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Viral Gastroenteritis Outbreaks in 2014 - Pfister
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Viral gastroenteritis is an infection caused by a variety of viruses that result in vomiting or diarrhea. It is often referred to as "stomach flu," although it is not caused by influenza viruses. Many different viruses can cause gastroenteritis, including rotaviruses; <http://www.cdc.gov/ncidod/dvrd/revb/gastro/rotavirus.htm> noroviruses <http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm> (NoVs); and adenoviruses.
Historically, the majority of Lake County outbreaks occur during the colder months from late fall through early spring, mostly in long-term care or assisted living settings. During 2014, 12 outbreaks occurred in both settings. Five outbreaks were confirmed and caused by NoVs, including one caused by genogroup (G) 1 strain. Seven outbreaks were suspect. Overall, 430 people were affected, including 292 residents and 138 staff. On average in Lake County, 16 outbreaks per year were reported for the time period 2009-2013. The LCHD/CHC Communicable Disease Program and, when applicable, the Food Program investigated each outbreak and provided assistance and guidance to each affected facility.
In the United States, NoVs are the identified source of viral gastroenteritis in more than 50% of foodborne and waterborne illnesses. Worldwide, the GII.4 Sydney 2012 strain is reported as the source of more than 50% of the NoV outbreaks in multiple countries and it continues to spread globally. During the past decade, this strain has mutated roughly every 2-3 years, elevating risk for increased outbreaks and virulence with each change. In the United States, GII.4 Sydney 2012 became the predominant NoV strain implicated in outbreaks during the last four months of 2012.
NoV gastroenteritis is an illness with common symptoms of abrupt watery diarrhea, vomiting, nausea and abdominal cramps. Some cases are asymptomatic, especially children. A very small quantity of viral particles (>10 organisms) is required to cause illness. This infection has an incubation period of 12-48 hours with symptoms lasting from 24-60 hours. NoV illness can lead to severe dehydration, hospitalization and even death in young children, the elderly, and people with other health conditions.
NoVs are transmitted through ill food handlers and preparers, from person to person and by contamination of surfaces through aerosolization of fecal and vomitus particles, improper cleaning of surfaces and poor hand washing technique while acutely ill. This virus can remain viable on surfaces at room temperature for 12-28 days.
Proper hand hygiene, environmental disinfection, and isolation of ill persons remain the mainstays of NoV prevention and control. Hand washing with soap and water for 20 seconds will decrease the risk of illness. These simple measures are the key to preventing this disease and maintaining good health.
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