Reusable Shopping Bag Helped Spread Stomach Bug

woman in the fetal position on the bathroom floor

Note to self: Do not store shopping bags in bathrooms.

Note to green activists: You may be facing a bit of an image problem for those environmentally virtuous cloth shopping bags. Though I suppose this could have happened with a plastic bag, too.

Now to the story: NPR and the Los Angeles Times report today that a contaminated shopping bag left in a hotel bathroom caused the spread of norovirus — the highly contagious stomach bug — among a girls’ soccer team this fall. They cite an article by Oregon researchers in the Journal of Infectious Diseases. From the LA Times:

The investigation showed that the virus was found on a reusable grocery bag that had been used to store snacks for the team. It had, unfortunately, been stored in the bathroom. When the sick girl used the bathroom, the norovirus was aerosolized and deposited on the bag, where it was later transferred to other girls when they got snacks.

“While we certainly recommend not storing food in bathrooms,” Repp and Keene wrote, “it is more important to recommend that areas where aerosol exposures may have occurred should be thoroughly disinfected; this includes not only exposed surfaces, but objects in the environment” such as grocery bags.

The paper’s authors also suggest: “When feasible, we recommend dedicated bathrooms for sick persons and informing cleaning staff (professional or otherwise) about the need for adequate environmental sanitation of surfaces and fomites to prevent spread.”

For more advice on preventing norovirus: How to outsmart the stealthy stomach bug.

CDC: Deaths Rise From Serious Stomach Bugs, Mainly In Elderly

Clostridium difficile colonies after 48 hours of growth on a blood agar plate. (Dr. L. V. Holdeman/CDC)

Clostridium difficile colonies after 48 hours of growth on a blood agar plate. (L. V. Holdeman / CDC Public Health Image Library)

This just in from the CDC: Between 1999 and 2007, deaths from stomach inflammation more than doubled — mainly because of virulent new strains of a bacteria called C. difficile. The hugely common norovirus also killed several hundred people a year out of the 20 million it infected. The vast majority of those who died were over 65.

One of our most popular recent posts was Aayesha Siddiqui’s primer on How to Outsmart The Stealty Stomach Bug — I think I’ll read it again right now. From the CDC:

The number of people who died from gastroenteritis (inflammation of the stomach and intestines that causes vomiting and diarrhea) more than doubled from 1999 to 2007, according to a study by the Centers for Disease Control and Prevention. The findings will be presented today at the International Conference on Emerging Infectious Diseases in Atlanta.

Over the eight-year study period, gastroenteritis-associated deaths from all causes increased from nearly 7,000 to more than 17,000 per year. Adults over 65 years old accounted for 83 percent of deaths. Clostridium difficile (C. difficile) and norovirus were the most common infectious causes of gastroenteritis-associated deaths. Continue reading

Hand Sanitizers: Are They Really Worth It?

By Aayesha Siddiqui (@aayesha)
CommonHealth Contributor

Last week I posted about norovius, a common and contagious virus that sends people scurrying for the bathroom. One of the take home lessons was the importance of routinely washing your hands, whether you’re sick or healthy.

But then came the inevitable question: What about hand sanitizers? Won’t they work?

You’ll find wall dispensers full of alcohol-based liquids, gels, and foams outside elevators, in public bathrooms, all around the hospital even. Parents send their kids to school with mini-bottles of the stuff. One of our readers commented, “I keep one in my car to apply after being in public places like stores and supermarkets…thought I was getting rid of the germs.”

Our reader is getting rid of a lot of germs—but not all of them.

The Science Behind the Sanitizer

If you look at the active ingredient on the back label of your hand sanitizer, you’ll most likely find it’s ethyl alcohol (a.k.a. ethanol, the same alcohol that’s in your glass of wine or in your spray of perfume) or isopropyl alcohol (a.k.a. isopropanol, but you probably know it as rubbing alcohol). The bottle should also say that it’s between 60% to 95% alcohol (the concentration that’s most effective in killing off most germs).

So, how does the alcohol actually work? Think of a germ as having a well manicured hair-do. Continue reading

How To Outsmart The Stealthy Stomach Bug

woman in the fetal position on the bathroom floor

By Aayesha Siddiqui (@aayesha)
CommonHealth Contributor

“I threw up lunch for some reason,” my friend casually texted one recent afternoon.

It didn’t stop there: Hours later, he was bolting to the bathroom. “Diarrhea…the worst!” he moaned. His experience pales in comparison to that of my coworker’s friend who, while at a swanky New Year’s Eve party, fell victim to an unexpected and violent episode of vomiting. She recounted the horror: “The floor was wood — oak, as I recall — and scattered with gorgeous area rugs…The best I could do was aim for the floor between them.”

They’re not alone. Boston’s emergency departments have seen a recent increase in people with vomiting and diarrhea. The Boston Public Health Commission (BPHC) counted 287 emergency department cases just in the week between Christmas and New Year’s. New York is seeing a similar trend: the New York City Department of Health and Mental Hygiene reports that, over the two week holiday period in late December, there was a 50% increase in emergency department visits for vomiting and diarrhea compared to the fall months.

But let’s not panic just yet; this isn’t anything too out of the ordinary. Take a look at the BPHC graph below. You’ll notice that these emergency department cases of acute gastrointestinal illness (the medical name for all those trips to the bathroom) peak during the winter months:

So, what’s making so many gastrointestinal systems go haywire?

Well, there are lots of pathogens — viruses, bacteria, parasites — that could be the culprits, but there is one that stands out: norovirus. In fact, just in the last month, Minnesota, Iowa, and California have all had norovirus outbreaks.

According to the CDC, norovirus causes over 20 million cases of viral gastroenteritis every year. Continue reading

The Norovirus Buffet: 13 of 19 Guests Sickened

Local public health officials report a recent uptick in norovirus — a.k.a stomach flu, and I suspect much of it was centered at the home of my friend and co-author, Beth Jones. She kindly agreed to write up her sorry tale:

Missy is cute, blond, sweet, and four years old. She doesn’t look like a vector. But she initiated such a path of norovirus destruction at our Christmas party that it will forever be remembered as: The Party Where (Almost) Everyone Got Sick. Really, really, sick.

We had friends, a delicious buffet, mulled cider and spiced eggnog. Children ran through the house in dress-up costumes. The tree twinkled, conversations hummed. It was the lovely party we’d hoped for.

At the end of the day, Missy sat on the bottom of our staircase and complained that her stomach hurt. It was no surprise; the kids had been been playing for hours, eating on occasion. Picking up food, tasting it, putting it down. If I were to make a guess, my very unscientific norovirus research would lead me to that act of picking up and putting down. I’d wager that an infected half eaten snickerdoodle or a slice of smoked ham nibbled and abandoned by Missy was the cause of everything that followed.

According to the CDC, people can become infected by the highly contagious norovirus in a variety of ways including “direct contact with an infected person… when sharing food, drinks, or eating utensils…” Our luscious buffet was the likely vehicle for a fast-moving virus.

The party was on Saturday. The norovirus has a 48-hour incubation period. By Monday, Missy was in Children’s Hospital Boston receiving intravenous fluids; she couldn’t even drink water without vomiting. Her mother could barely get out of bed. Two friends mistakenly thought they had food poisoning. Another guest thought the mulled cider had caused her to throw up. Like dominos, nearly everyone was slammed by the virus, knocked down and lying flat in bed or crawling to the bathroom. Thirteen of the 19 people at our party were sick within two days of the holiday festivities. Continue reading

Stomach Flu At BU: We Report It On HealthMap

Normally, we wouldn’t make it a news item that there’s an uptick of vomiting and diarrhea at Boston University, centered at Warren Towers.

But it seemed like that information from the BU Student Health Services could serve as a good example for how we can all use HealthMap, the new sickness-tracking service that is a joint project between CommonHealth and Children’s Hospital Boston.

The BU health service writes that “It seems most likely that this does not represent a food-borne illness. The clinical presentation is possibly consistent with Norovirus. Gastrointestinal illnesses can be caused by viruses and/or bacteria (among other things). Both of these causes are contagious.”

So here’s what I did. I went a little ways down the right-hand bar of CommonHealth, and clicked on the HealthMap picture. At the lower left, I clicked on “Post a Report.” Then on “Provide an eyewitness report.” For a headline, I wrote “Possible Norovirus at Boston University’s Warren Towers.” I clicked on Norovirus from the drop-down menu of diseases, wrote “Boston University” for the location, gave my email and for the description, wrote “vomiting and diarrhea among students.” Clicked submit and was told “Thank you for your report!” Because it comes from a non-official source, it will take a day or so to be vetted, but then should appear on the map.

Why bother? Well, wouldn’t you want someone to do the same for you? And when you know that something is going around, that gives you the chance to up your prevention efforts, or if you do catch it, to be prepared with knowledge about treatments. For example, at B.U., the Health Service reported:

Prevention is key in such situations.

* Wash your hands frequently, particularly after using the bathroom and before eating or preparing food.
* Avoid those who are ill, if possible.
* Clean high touch surfaces in your room with anti-bacterial cleaner (Clorox wipes).

For the past two days, custodial staff has increased cleaning efforts in residence halls around campus, particularly in Warren Towers. We have also implemented increased infection control measures in the dining halls.