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Stomach flu slams St. Judes
Visitors cut-off to prevent spread of Norovirus
St. Jude Care Center, formerly Palm Haven, on East North Street in Manteca is one of six facilities in San Joaquin County experiencing a Norovirus outbreak. - photo by ROSE ALBANO RISSO

Fast facts about Norovirus; Some prevention measures

Facts about Norovirus, previously Norwalk Virus or Norwalk-like or Calicivirus infestions, from the San Joaquin Public Health Department

What is Norovirus infection?

Norovirus causes a gastrointestinal illness. It often occurs in outbreak form and, unfortunately, is sometimes referred to as “stomach flu” though the terms “flu” or influenza should really be restricted to a respiratory infection.

What are Norovirus infections?

The original Norovirus, previously named Norwalk virus, was first identified in 1972 after an outbreak of gastrointestinal illness in Norwalk, Ohio. Later, other viruses with similar features to Norwalk viruses, and therefore called Norwalk-like viruses or “SRSVs” (small round structured viruses”) were identified, cause similar disease, and were classified together as members of the calicivirus family.

Where is Norovirus found?

Norwalk and Norwalk-like viruses are found worldwide. The viruses are passed in the stool and vomit of infected persons.

How soon after exposure do symptoms appear?

Symptoms usually appear one to two days after exposure.

How common is Norovirus infection?

Noroviruses, previously called Norwalk and Norwalk-like viruses, are thought to be the leading causes of food-borne disease in the United States. However, since no routine and easy test is available, the real extent of the disease is not known.

How can Norovirus be prevented?

Wash hands with soap and warm water after toilet visits and before preparing or eating food. People with symptoms of Norwalk-like illness should not prepare food or provide patient care. Cook all shellfish thoroughly before eating. Wash raw vegetables before eating. Custodial institutions need to assure a high level of personal hygiene to avoid person-to-person spread. Caretakers need to increase precautions to avoid transmission, particularly by washing hands frequently and especially before and after patient care.

Family and friends of patients at St. Jude Care Center in Manteca are being advised to stay away for the next few days due to a suspected Norovirus outbreak.

“Visitors are not allowed to come in; we’re advising against it,” said a facility spokeswoman who declined to be identified. She said the outbreak at the 99-bed care home, formerly known as Palm Haven on East North Street, started on Jan. 23.

“It’s a stomach flu. They’re referring to it as a gastro-intestinal thing,” she said.

The San Joaquin County Public Health Department has confirmed the “gastro-intestinal outbreak” at St. Jude but it’s still being determined if the culprit is, in fact, the extremely contagious Norovirus.

“We have not identified the organism; we don’t have the organism yet. We have specimens that we’ll be bringing in and we’ll be testing. The suspicion is Norovirus,” said Ginger Wick, program manager for Communicable Diseases and Tuberculosis.

“There’s a new strain coming to the United States from Australia just recently, but we don’t have any reason to believe that that’s what we have here,” she said.

“Unfortunately, this is very common at this time of year in nursing homes and other congregate-living situations,” Wick said about this particular virus outbreak.

“This is one of the things that we expect every year in nursing homes. I think we have five to six outbreaks going on” throughout the county, she said.

One of those facilities that have been ordered on lock down because of this virus infection is Bethany Home of Ripon with 20 to 30 percent of its residents reportedly being infected. The spokeswoman at St. Jude in Manteca said they don’t have an exact number of patients who are ill.

Two to three weeks to get virus infection under control

It takes two to three weeks to get the Norovirus outbreak under control, “even if (the infected facilities) do everything we tell them to do,” Wick said.

Besides asking visitors to stay out of the facility, those who are working with the patients or residents are advised to “use protective equipment” such as gloves, masks, and gowns. Those who are ill have to be isolated and fed in their own rooms.

“We close the dining room so that we don’t have groups of people together. If somebody vomits in a common area, such as a dining room, the virus can come up and then people can get it by breathing it in.  (The Norovirus) is not an airborne disease, but in that kind of situation, it’s very contagious,” Wick said.

Members of the staff who are ill are “excluded from working until they’re well. They (St. Jude) need to check with their employees every day to make sure nobody is sick,” she added.

Visitors are asked to stay away from the facility during that period because the virus “can be passed on the hands or on a surface,” she said. However, Wick added that “relatives can come in to the facility if they’re going to visit family, but they have to wear gloves, gowns and masks. The facility will help them whatever it is they need to do to see their relatives.”

“This particular facility called us appropriately and is cooperating with us on what needs to be done. They’ve been very cooperative with us,” she said of St. Jude, which is owned by Para and Palli Corporation.

“Everything is going well. We’re hoping to have a handle on this in a couple of days,” the St. Jude spokeswoman said with optimism.

No vaccine or treatment for Norovirus at this time

Unfortunately, said Wick, “there’s no treatment” for the Norovirus at this time.

“All they can do is treat the symptoms, such as vomiting and diarrhea. So if people are infected, you want to make sure you do fluid replacements. You don’t want to use anything like (the over-the-counter pill) Imodium because that keeps the virus in your body. You want to get the virus out,” Wick said. “I know people tend to do that (take Imodium) but we don’t usually recommend people to do that.”

Besides diarrhea and vomiting, the signs and symptoms of Norovirus infection, according to the health department, include nausea, abdominal cramps, and low-grade fever “or none at all.”

A Norovirus infection is “not fatal, usually, but it can be,” Wick said. For individuals who are debilitated, or for people with underlying illnesses, this kind of infection can be fatal, she said.

And, unlike tuberculosis and other prevalent diseases, there is no vaccine yet available to prevent Norovirus infection.

But, said Wick, “I know they’re working on a vaccine. This virus mutates quickly.”

Unfortunately, she added, “we expect this (outbreak) to happen every year. There’s nothing you can do to prevent it other than washing your hands. This is one of the viruses that can easily pass from person to person. Nobody knows where this originally came from,” she said.

Below are some tips on how to avoid being infected with the Norovirus from Wick:

• Wash your hands a lot. Make sure that you wash your hands with soap and water especially after you go to the bathroom and before you prepare or eat food.

• If you’re having Norovirus symptoms – diarrhea and vomiting – it’s better if you don’t prepare food for somebody else so you don’t risk spreading it.

• You want to make sure you wash fruits and vegetables before you serve them.

• Make sure you cook shellfish thoroughly before eating. Why shellfish? It’s because there have been shellfish associated with some outbreak of Norovirus. It’s not common around here, but it can happen. About 20 percent of Norovirus infection is caused by contaminated food.