed to act fast and be efficient. For Dr. Abah – and for Cameroon’s public health emergency operations center – it was time to put some newfound knowledge to the test.

From fellowship to field

Dr. Abah leads Cameroon H5N1 response
Dr. Abah leads Cameroon’s H5N1 response

Dr. Abah returned home from his fellowship on a Sunday night. On Tuesday, he stepped in as Incident Manager for the response. On Wednesday, he walked around the room and put nameplates at every desk.

This simple action served two important purposes.

The first was to make sure everyone knew their designated roles. In an emergency, we use an organizational structure called an Incident Management System to assign specific roles and responsibilities to every person. This ensures that everyone knows exactly what they and others are doing.

Nameplates also meant that everyone had an assigned seat, so that people who worked on the same tasks sat near each other. When information has to travel fast, proximity is priceless.

After he organized the people, Dr. Abah organized their time. He set up a system that gave everyone an allotted number of minutes to speak at meetings. He even appointed a timekeeper to help stay on track. “As you may or may not know,” joked Kerre Avery, a CDC Emergency Management Specialist who works closely with Cameroon, “it’s the French custom to talk a lot.”

Dr. Abah also improved the way information traveled, both within the response and outside it.  He adopted the CDC template for daily update slides and situation reports in the EOC, and added a communications team to the incident management structure to help get critical messages out to the public.

For Dr. Abah, these were the opening steps of a wider plan to respond to the crisis. During his fellowship, he had learned the critical importance of planning and organization. “For me, the planning was key,” he said. “I now know that we can’t do anything without a plan.”

Knowledge can’t wait                                                                  

When Dr. Abah first learned of the H5N1 outbreak, he had not yet completed his fellowship, but he knew that the lessons he was learning would help his colleagues back home. He set up an internet-based platform so they could all see and benefit from the lessons. He also reached out with new ideas: “I wanted to speak to higher management,” he said. “I told them they had to have an Incident Manager [in the EOC].”

Cameroon was already getting better and better at responding to health threats. A year ago, it took the country eight weeks to activate their public health emergency operations center in response to a cholera outbreak. Several months later, when Lassa fever erupted, they had reduced their response time to a week. By the time H5N1 appeared in local poultry, it took the country less than 24 hours to activate the PHEOC.

Cameroon’s recent improvements – including their investment in sending Dr. Abah to the fellowship – are all part of a worldwide effort to better prevent, detect, and respond to public health emergencies. And their efforts in preparedness are paying off: during the latest outbreak, there were zero transmissions of H5N1 to humans.

Inspiring lessons

The lessons the Public Health Emergency Management Fellowship teaches are designed to be applied to virtually any crisis situation. Since the 2013 inaugural class, CDC has hosted 39 fellows from 25 countries, giving them important education they can take back and use in their home countries.

While in the U.S., Dr. Abah was particularly inspired by a visit to meet Dr. Nicole Lurie, the Assistant Secretary for Preparedness and Response in Washington, D.C. Her advice to him summarizes perhaps the most important lessons from the fellowship.

“I keep in my memories three words of advice from Dr. Lurie.” Dr. Abah recalls. “Never give up, stay connected, and get better.”

The Public Health Emergency Management Fellowship is implemented by CDC’s Division of Emergency Operations. The program helps countries meet the goals of the Global Health Security Agenda, including having an emergency operations center that can respond within two hours of a public health emergency.

Learn More

 Read our other National Preparedness Month blogs:

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Repost: Where Does Ebola Come From? Communicating Science as a Matter of Life and Death – Part 1 of 2 By Ida Jooste | PLOS SciCommAddThis Sharing Buttons above Editor’s note: In light of yesterday’s confirmation by the Liberian Health Ministry of the death from Ebola of a thirty year-old woman, the first such death since January (2016) when the country was again

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Doctors Without Borders: Don’t wait for Ebola magic bullets

Earlier this week I argued that hand-wringing over the lack of Ebola vaccines and drugs is misguided. We have effective tools to fight Ebola right now.

This week in the New England Journal of Medicine, physicians from WHO and Médecins sans Frontières make a similar argument much more eloquently:

There has recently been immense media, public, and medical attention to specific treatments for Ebola virus infection. Although these experimental interventions represent important potential treatments, they also reflect our seemingly innate focus on developing magic bullets. It seems that focusing on reducing mortality in the existing “control group” by applying the current standard of care is less interesting, even if much more likely to be effective. Though we recognize the potential incremental value of new antiviral options, we believe that EVD requires a greater focus on available basic care…

Public health interventions including characterizing the outbreak epidemiology, contact tracing, social mobilization, and public education are essential steps in stopping Ebola and will ultimately save many more lives than can be saved by individual patient care…

Excellent clinical care and improved outcomes will result in improved community compliance, will help to break transmission chains, and will lead to a greater willingness of health care workers to engage in care delivery. To quote William Osler, “The best preparation for tomorrow is to do today’s work superbly well.”


Filed under: This Mortal Coil Tagged: Disease, doctors without borders, Ebola, Infectious disease, Linkonomicon, medecins sans frontieres, MSF, outbreak, vaccine, who, world health organization

Rare enterovirus in US children: what’s going on?

Recently, a mild-to-severe respiratory illness in children in the Southeast and Midwest United States has been emerging. The US Centers for Disease Control and Prevention (CDC) report that between mid-August and September 11th, 2014, their laboratory has confirmed

The post Rare enterovirus in US children: what’s going on? appeared first on PLOS Blogs Network.