Gastrointestinal Flu: Norovirus in Health Care and Long-Term Care Facilities

ArticleinClinical Infectious Diseases 47(9):1202-8 · October 2008with13 Reads
DOI: 10.1086/592299 · Source: PubMed
Abstract
Noroviruses, recognized as the leading global cause of viral gastroenteritis and a major contributor to food-borne illness, present a growing challenge in health care and long-term care facilities. The virus spreads easily and by multiple routes. A visitor to a ward might initiate an outbreak by person-to-person contact, vomiting staff members or patients can disseminate the virus by airborne means, and contaminated surfaces, such as doorknobs and computer keyboards, can sustain an epidemic. In addition, although self-limited in healthy hosts, the virus can cause increased morbidity in more-vulnerable people. The GII.4 strain of the virus now dominates in multiple recent worldwide epidemics as well as in health care and long-term care facilities. Much like the influenza virus, norovirus appears to evolve by antigenic drift and evading the immune system, causing waves of global epidemics. Previous attempts at controlling outbreaks, both in the community and in closed facilities, provide guidance about the vigilance and action required by the health care community to diminish the clinical impact of norovirus infection.

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    • "The virus is transmitted directly from person to person or indirectly through the consumption of contaminated food, water, or by contact with contaminated surfaces and fomites [3][4][5][6]. The majority of norovirus outbreaks occur in semi-closed communities such as long-term care facilities, hospital wards, cruise ships, military barracks, and child-care centers where food is rarely implicated as the cause of the outbreak [6][7][8][9]. Increasing evidence shows that transmission via contaminated surfaces and hands plays a significant role in the spread of the virus [3]. Thus, cleaning and disinfection of surfaces and hands are likely the most effective ways to control norovirus gastroenteritis [10][11][12] . "
    [Show abstract] [Hide abstract] ABSTRACT: Alcohol-based hand sanitizers are widely used to disinfect hands to prevent the spread of pathogens including noroviruses. Alcohols inactivate norovirus by destruction of the viral capsid, resulting in the leakage of viral RNA (virolysis). Since conflicting results have been reported on the susceptibility of human noroviruses against alcohols, we exposed a panel of 30 human norovirus strains (14 GI and 16 GII strains) to different concentrations (50%, 70%, 90%) of ethanol and isopropanol and tested the viral RNA titer by RT-qPCR. Viral RNA titers of 10 (71.4%), 14 (100%), 3 (21.4%) and 7 (50%) of the 14 GI strains were reduced by > 1 log10 RNA copies/ml after exposure to 70% and 90% ethanol, and 70% and 90% isopropanol, respectively. RNA titers of 6 of the 7 non-GII 4 strains remained unaffected after alcohol exposure. Compared to GII strains, GI strains were more susceptible to ethanol than to isopropanol. At 90%, both alcohols reduced RNA titers of 8 of the 9 GII.4 strains by ≥ 1 log10 RNA copies/ml. After exposure to 70% ethanol, RNA titers of GII.4 Den Haag and Sydney strains decreased by ≥ 1.9 log10, whereas RNA reductions for GII.4 New Orleans strains were < 0.5 log10. To explain these differences, we sequenced the complete capsid gene of the 9 GII.4 strains and identified 17 amino acid substitutions in the P2 region among the 3 GII.4 variant viruses. When comparing with an additional set of 200 GII.4 VP1 sequences, only S310 and P396 were present in all GII.4 New Orleans viruses but not in the ethanol-sensitive GII.4 Sydney and GII.4 Den Haag viruses Our data demonstrate that alcohol susceptibility patterns between different norovirus genotypes vary widely and that virolysis data for a single strain or genotype are not representative for all noroviruses.
    Full-text · Article · Jun 2016
    • "AGE is epitomized by diarrhea, coupled with nausea, vomiting, fever, and abdominal pain[22]. Most cases of mild diarrhea are of viral etiology, while severe diarrhea, especially associated with fever, tends to be of bacterial etiology[23]. Though there are splendid advancements in modern medicine, traditional medicine has always been accomplished for treating gastrointestinal infections. "
    Full-text · Article · Jul 2015 · Asian Pacific Journal of Tropical Biomedicine
    • "AGE is epitomized by diarrhea, coupled with nausea, vomiting, fever, and abdominal pain[22]. Most cases of mild diarrhea are of viral etiology, while severe diarrhea, especially associated with fever, tends to be of bacterial etiology[23]. Though there are splendid advancements in modern medicine, traditional medicine has always been accomplished for treating gastrointestinal infections. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To explore the quantitative estimation of biomarkers gallic acid and berberine in polyherbal formulation Entoban syrup. Methods: High performance thin layer chromatography was performed to evaluate the presence of gallic acid and berberine employing toluene: ethyl acetate: formic acid: methanol 12:9:4:0.5 (v/v/v/v) and ethanol: water: formic acid 90:9:1 (v/v/v), as a mobile phase respectively. Results: The Rf values (0.58) for gallic acid and (0.76) for berberine in both sample and reference standard were found comparable under UV light at 273 nm and 366 nm respectively. The high performance thin layer chromatography method developed for quantization was simple, accurate and specific. Conclusions: The present standardization provides specific and accurate tool to develop qualifications for identity, transparency and reproducibility of biomarkers in Entoban syrup.
    Full-text · Article · Jul 2015
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