Infectious Diseases

Norovirus Spreading Across Montana

By Courtney Lowery, 1-04-07

I now know what I have to thank for spending the wee hours of Christmas Eve on the floor of the bathroom at my boyfriend's parents' house: The Norovirus, commonly called the Norwalk Virus.

The virus seems to have hit Billings the hardest so far, but it's also going around in 12 other Montana counties, including Cascade, which is where I spent the holidays -- vomiting.

So far, there's only been one case reported in Missoula County, says Pam Goldberg, a registered nurse and the county's infectious disease specialist.

Goldberg says her office is especially concerned about alerting retirement communities and getting the word to food handlers. Gayle Shirley, the spokeswoman for the state Department of Public Health and Human Services echoed what many county health officials are saying: Hand washing with a vigilance and staying home and away from people if you are infected are the best ways to avoid catching and spreading the virus.

As Diane Cochran reports in the Billings Gazette this week, at least five nursing homes in Billings have been hit by the virus, which causes with violent (and I mean violent) vomiting and diarrhea.

State officials say the virus is running a region-wide course and the state health department has asked the Centers for Disease Control and Prevention to test samples of the strain. Because it is not a disease that requires reporting, its hard to tell just how widespread the virus is.

But, Dr. Todd Damrow, an epidemiologist for the state health department tells Cochran that the number of cases is abnormal and his office needs to "spend more time figuring out what's going on."

The virus is commonly spread through what the CDC calls the "fecal-oral route" (which is as nasty as it sounds) -- usually through contaminated food or water or by person-to-person. Goldberg says it can also transmit through the air via vomit particles, but it doesn't go through the respiratory system.

The most effective precaution is again, hand washing, Goldberg says, "incredible, immaculate hand washing."

It's highly contagious and has an incubation period of 24-48 hours (meaning you can start seeing symptoms a day or two days after being exposed), but the CDC Web site says symptoms can come on as early as 12 hours after being exposed. The CDC site also says a sick person starts to "shed" the virus starting when symptoms begin and can continue "shedding" for two weeks after recovery. But, it's unclear how infectious the virus is after 72 hours after recovery.

Speaking of recovery, it's usually pretty quick with a Norovirus. The virus generally lasts about 24 hours but Goldberg says in the worst cases, it can last three days. Once the nausea and vomiting stops, you're pretty much in the clear, but until then, it's pretty terrible. "It's not a fun disease," Shirley said.

The only major complication that can pop up is dehydration because you really are losing an incredible amount of fluid. I think I puked at least 30 times in a matter of 8 hours. (Roughly once every 15 minutes or so.) In some cases -- especially in already compromised patients -- it can require hospitalization for intravenous fluids.

I had suspected my retching was from food poisoning at a local taco shop because literally, I'd never been that sick before from just a bug, but then I also got a fever (which apparently happens sometimes) and creaky joints. Then, my Mom called from her couch about a week later. She told me she finally understood what I meant by "both ends at the same time." That's when I started looking into the Noroviruses.

Noroviruses are a group of viruses named after the original strain of the "Norwalk Virus," which caused an outbreak in 1968 in Norwalk, Ohio. Now, there are about five "genogroups" of the original virus.

The virus has been in the news lately, shutting down the entire San Quentin State Prison in California this week, rising in case numbers in Utah recently and possibly sickening at least 370 Olive Garden diners in Indiana earlier this month.

Besides the dehydration concern and infectiousness of the disease, the virus isn't too worrisome. It's relatively short (but excruciating)-lived and as I mentioned before carries no long-term complications other than having to have your boyfriend's Mom inspect your stool. But, since you're not really able to garner the energy embarrassment would take, it's not that big of a deal. And, long-term, I guess it means I just really am officially part of the family now. Once you've puked in someone's pressure-cooker pot (my boyfriend couldn't find anything else at midnight in his parents' kitchen), you're pretty much bonded for life.

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