You may know it as the “cruise ship virus,” a gastrointestinal illness that most commonly strikes passengers at sea. However, the medical term for this pesky stomach bug is called norovirus, and it has sickened nearly 100 people and resulted in the quarantine of at least 1,000 more ahead of the 2018 Winter Olympics in PyeongChang, South Korea.

According to the Centers for Disease Control and Prevention (CDC), norovirus is very contagious and can be transmitted from an infected person, contaminated food or water, or by touching contaminated surfaces. It is notorious for causing outbreaks with people in close quarters like cruise ships or children’s daycare centers.

HCA Today sat down with HCA Healthcare’s President of Clinical Services and Chief Medical Officer, Jonathan Perlin, MD, to learn more about the illness that has sidelined security guards and others at the Winter Olympic sites.

What is norovirus?

It is a viral infection that causes your stomach or intestines—or both—to get inflamed, resulting in stomach pain, nausea, vomiting and diarrhea. Norovirus is sometimes referred to as the “stomach flu,” but it is not associated with influenza or influenza viruses. It is most common in the winter, although you can catch the virus anytime of the year.

How many people are affected by it each year?

In the United States, norovirus is estimated to cause up to 21 million illnesses annually. According to the CDC, 90 percent of diarrheal disease outbreaks on cruise ships are caused by norovirus, and it is the leading cause of outbreaks of food-borne illness in restaurants and salad bars in the nation.

Who is typically affected by norovirus?

Young children are most likely to be affected by the gastrointestinal illness. Norovirus is among the leading causes of medical visits for young children.  In fact, most children will have experienced at least one infection by age 5.

How long does it take to run its course?

People generally start experiencing symptoms 12–48 hours after exposure. And those symptoms usually start with vomiting and diarrhea. Other symptoms include abdominal cramps, nausea, and sometimes a low-grade fever. The symptoms last 1-3 days for most patients.

How do you catch it?

Norovirus is highly contagious, and is principally spread by contact with stool or vomit from an infected person. It can spread by:

  • Direct person-to-person contact, especially in the setting of inadequate hand hygiene.
  •  Indirectly, via contaminated surfaces, objects, food or water;
  • Contamination through shared food, food prepared in an unsanitary manner, or where drinking water is inadequately treated;
  • “ready-to-eat” cold foods, such as sandwiches and salads, or
  • contaminated water concentrated within raw shellfish such as oysters.

How is it diagnosed and treated?

Laboratory testing of stool specimens can be used during outbreak investigations by public health agencies, however, norovirus is generally diagnosed based on an individual’s symptoms. Since it is a virus, antibiotics aren’t useful for treatment. Most people recover by staying hydrated throughout the duration of the illness. In some cases, dehydration, especially in patients who are very young or elderly, may require medical attention.

How can we protect ourselves?

The best protection against the spread of norovirus is through frequent and proper handwashing, which means washing your hands with soap and water for at least 20 seconds. Alcohol-based hand sanitizers may be useful between hand washings but should not be considered a substitute for soap and water.

In addition to handwashing:

  • clean up fecal matter or vomit carefully and disinfect contaminated surfaces and toilet areas, and
  • wash soiled clothes or bedding at the maximum available cycle length and highest machine temperature setting for both washing and drying.

While Olympic athletes reportedly have not yet been affected by the virus, organizers are raising awareness and undergoing preventative measures to help prevent its spread. We encourage our readers to do the same.

norovirus

Dr. Jonathan Perlin is the president of clinical services and chief medical officer at HCA Healthcare, headquartered in Nashville, Tenn.