NORO virus how it is spread, some ideas

[HikerMom58]

Remember the primary way of spreading Norovirus is transmission of feces or vomit from an infected person. You're not likely to contract Norovirus in a stream or spring, but it's possible and anyway you should boil your cooking water (rolling boil, not "fish eyes") anyway for other nasty things that could be there like giardia. Just as importantly, since most of us eat out of the pan we boil our water in, this will help make it more sanitized. Dip your spork/utensils in the water briefly while it's boiling to help make sure they are clean also.

During outbreaks, avoid shelters, shelter areas, and above all privies! Don't share your food or your cookware/utensils or accept any from anyone! Passing the virus from your hands to your mouth is by far the most likely way to get infected!

Carry a disinfecting soap through the outbreak area and beyond for at least a couple of weeks and use it instead of or in addition to hand sanitizer. Good old alcohol sanitizer is still good for other general bacteria. Norovirus isn't the only thing that can get you out there!

When in town, be extra cautious of surfaces which may come in contact with lot's of hikers (bars tops, tabletops) and avoid hiker hostels in the outbreak areas.

Don't panic, but don't be stupid either. Know how the virus is spread, then apply some common sense to minimize your chances of infection.

Good post Prime Time! Let's hope this year will be better than last year. Stay away Noro!

[4eyedbuzzard]

you should boil your cooking water (rolling boil, not "fish eyes") anyway for other nasty things that could be there like giardia. . .
Don't panic, but don't be stupid either. Know how the virus is spread, then apply some common sense to minimize your chances of infection.

Giardia is actually a very temperature sensitive organism and the cysts cannot live long in temps above 130°F according to EPA. It is killed at roughly 170°F if held at or above that temp for 10 minutes. At 185°F or above it is killed within a minute, as are most other things. Heating water to an actual rolling boil is unnecessary as most enteric pathogens are killed at much lower temperatures, and the ones that aren't killed (e.g. Clostridium botulinum) at those temps would require a pressure cooker to heat the water above 212 °F boiling point. Note that the energy required to achieve a rolling boil doesn't make the water any hotter than it was just before it boiled - it serves only to create and then maintain the phase state change from liquid to gas (steam). I would hope this would put at ease most alcohol stove users, who rarely get their water to a rolling boil.

[Prime Time]

Giardia is actually a very temperature sensitive organism and the cysts cannot live long in temps above 130°F according to EPA. It is killed at roughly 170°F if held at or above that temp for 10 minutes. At 185°F or above it is killed within a minute, as are most other things. Heating water to an actual rolling boil is unnecessary as most enteric pathogens are killed at much lower temperatures, and the ones that aren't killed (e.g. Clostridium botulinum) at those temps would require a pressure cooker to heat the water above 212 °F boiling point. Note that the energy required to achieve a rolling boil doesn't make the water any hotter than it was just before it boiled - it serves only to create and then maintain the phase state change from liquid to gas (steam). I would hope this would put at ease most alcohol stove users, who rarely get their water to a rolling boil.

I'm just quoting the CDC which recommends bringing water to "a full rolling boil for 1 full minute" to kill Giardia. Maybe they're just being safe, but disease control is what they do so I guess If I'm gonna post something here, so will I.

[DocMahns]

Bfayer - are you sure about hydrogen peroxide? I heard an ER doctor say that peroxide is nearly useless. His take was that it may be better than nothing but not much more than that.

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The reason why the medical community is pushing away from hydrogen peroxide is because when you clean a wound using it, it kills good healthy/helpful cells as well as opportunistic pathogens. This can lead to delayed wound healing and increase chance of necrosis. Water and a mild soap encapsulate the bad bacteria and wash them away leaving healthy cells in tact and happy. Most of the time we only use an isotonic saline solution to cleanse wounds with no soap or other detergent.

[bfayer]

The reason why the medical community is pushing away from hydrogen peroxide is because when you clean a wound using it, it kills good healthy/helpful cells as well as opportunistic pathogens. This can lead to delayed wound healing and increase chance of necrosis. Water and a mild soap encapsulate the bad bacteria and wash them away leaving healthy cells in tact and happy. Most of the time we only use an isotonic saline solution to cleanse wounds with no soap or other detergent.

I have no idea, but I will take your word for it. Sounds good anyway

I do know all the documentation I have on Noro, says hydrogen peroxide is very effective for cleaning surfaces that may be contaminated with Noro. There are others, but for a hiker, hydrogen peroxide is probably the easiest to deal with. Bleach works well too, but I don't think hikers are going to be washing their hands with bleach everyday.

Hydrogen peroxide wipes are available on Amazon (and other places), and are not expensive. Keep them closed up, and keep them out of the sun.

[Meriadoc]

I spoke to a guy from the Health Department in Erwin (after he had interviewed someone w/ Noro). He told me that you don't gain an immunity from the disease after you catch it. He told me that you are still contagious for a few days after you no longer show symptoms.

Interesting. In 2012 I caught noro in Tennessee along with the bubble. I flip flopped and on my way south ran into the bubble again. Some kind person had brought noro up to Maine too! I caught it a second time. The second time was much easier than the first. I thought it might have been some leftover immunity. But there are so many factors that go into it that I didn't know. It's too bad that there is no immunity gained - that would have been cool.

Oh, and from what I read on noro, you can be contagious for two weeks after the symptoms resolve.
Went and pulled up a source for that: http://www.cdc.gov/norovirus/about/transmission.html
And there I found the following statement:
"Being infected with one type of norovirus may not protect you against other types." That certainly implies that limited immunity is gained.

[4eyedbuzzard]

I'm just quoting the CDC which recommends bringing water to "a full rolling boil for 1 full minute" to kill Giardia. Maybe they're just being safe, but disease control is what they do so I guess If I'm gonna post something here, so will I.

I understand that you are just quoting CDC's (pretty predictable) answer to any question on water purity - boil it. I imagine they are overly conservative as heating water too much isn't going to have a negative health outcome, they aren't the one's carrying or paying for the fuel, nor spending the time doing it, and some in the general public would likely have problems figuring out temperature and/or time. But the reality of what actually needs to be done, of which CDC is well aware as medical/scientific professionals, is far from what they recommend people do, as the chart below from the Infectious Diseases Society of America shows. (link to the chart at their site here http://cid.oxfordjournals.org/conten...expansion.html )

We don't have unlimited sources of energy (fuel) in the backcountry to waste just to create rolling boils and steam to prove we've reached beyond a certain temperature. If CDC made similarly conservative suggestions on such things as sleeping bag temperature ratings, clothing, first aid kit supplies, etc, we might be lucky to leave the trailhead with a pack weight under 50 lbs.

I just wanted to post this so you and/or others here don't think I pull this stuff out of my ***. If you can get water to that pre-boil temp with lots of fish-eyes, it's going to kill everything.

Clin Infect Dis. 2002 Feb 34(3) 355-64, Table 2.jpg

[Heeler59]

Quote: To kill germs water needs to boil for 10 min

Once again, this is a false statement. Water only has to come to a boil.

This is true, water only has to come to a boil. Please read the CDC information. It is the most up to date, and the most accurate. Norovirus is spread in close quarters person to person, usually contaminated food or equipment. It is not coming from water obtained from a running stream.

[1234]

This is true, water only has to come to a boil. Please read the CDC information. It is the most up to date, and the most accurate. Norovirus is spread in close quarters person to person, usually contaminated food or equipment. It is not coming from water obtained from a running stream.

If you are going to quote someone please quote, " To kill germs water needs to boil for 10 min I could not find how long it took for boiling water to kill noro. If someone can answer this please do." I have checked all the links and charts and still have no answer, one chart did have 10 min boil AT 100 degrees C or 212degrees for 10 min to kill one type of virus. Per the chart different germs, virus's and protozoa took different temperatures for different length of time to be killed. NORO was not on the chart. So we have no real answer, we only now know that it is a possibility that it may be killed at a lower temp than a boil.

[1234]

correction "vibrio cholerac takes 100 degrees C for 10 sec" to be killed.

[1234]

quote right off the CDC web page: Norovirus outbreaks have also been caused by contaminated water from wells and recreational settings, such as pools. http://www.cdc.gov/norovirus/trends-outbreaks.html Foods that are commonly involved in outbreaks of norovirus illness are—

• leafy greens (such as lettuce),
• fresh fruits, and
• shellfish (such as oysters).

But, any food that is served raw or handled after being cooked can get contaminated.
To search for foodborne outbreaks caused by norovirus, go to the Foodborne Outbreak Online Database (FOOD).

[1234]

I do not want to lose focus here, I do not want to see another outbreak this year. Best prevention it knowledge. Number one thing everything leads back to is WASH your hands completely with soap and water. If you have hospital grade disinfectant wipes by all means use them. After you use the "rest room" or woods, Wash, prior to putting food into your mouth, wash. It really is that simple. Avoiding shelters will not keep you safe from infection, cleanliness will.

[4eyedbuzzard]

If you are going to quote someone please quote, " To kill germs water needs to boil for 10 min I could not find how long it took for boiling water to kill noro. If someone can answer this please do." I have checked all the links and charts and still have no answer, one chart did have 10 min boil AT 100 degrees C or 212degrees for 10 min to kill one type of virus. Per the chart different germs, virus's and protozoa took different temperatures for different length of time to be killed. NORO was not on the chart. So we have no real answer, we only now know that it is a possibility that it may be killed at a lower temp than a boil.

There are literally dozens of different "Norwalk like" virus strains, which are all regularly lumped together and called norovirus. It isn't just one distinct "critter". They are all enteric (intestinal) viruses.

[Heeler59]

I do not want to lose focus here, I do not want to see another outbreak this year. Best prevention it knowledge. Number one thing everything leads back to is WASH your hands completely with soap and water. If you have hospital grade disinfectant wipes by all means use them. After you use the "rest room" or woods, Wash, prior to putting food into your mouth, wash. It really is that simple. Avoiding shelters will not keep you safe from infection, cleanliness will.

I'm not sure what you mean by "hospital grade disinfectant wipes". I am a hospitalist PA, and the only disinfectant wipes we use in this environment are intended for inanimate surfaces, and the label clearly says not to use on human skin. They are very toxic, thus they kill all kinds of germs very well. Yes, your best bet for killing viruses is soap and water and scrubbing, EtOH gel won't get it all.

[rocketsocks]

There are literally dozens of different "Norwalk like" virus strains, which are all regularly lumped together and called norovirus. It isn't just one distinct "critter". They are all enteric (intestinal) viruses.

I wouldn't want any of them. So I treat my water, and use the approved 2 ply squares for bottom floggin...do you really want to get these critters in your gut.

b98dd26026f9e88558695a6126977719_full.jpgmg_giardia.jpgfemale-celeb-in-Beard-04.jpgpopoval2-430W.jpg

[Feral Bill]

I don't see how careful cleanup after you own BM would make a difference. You are not spreading pathogens to yourself. You could keep from passing on something to another person, of course. Still, I clean up, and boil extra water for a mealtime hand wash. I guess if I was with a group showing symptoms, I would go elsewhere, fast.

[4eyedbuzzard]

I don't see how careful cleanup after you own BM would make a difference. You are not spreading pathogens to yourself. You could keep from passing on something to another person, of course. Still, I clean up, and boil extra water for a mealtime hand wash. I guess if I was with a group showing symptoms, I would go elsewhere, fast.

You wash your hands before eating (or really any other time) to protect yourself. You wash them after wiping to protect the herd.

[Kraken Skullz]

Seeing some of the comments it appears this is a pretty big worry on the AT. Any others that we should be worried about this time of year?

[4eyedbuzzard]

Seeing some of the comments it appears this is a pretty big worry on the AT. Any others that we should be worried about this time of year?

Getting sick sucks, but generally everybody recovers in a couple of days. Getting a tick borne disease like Lyme, or falling and breaking bones is a lot worse. There are bigger health hazards on the AT than Noroviruses.

[winger]

Getting sick sucks, but generally everybody recovers in a couple of days. Getting a tick borne disease like Lyme, or falling and breaking bones is a lot worse. There are bigger health hazards on the AT than Noroviruses.

There may be more serious diseases, such as Lyme, but there are few illnesses, as quickly devastating as Norovirus. Does anyone wish to be pooping and puking for 24-48 hrs away from home and its conveniences? Norovirus, is spread quickly and from person to person. Lyme is spread by tick. There is a far lower incidence of Lyme compared to Norovirus. Everyone needs to practice basic hygiene and avoidance.