COVID-19 hospitalizations on the rise in Hawaii Hawaii Tribune-Herald
Why Did Type 1 Diabetes Rise Early in the COVID-19 Pandemic? Medscape
Former Miami cop admits to milking a COVID-19 relief program out of more than $40,000 Miami Herald
Public Advisory: Update on COVID-19 Spring Booster Campaign in ... Government of Newfoundland and Labrador
As this winter's tripledemic respiratory virus surge winds down and gives way to allergy season, some doctors are cautioning about another highly contagious virus spreading across the United States and sickening children: norovirus.
Cases and outbreaks of the notorious wintertime stomach bug have been steadily rising in the U.S. since last fall, more recently spiking and reaching new highs for this season, according to the most recent surveillance data from the U.S. Centers for Disease Control and Prevention.
Norovirus commonly known as the stomach flu is actually a group of viruses that cause acute gastroenteritis, an inflammation of the lining of the stomach and intestines, which leads to acute vomiting and diarrhea, per the CDC. Unlike its nickname suggests, norovirus is not related to the flu or influenza viruses.
In the U.S., the percentage of norovirus tests coming back positive, averaged over three weeks, was over 18% for the week ending on March 25, which surpasses last year's peak, according to the most recent data from the CDC'sNational Respiratory and Enteric Virus Surveillance System (NREVSS).
Outbreaks of norovirus are also on the rise in the 14 states reporting data to CDCs NoroSTAT program, Kate Grusich, CDC spokesperson, tells TODAY.com in a statement.
"The most recent CDC data ....show that reported cases from state health departments and clinical laboratories are increasing, but still remain within the expected range for this time of year," Grusich says, adding that the U.S. typically sees about 2,500 outbreaks per year.
However, some experts tell TODAY.com they're still bracing for norovirus outbreaks, especially among school-age children.
In late March, hundreds of children at a high school in Long Island, New York, were out sick with what officials believe was norovirus linked to an outbreak at a school dance, NBC New York reported.
Charlottesville, Virginia, is also facing a norovirus outbreak, local outlet NBC 28 reported.
The situation across the pond doesn't ease concerns either. Earlier this month, health officials in England warned that norovirus cases had reached the highest levels for this time of year in over a decade. In mid-March, reports of norovirus were 77% higher than the five-season average during the same period, according to the U.K. Health Security Agency.
So what can we expect for spring in the U.S.? We spoke to experts about how this year's norovirus season may compare to others and what you need to know about symptoms, transmission, treatment and prevention.
Norovirus outbreaks are common in the U.S., says Grusich. Each year, norovirus causes 19 to 21 million cases of vomiting and diarrhea, 109,000 hospitalizations and 900 deaths, per the CDC.
Although norovirus can spread year-round, it has a wintertime seasonality in the U.S., says Grusich, so cases tend to peak during the colder months. The vast majority of outbreaks occur between November and April, according to the CDC.
While it is too early to tell exactly when exactly norovirus will peak in the U.S. and how the 2022-2023 will compare to prepandemic seasons, it is clear that cases and outbreaks are rising right now.
Its going up quickly right now. Its not yet at the peak weve seen in previous years, but its definitely on the rise and pretty suddenly in the past few weeks," Dr. Ali Alhassani, a pediatrician at Boston Childrens Hospital and head of clinical at Summer Health,tells TODAY.com.
A surge in norovirus outbreaks could lead to an increased number of emergency room visits, Alhassani notes, or a reduction in the already-strained health workforce.
Dr. Luis Ostrosky, an infectious disease specialist at UTHealth Houston and Memorial Hermann in Houston, tells TODAY.com that norovirus activity is higher and earlier than usual (right now), but definitely not a big outlier compared to pre-pandemic levels.
Children who managed to evade the virus over the past few years are now being exposed to norovirus and many other viruses that tend to peak and circulate among schools at this time of year.
"We've always had seasonal increases and waves of norovirus, and our hospitals would be filled with kids," Dr. Albert Ko, infectious disease physician and professor of public health, epidemiology and medicine at Yale School of Public Health, tells TODAY.com. "What kind of took us off was the pandemic," Ko adds.
Prevention measures implemented to curb COVID-19 were likely effective in preventing norovirus outbreaks, says Grusich, and as restrictions have relaxed, the number of outbreaks has returned to levels similar to pre-pandemic years.
This is certainly higher than what we experienced during COVID, but its in the order of what we saw prior to the pandemic, give or take theres variation year to year, says Ko.
While the jump in the norovirus test positivity is concerning, Ko says, it is not unexpected. I would be surprised if this years peak is worse than last years. ... I think were going to be starting to get back to the epidemiological pattern that we normally see, says Ko.
The same virus strains that circulate in the U.S. are often what surges in Europe, says Alhassani. Although cases are starting to level off in England, Ko notes, it's still unclear whether this record surge is a harbinger of how severe norovirus will get in the U.S.
Norovirus is transmitted primarily "when bacteria or viruses shed in stool ends up on our hands and surfaces and then eventually ends up in our mouth and we ingest it and get infected," says Alhassani.
Norovirus may be transmitted directly from an infected person or from contaminated surfaces, objects, foods or drinks.
"Anybody who is in close contact with someone who has an active infection with norovirus is at high risk of getting it," says Alhassani. Norovirus can spread through activities like caring for an infected person, changing diapers or sharing utensils.
"Norovirus is so infectious that even if somebody throws up and there's droplets of vomit aerosolized in the air, that can actually cause infection," Alhassani adds.
It takes a very small number of virus particles to transmit the disease, says Ko, which is why norovirus causes so many explosive outbreaks. Per the CDC, less than 100 norovirus particles can make you sick, and infected people typically shed billions of particles.
Most people are infectious from the time symptoms begin until about two or three days after symptoms resolve, Ko says, but some people can remain contagious or up to two weeks after recovery.
Outbreaks often occur in schools, day cares, nursing homes and cruise ships, the experts note.
The most common symptoms of norovirus are vomiting, nausea, diarrhea and abdominal pain, says Ko. Other possible symptoms include a headache, body aches and a low-grade fever. Norovirus symptoms usually develop within 12 to 48 hours after exposure, per the CDC.
"Norovirus ... will just last a few days," says Ostrosky. "For the majority of the population, its going to be just a nuisance."
Those at higher risk of developing severe or prolonged symptoms include babies, the elderly and the immunocompromised, says Ostrosky. If symptoms transition into chronic diarrhea and weight loss, this can lead to complications like dehydration or poor absorption of medications, he adds.
"There's actually no specific treatment or antiviral for norovirus," says Ostrosky. Hydration is key to replenish fluids lost from vomiting and diarrhea, the experts note, which means drinking plenty of water, Pedialyte or sports drinks.
"Then it's just eating bland foods and trying to let it pass through the body, which usually takes like one to three days," says Alhassani, adding that over-the-counter anti-nausea medicine and pain relievers may also be used to ease symptoms.
The vast majority of people can be managed at home and, in fact, should be isolated at home until theyre improving, given how contagious norovirus can be, says Ostrosky.
However, it's important to watch for signs of severe dehydration and to contact a health care provider if these occur, the experts note. These include dry mouth, decreased urination, dizziness and, in children specifically, crying without tears, fussiness or unusual sleepiness, per the CDC.
Children under 1, people who are immunocompromised, or those with prolonged or severe symptoms should also be seen by a physician, says Alhassani. While it infects many people, (norovirus) tends to not send as many people into the hospital and certainly the ICU, he adds.
A person can be infected with norovirus multiple times in their lifetime. After recovering, you may possibly develop some short-term immunity, says Ko, but it won't be robust and it wanes quickly.
It's only partial immunity ... because there are different types of norovirus, and being exposed to one doesnt give you complete protection to another, he says.
There's no vaccine against norovirus, says Ko, but there are steps you can take to prevent infection and transmission.
Hand hygiene is extremely important but the way you clean your hands matters, Ostrosky notes, and it has to be with soap and water. Hand sanitizer does not work against norovirus.
Norovirus is one of the few viruses that doesnt get deactivated by alcohol. You actually need to use soap and water to physically destroy it and remove it from your hands, says Ostrosky.
Wash your hands after using the restroom, before eating or cooking and after caring for someone with norovirus.
When cleaning surfaces or objects that may be contaminated with norovirus, Ostrosky suggests using a high-level disinfectant like bleach.
If you or your child are sick with norovirus, isolate to prevent the virus from spreading within the household, says Alhassani. Anyone sick with norovirus should stay home until they feel better. Avoid food preparation until at least 48 hours after symptoms stop, says Grusich.
"We can expect to continue seeing more viral illnesses, both respiratory and gastrointestinal, in this post-COVID era we're sort of approaching," says Ostrosky, adding that the basics of hand-washing, isolation and respiratory etiquette can go a long way.
This article was originally published on TODAY.com
In 2011, a farmer in Oklahoma had a bunch of sick pigs. The animals had what looked like the flu.
"Just like a person with respiratory disease, the pigs had labored breathing, maybe a runny nose, cough and potentially a fever," says virologist Benjamin Hause.
At the time, Hause was working at the company Newport Laboratories, which develops custom vaccines for livestock. "We would detect and isolate pathogens from animals. Then we would grow the pathogens in the lab, kill them and formulate vaccines," says Hause, who's now an executive at Cambridge Technologies, another vaccine company.
The Oklahoma farmer took a few samples from the pigs' noses a bit like how you swab your nose for an at-home COVID test. He sent the samples to Hause so he could figure out what was making the pigs sick.
Hidden viruses: how pandemics really begin
NPR is running a series on spillover viruses that's when animal pathogens jump into people. Researchers used to think spillovers were rare. Now it is clear they happen all the time. That has changed how scientists look for new deadly viruses. To learn more, we traveled to Guatemala and Bangladesh, to Borneo and South Africa.
Hause immediately thought that the regular flu virus was infecting the pigs. "We expected to find influenza A," he says, "because that's the most common problem." It's also the same type of virus that often causes the seasonal flu in people.
But when he and his colleagues grew the virus in the lab, they quickly realized they were wrong. Hause was shocked by what he saw.
"I thought, 'What is this thing? We've never seen anything like this before,' " he says. "Right away, we were concerned that this virus could infect people."
For decades, scientists thought that animal viruses seldom jump into people. They thought these spillovers were extremely rare. But in the past few years, studies have been showing that this thinking is wrong.
"I don't think [spillover] is extremely rare," says evolutionary virologist Stephen Goldstein at the University of Utah. "I mean, we know this because when people start looking, people find it."
In fact, there's likely a whole group of animal viruses making people sick all over the world that doctors know nothing about. They've been hidden. They masquerade as a regular cold, flu or even pneumonia.
For example, if you have a respiratory infection in the U.S., doctors can identify the pathogen causing the infection only about 40% of the time. There's growing evidence that the other 60% of infections could be caused by animal viruses such as a dog coronavirus found in Malaysia, Haiti and Arkansas, or even possibly the same virus Hause and his colleagues found in those pigs. Recent studies have made clear that this virus floats in the air at farms and is likely infecting people who work there.
Hause and his colleagues eventually figured out that they had stumbled upon an entirely new influenza virus, unrelated to the ones known to infect people. "It's completely different than influenza A," says virologist Feng Li at the University of Kentucky, who co-led the discovery of the new virus.
Once scientists started looking for signs of infections in other animals, besides pigs, they found it nearly everywhere they looked: in sheep, goats, camels, horses.
But Li says they hit the jackpot when they looked in one particular animal: cows.
"The percentage of cows in the U.S. that have antibodies to influenza D is way, way high," he says. "Whenever you look at herds, about 50% of individual cows have high levels of antibodies to this virus. That was really surprising."
And it's not just cows in Oklahoma but across the whole country, from west to east and north to south, Li says. "From California to Vermont, and North Dakota to Texas, cows are infected with this virus. They are the primary reservoir for the virus."
On top of that, this virus is incredibly stable, Li says. "It can survive at high temperatures and in acidic environments," he says. "That's why scientists have found influenza D in the air at airports in the U.S." They've also found it in the air at chicken farms in Malaysia.
And so the question has become: If this virus can infect so many different animals and is found in so many cows, does it make people sick? Especially the people who work closely with cows on dairy farms or ranches?
In 2019 and 2020, scientists at Boston University ran a small and simple experiment. They went to five dairy farms in the West and Southwest, and they washed out the workers' noses before and after their shifts working on the farms. Then they looked for influenza D inside the washes.
The researchers studied only 31 workers over the course of only five days. But they found quite a lot of the virus. "We found about two-thirds of the participants were exposed to influenza D at some point during our study period," says environmental epidemiologist Jessica Leibler, who led the study. They published their findings in November in the journal Zoonoses.
While Leibler and colleagues tested only a small number of workers, the high percentage who had the virus in their noses suggests that influenza D is quite likely common on dairy farms in the Southwest. If the virus was rare on the farms, then finding it at such high levels by chance would be highly unlikely. "To me, the findings suggest that if you look for influenza D, you probably will find it," she says.
Now Leibler and her team looked only for an exposure to influenza D. But previous studies have looked for signs of infections in cattle workers in Florida. Specifically, the study tested for influenza D antibodies in the workers' blood.
"They found a really, really high percentage of workers with influenza D antibodies," Leibler says. "Again, it was again a small study, but more than 90% of the workers had antibodies to influenza D, which implies these workers weren't only exposed, but they were also infected."
In contrast, the prevalence of influenza D antibodies in people who don't work on farms was much lower. Only about 18% of the general population showed signs of being infected, researchers reported in the Journal of Clinical Virology.
Now, no one knows yet if influenza D causes any symptoms in people. But altogether, these studies indicate influenza D is likely what's called an emerging virus, Leibler says. It's jumping into people who work with animals, such as dairy farmers, but it's not likely spreading much beyond that.
"This doesn't seem to be something, right now, that the general public is exposed to in a large way," she says. "But it's something that's a concern for these front-line workers exposed on farms."
That's because there's a real risk that the virus could adapt to people as more and more workers are infected, she says. "Influenza viruses mutate rapidly and frequently. So, over time, influenza D can evolve. It could increase its ability to infect humans and be more easily transmitted among humans or it could become more virulent" and start making people sicker.
For that reason, Leibler and her colleagues are calling for more research on, and surveillance of, this new flu to ensure the safety of the dairy workers but also to ensure that the virus doesn't surprise the world as SARS-CoV-2 did.
In fact, Stephen Goldstein of the University of Utah says, to stop the next pandemic before it occurs, scientists and officials should focus on these viruses that have already made the jump into people instead of cataloging viruses in wild animals.
"Doing virus discovery in wild animals is interesting from a scientific standpoint, but from the standpoint of predicting pandemics, I think it's a ridiculous concept," he says. "Instead we need surveillance active surveillance in humans and also in domestic animals."
Currently, at least one company Cambridge Technologies is working on a vaccine against influenza D for animals. But in general, very few farms are looking out for the virus in animals or workers, Jessica Leibler says.
For comments on this topic, NPR reached out to the National Cattlemen's Beef Association, the lobbying group for cattle ranchers. A spokesperson referred us to the U.S. Department of Agriculture. The USDA, along with the Centers for Disease Control and Prevention, said in emails that, at this point, there isn't any evidence that Influenza D is causing significant harm to livestock, so there aren't currently any surveillance systems in place for livestock or workers.
As Leibler points out, officials and scientists had a similar view of coronaviruses for a long time that they weren't a major concern because they only caused a cold.
"Sometimes an animal virus doesn't seem to make people very sick and so scientists brush it away as not really important," Leibler says. "That's what scientists thought about coronaviruses for a long time that they weren't a major concern because they only caused a cold.
"It only took a huge global pandemic to realize that viruses can change really quickly, and you don't know when they're going to change."
Deadly virus from tick bites that causes flu-like symptoms found in three patients in the UK Daily Mail
