Norovirus Factsheet

by James Hoskins on 19 Mar 15:29

Norovirus or Winter vomiting disease is the most common cause of infectious diarrhoea and vomiting in the UK. The virus is also called Norwalk virus or Small round structured virus. Norovirus is most common in the winter, but you can catch it at other times of the year.

Highly infectious, outbreaks occur where people congregate in a confined space. Think offices, schools, hotels and cruise ships. Up to 1 million people catch Norovirus every year.

Oh no, I think I’ve got the winter vomiting bug.

When you catch norovirus you may not notice anything for 24-72 hours, this is called the incubation period. Many people suffer severe vomiting, sometimes described as ‘projectile vomiting’. A lucky few don’t puke. You may get stomach cramps and diarrhoea. You will probably feel ill for 24-48 hours and many people feel ‘washed out’ for a few days after symptoms have settled.

It’s important to know that you will remain highly infectious for at least 48 hours after the last visible signs of illness and may still excrete virus for 2 weeks after the illness. Thankfully there are no long term affects from norovirus so you can look forward to a full recovery.

I’ve had Norovirus so I should be safe, right?

Sadly immunity is short-lived. This means that even if you’ve ‘experienced’ the norovirus before you can still catch it again.

I feel awful, can you give me something to make me feel better?

There are no pills to cure you, but your immune system should do a fine job on it’s own. Just make sure you don’t get dehydrated, so drink lots of water.

How do you catch the norovirus?

Norovirus can spread very easily from person to person and only a very small amount of the virus is needed to cause infection. You can catch norovirus by:

• Being exposed to virus in the vomit or diarrhoea of an infected person, most probably as your cleaning up after them.
• Not washing hands after using a contaminated toilet.
• Touching surfaces (such as toilet seats, remote controls, furniture) that have virus on them.
• Food that has been contaminated.**
• Breathing in virus that remains in the air for some time after projectile vomiting.

**According to the Health Protection Agency oysters are a common source of norovirus infection. They become contaminated because of raw sewage in the sea.

Can I stop the virus spreading?

Good hand washing with soap and water is the best way to stop norovirus from spreading. Alcohol handgel does not kill norovirus – well apart from this one – so wash your hands:

• If you touch someone with norovirus.
• After cleaning up vomit or diarrhoea
• After going to the toilet
• Before cooking or eating food

Cleaning products that contain bleach will kill norovirus, so wipe down hard surfaces and objects that may be contaminated.

Keep it to yourself.

If you think you have norovirus please don’t pass it on. Stay at home and don’t come back to work or school for 48 hours after your last visible symptoms have subsided.

Norovirus Comes Back to Town

by James Hoskins on 18 Mar 11:24

My son and I went to a mad scientist birthday party at the weekend, an event notable for some marvellous experiment with eggs, a closely contested game of musical chairs and the arrival of this season’s Norovirus just as the jelly was served.

This little incident prompted me to do a little bit of research on how long you should keep your kids away from school when the winter vomiting bug arrives. A spot of Googling and a visit to the NHS Evidence site led me to a Health Protection Agency’s 2006 “Guidance on Infection Control In Schools and other Child Care Settings” – pdf here. It’s all useful stuff and neatly answers my question:

For Diarrhoea and/or vomiting the recommended period to be kept away from school, nursery or childminders is 48 hours from the last episode of diarrhoea or vomiting.

I wonder how many parents are aware of this guidance and, of those, how many actually stick to it?

The guide also contains some excellent advice on good hygiene practice which, along with keeping sick children isolated, seems to be the best strategy for keeping the Norovirus in check. This is what the HPA has to say:

• Handwashing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting and respiratory disease. The recommended method is the use of liquid soap, water and paper towels. Always wash hands after using the toilet, before eating or handling food, and after handling animals. Cover all cuts and abrasions with water proof dressings.
• Coughing and Sneezing easily spread infections. Children and adults should be encouraged to cover their mouth and nose with a tissue. Wash your hands after using or disposing of tissues. Spitting should be discouraged.
• Cleaning of the environment, including toys and equipment should be frequent, thorough, and follow national guidance e.g. use colour coded equipment, COSHH, correct decontamination of cleaning equipment. Monitor cleaning contracts and ensure cleaners are appropriately trained with access to Personal Protective Equipment PPE.
• Cleaning of blood and body fluid spillages. All spillages of blood, faeces, saliva, vomit, nasal, and eye discharges should be cleaned up immediately (always wear PPE). When spillages occur, clean using a product which combines both a detergent and a disinfectant. Use as per manufacturers instructions and ensure it is effective against bacteria and viruses, and suitable for use on the affected surface. NEVER USE mops for cleaning up blood and body fluid spillages use disposable paper towels and discard clinical waste as described below. A spillage kit should be available for blood spills.
• Personal Protective Clothing (PPE). Disposable non powdered vinyl or latex free CE marked gloves and disposable plastic aprons, must be worn where there is a risk of splashing or contamination with blood/body fluids. (E.g. nappy or pad changing) Goggles should also be available for use if there is a risk of splashing to the face. Correct PPE should be used when handling cleaning chemicals.
• Laundry should be dealt with in a separate dedicated facility. Soiled linen should be washed separately at the hottest wash fabric will tolerate. Wear PPE when handling soiled linen. Soiled children’s clothing should be bagged to go home, never rinse by hand.
• Clinical waste. Always segregate domestic and clinical waste in accordance with local policy. Used nappies/pads, gloves, aprons and soiled dressings should be stored in correct clinical waste bags in foot operated bins. All clinical waste must be removed by a registered waste contractor. All clinical waste bags should be less than 2/3rds full and stored in a dedicated, secure area whilst awaiting collection.

Study Claims Twice as Many Diabetics in US Within 25 Years

by James Hoskins on 27 Nov 15:36

By 2034, the number of Americans suffering from Diabetes will almost double and the annual cost of treating the disease will almost triple to $336 billion.

Researchers at the University of Chicago have created a model of diabetes costs that uses existing data on the natural history of the disease and risk factors like obesity to predict how much the disease will cost in the future. The model, published in the Diabetes Care Journal, is designed to be used by government agencies to predict the direct cost of Diabetes treatment in the future. These figures can then be used when assessing the potential costs and benefits of alternative government policies – the kind of initiatives that could reduce obesity.

The study concludes that in 25 years direct annual spending on Diabetes will climb from $113 billion to $336 billion as the number of people suffering from the disease – both diagnosed and undiagnosed – will rise from 23.7 million to 44.1 million. The researchers conclude that “Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system.”

Autism: Children More Likely to Have Handwriting Problems

by Emma Cawkwell on 27 Nov 12:18

Children with autism may have lower quality handwriting and trouble forming letters compared to children without autism, according to a study published by the American Academy of Neurology.

The study included 28 children between the ages of eight and 13. Half of the children had autism spectrum disorder. The other half had no developmental, psychiatric or brain disorders. All of the children scored within the normal range for perceptual reasoning on an IQ test.

The children were given the Minnesota Handwriting Assessment Test, which uses a scrambled sentence to eliminate any speed advantage for more fluent readers. The sentence used on the test was “the brown jumped lazy fox quick dogs over.” Participants were asked to copy the words in the sentence, making the letters the same size and shape as the sample using their best handwriting. The handwriting was scored based on five categories: legibility, form, alignment, size and spacing. The children’s motor skills, including balance and timed movements, were also examined and given a rating.

The research found that half of the children with autism earned less than 80 percent of the total possible points on the handwriting assessment, compared to only one child in the group without autism. In addition, nine of the 14 children with autism scored below 80 percent on the form category of the handwriting assessment, compared to only two of the 14 children without autism.

“Our results suggest that therapies targeting motor skills may help improve handwriting in children with autism, which is important for success in school and building self-esteem,” said study author Amy Bastian, PhD, of the Kennedy Krieger Institute and Johns Hopkins School of Medicine in Baltimore, MD. “Such therapies could include training of letter formation and general training of fine motor control to help improve the quality of their writing.” While overall quality of handwriting was worse in children with autism spectrum disorders, they were still able to align, space and size their letters just as well as children without autism.

Swine Flu Vaccines On The Way

by James Hoskins on 08 Oct 11:13

Clinical trials have begun to determine which of two vaccines will be used in the UK’s national swine flu vaccination programme.

The trial is already under way and over the next few weeks 1,000 children aged between 6 months and 12 years will be given two doses of vaccine. Blood tests will hopefully reveal which vaccine provokes the greatest immune response. Trial co-ordinators will also be on the lookout for side effects although early evidence suggests that these will be mild.

The European Medicines Agency recommended the two vaccines from Novartis AG and GlaxoSmithKline earlier than usual. Both products are still being tested, but the ESA wanted to ensure that a vaccine would be available for the current winter flu season.

Both of the current contenders contain adjuvants, chemical compounds used to stimulate the immune system and increase the body’s response to a vaccine. There is some controversy over the use of adjuvants when vaccinating pregnant women or children – two groups considered to be at risk from swine flu. There is no hard evidence that adjuvants may be harmful, but many countries including the USA and Canada are buying adjuvant free vaccines for pregnant women.

How Do You Catch the Flu?

by James Hoskins on 08 Sep 09:40

It’s 70 years since the Ministry of Health told us that ‘Coughs and sneezes spread diseases’ but we still don’t know the answers to some very basic questions. A new study in Nottingham should help us know more.

When you catch flu, typically your symptoms are more severe at the beginning of the illness and then you get better over a number of days, but how long do you remain infectious? Also, when you’re coughing and spluttering, where does the virus go? What surfaces will it land on and how far will it travel?

Prof. Jon Van-Tam and his team have the enviable task of tracking down and visiting swine flu sufferers. By taking daily swabs they will find out exactly how long sufferers continue to produce the virus. We already know that children excrete more virus than adults and for a longer period of time, this study should tell us how much more and how long.

The team will also be taking samples from surfaces near infected people and also from door handles, kettles and tv remote controls – in fact anything that a sick person might handle. They will also be using special air pumps and filters to sample the air at various distances from infected individuals to see how much virus is floating around and how far it travels. It will be interesting to see how easy it is to catch the flu simply from being coughed on.

Get Fatter to Loose Weight

by James Hoskins on 07 Aug 14:51

Brown fat burns excess glucose preventing it from being converted to white fat and stored.

Researchers at the Dana-Farber Cancer Institute in Boston took naive fibroblastic cells in mice and altered them so they grew into brown fat. Bruce Spiegelman and his team then used positron emission tomography to observe these cells as they burned excess energy.

The hope is that this research will lead to new treatments for obesity and Type II Diabetes.

Original Article in Nature

Cambodian Malaria Now Resistant to Artemisinin

by James Hoskins on 31 Jul 10:38

Artemisinin is currently the first choice for treating Malaria and seemed to be totally effective even against the deadliest strain of the disease. New research published in the New England Journal of Medicine shows that resistant strains of the parasite have emerged in western Cambodia and these strains are now spreading.

Artemisinin is derived from Artemisia annua, also known as sweet wormwood which had been used in Chinese medicine for centuries under the name ‘Qinghaosu’. The drug is normally prescribed in conjunction with other drugs as artemisinin-based combination therapies (ACTs) in the hope that parasites resistant to one drug will be killed by the other.

Swine flu: fever best diagnostic predictor

by James Hoskins on 20 Jul 14:24

The HPA have just published some initial research into the first months of the H1N1 outbreak. Based on the first 252 cases, the disease was most commonly spread through schools and affected young people although age is not a reliable diagnostic predictor.

The findings also suggest the following points as a useful guide to diagnosis:

• Fever was a sensitive clinical indicator, so its absence made swine flu an unlikely diagnosis.
• Dry cough, sore throat, headache and fatigue were common concomitant symptoms.
• A diagnosis of swine flu should be considered in the presence of these symptoms even if there is no known contact with infected cases (7% of cases had had no known contact with cases, even at this early stage of spread).
• Diarrhoea and vomiting were of poorer diagnostic value.

NHS Choices breakdown and original HPA Swine flu paper