There’s a nasty stomach bug going around.

It hit my husband’s workplace last week, and then our daughter’s school.

Today, a colleague of mine has called out sick with it…

And the hospital just sent out this email:

A message from Infection Control and Occupational Health

We are seeing an increase in gastrointestinal illness (nausea, vomiting, and/or diarrhea), consistent with Norovirus, in staff and in the community.   

We want to take this opportunity to again remind all staff that transmission of this virus can occur from person to person. The virus can be passed in stool and vomitus of infected persons from the onset of illness until several days after symptoms resolve.

We would also like to remind staff that food should not be eaten in any area where care is provided and that sharing of food among staff is strongly discouraged on all units and should not occur on any unit with known or suspected norovirus disease.

Please remember the following:

In both the hospital and the home, transmission of this virus can be prevented by washing of hands with soap and water (followed by Cal Stat) after coming into contact with ill persons or potentially contaminated surfaces.

The last section confused me. Do you NEED to use Cal-Stat, or any alcohol-based cleanser, IN ADDITION to handwashing?

We do know that when we’re talking about the dreaded Norovirus, none of the alcohol-based cleansers are effective alone.

So I looked it up. Per the online medical textbook (Uptodate), Norovirus spreads very effectively, for many reasons:

*Infected people can be contagious from a day before symptoms even start, through up to two weeks after symptoms resolve.  

*It is very stable and can survive on surfaces for a few days. Think doorknobs, computer keyboards, subway seats and handles, shopping carts… Nothing is safe! It only takes 18 to 100 microscopic virus particles to infect someone. When you eat those chips or nibble your nails, those few particles on hands travel from your hands into your mouth, and then…

*Contaminated food and water is a very common mode of transmission… Imagine. A cook who doesn’t get paid sick leave comes back to work after a GI illness as soon as they can stand up. They’re in a hurry to prepare your salad, and don’t wash their hands properly…

*When people vomit, viral particles can aerosolize, so you can inhale it, too. I would imagine that toilets with a more violent flushing mechanism (think: airplane lavatory) would also aerosolize viral particles.

The CDC has a ton of helpful information about Norovirus and how to prevent spreading, and the info jives with the textbooks and other sources. The long and short of it is: handwashing is one of the only things you can do to protect yourself and others, at least from hand-to-mouth transmission. But to be effective, you have to wash your hands the right way.

What is the right way to wash your hands? The CDC has an instructional video, but I’ll just tell you:

1.Wet your hands.

2. Lather with soap and scrub for at least thirty seconds. Helpful hint here: sing a little song. The classic is “Happy birthday”, but I think a modified “Row row row your boat” could work as well (and I just made this up):

“Wash, wash, wash the germs,

Gently down the drain,

Thoroughly, thoroughly, thoroughly, thoroughly,

This is such a pain.”

3. Now rinse.

4. Dry, but whatever you do, when you leave the bathroom, do NOT touch the door handle. Use a paper towel, or at the very least, your sleeve.

5. Pray. No, seriously, per multiple sources, if you really want to add an alcohol-based hand sanitizer here, you can, but it’s not clear that that will be more effective than prayer.

For contaminated surfaces, the CDC recommends washing with “a chlorine bleach solution with a concentration of 1000–5000 ppm (5–25 tablespoons of household bleach [5.25%] per gallon of water) or other disinfectant registered as effective against norovirus by the Environmental Protection Agency (EPA).”

For contaminated laundry, you’ll need to throw in some bleach, as well, and run the wash on HOT. Viral particles can spread on contaminated clothing, and can survive up to 140 degrees temperature. 

Whew! Now that I’m completely grossed out, it’s time to make dinner.

Stay healthy!

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Want to read some basic Norovirus facts, or have something you can hand to others? try the CDC, they have a simple handout with everything most people need to know.

Washing hands under a faucet with soap and water
Image from the CDC’s website on handwashing