Two Rivers Public Health District is experiencing an increase of both norovirus and rotavirus cases in the district. In order to prevent the spread of both illnesses between people, Two Rivers strongly recommends taking the following actions:

• Washing hands carefully and frequently
• Staying home when experiencing vomiting and diarrhea
• Careful cleaning of surfaces that have had contact with vomit and diarrhea using an EPA certified cleaning products

Norovirus is a very contagious virus that causes vomiting and diarrhea. People of all ages can get infected and sick with norovirus. People with norovirus illness can shed billions of norovirus particles. Only a few virus particles can make other people sick. Norovirus symptoms usually begin one to two days after exposure to the virus, but can begin as early as twelve hours after exposure. Most people with norovirus usually get better within one to three days.

Rotavirus is a very contagious virus that primarily affects infants and young children. However, people of all ages can get infected. Symptoms of rotavirus usually start about two days after a person is exposed to the virus and can last three to eight days. Rotavirus vaccine can help prevent serious illness in children and is commonly administered starting at 2 months old.

Norovirus and rotavirus outbreaks also frequently occur in schools, childcare centers, colleges, and universities. Both norovirus and rotavirus are spread by accidentally getting tiny particles of feces (poop) or vomit from an infected person in your mouth. Outbreaks on school and university campuses have even led to campus closures. Close quarters, shared spaces, and high-touch surfaces make it easy for norovirus and rotavirus to spread.

If you are experiencing norovirus or rotavirus symptoms, please contact your primary care provider and stay home. Typical symptoms for both norovirus and rotavirus are:

• diarrhea
• vomiting
• nausea
• stomach pain • fever
• headache
• body aches

Seattle-King County Public Health is investigating an outbreak of norovirus-like illness associated with vomiting, diarrhea, abdominal pain, and chills at Rock Wood Fired Pizza in Renton, WA.

No hospitalizations or deaths are associated with the 12-case outbreak.   Rock Wood Fired Pizza, located at 830 N. 10th St. in Renton has a “good” current rating for prior food safety inspections.

Public Health currently has not identified how norovirus was spread within the restaurant. This is not uncommon for norovirus outbreaks, because the virus can spread through multiple contaminated food items, environmental surfaces, and from person to person.

Since February 22, 2022, 9 people from 2 separate meal parties reported becoming ill after eating food from the Rock Wood Fired Pizza between February 19 and 20, 2022.

Public Health has identified three ill employees who reported symptoms consistent with norovirus dating back to February 20, 2022, but who did not work while sick.

Further investigation is ongoing.

Public Health actions

Environmental Health Investigators visited the restaurant on February 23, 2022. Investigators did not find any risk factors that are known to contribute to the spread of norovirus. The restaurant closed on February 23, 2022, to complete a thorough cleaning and disinfection. All ready-to-eat foods were discarded for those processed before the restaurant was disinfected.

Environmental Health investigators again visited the restaurant on February 24 and confirmed proper cleaning and disinfection were completed. The restaurant reopened on February 24, 2022.

Investigators reviewed with restaurant management the requirement that ill staff are not allowed to work until they are symptom-free for at least 48 hours and provided education about preventing the spread of norovirus, including proper handwashing and preventing bare hand contact with ready-to-eat foods.

Laboratory testing is in process for some of the individuals who reported norovirus-like illnesses. Often in norovirus outbreaks, no laboratory testing is done because people tend to get better within a day or two. Symptoms among those who got sick are suggestive of norovirus.

Norovirus is a highly contagious virus that frequently spreads person-to-person and is often associated with food. Norovirus illness often has a sudden onset of nausea and vomiting and/or watery diarrhea with cramps. A low-grade fever, chills, and body aches sometimes occur.

Norovirus rarely causes severe complications. Dehydration is the most common complication, particularly among young children and the elderly. No vaccine is available for norovirus.

Public Health  says these measures help reduce the risk of contracting norovirus::

  • Wash hands, cutting boards, and counters used for food preparation immediately after use to avoid cross-contamination of other foods.
  • Wash hands thoroughly with soap after using the bathroom or changing diapers, and before preparing any food or eating.
  • Wait at least 48 hours after the last episode of vomiting and/or diarrhea before preparing any food for others.

Renton is immediately south of Seattle.  Public Health serves about 2.1 million people in the Seattle metropolitan area.

Pittsburgh Carmalt PreK-8 will be closed Monday for cleaning after an apparent norovirus outbreak among students and staff members.

Pittsburgh Public School District spokeswoman Ebony Pugh said the schools, located in the Brookline neighborhood, have been receiving a “high volume” of reports of non-COVID-related illness from students and staff since Thursday.

The district, in consultation with the Allegheny County Health Department, determined the illness is most likely norovirus.

Norovirus is a virus that is transmitted through contact with stool or vomit and touching contaminated surfaces.

On Monday, the district’s maintenance team will clean the building “thoroughly” in order to prevent further infections.

Classes will resume on Tuesday, Dec. 14.

Common symptoms associated with norovirus include diarrhea, vomiting and stomach pain. A loss of energy, mild headache and low-grade fever are sometimes present, the district said.

There is no specific treatment for norovirus and symptoms usually resolve within 24-48 hours.

Norovirus is likely among the reasons behind increased reports of recent illnesses in Wyoming, according to the Wyoming Department of Health (WDH).

People who are sick with norovirus may experience nausea, vomiting, watery diarrhea, stomach cramps, fatigue and dehydration. Other viruses and illnesses caused by bacteria contamination such as from E. coli can cause similar symptoms, but norovirus is the most common culprit.

Commonly described as “stomach flu” or “food poisoning,” norovirus is spread when people eat or drink contaminated food and beverages, touch contaminated surfaces or through close contact with someone already sick.

Matt Peterson, WDH surveillance epidemiologist, said contamination is almost always not obvious. “We’re often talking about extremely tiny amounts of poop or vomit. We can’t see it but it can make us very sick,” he said “When people get ill this way, they most often blame the last thing they ate, but norovirus and bacterial illness can spread through many routes other than just eating food,” Peterson said.

Illness can hit quickly between 12 to 48 hours after a person has been exposed. Symptoms usually last from one to three days and go away without causing long-term problems.

“Norovirus and other illnesses with similar symptoms can be serious when people become dehydrated,” Peterson said. He noted those who become severely ill may need to call or visit a medical professional.  Infants, young children, immune-compromised persons, and persons unable to care for themselves, such as the disabled or elderly, are at higher risk for dehydration and may need hospitalization.

“We are specifically seeing increased reports of E. coli across the state recently compared to previous years, which can be particularly concerning in children under 5,” Peterson said. Parents with children who are suffering from stomach-related symptoms that do not improve after 72 hours, or if their child has bloody diarrhea, should seek medical care for the child because these could be signs of bacterial infection.

“Norovirus illnesses can be prevented,” Peterson said. “It sounds too simple, but, truly, good hand washing is critical. People can still be contagious and spread the virus for a few days after they no longer have symptoms.”

Recommended steps to help prevent illness include:

Frequently wash hands, especially after using the restroom or changing diapers, and before eating or preparing food.

If ill, stay home from work and school, especially if employed in food-handling, healthcare or child care.

Thoroughly clean and disinfect contaminated surfaces immediately after an episode of vomiting or diarrhea with a solution of 1 cup household bleach per 1 gallon of water and letting the solution sit for one minute. Always follow manufacturers’ safety precautions.

Immediately remove and wash contaminated clothing or linens after an episode of illness (use hot water and soap).

Flush or discard any vomit and/or poop in the toilet and keep the surrounding area clean.

Ill persons should take extra care to avoid spreading the virus by minimizing contact with other persons while ill and practicing good hygiene.

At Georgetown University in Washington D.C., Vice President and Chief Public Health Officer, Dr. Ranit Mishori, in an update on the Georgetown outbreak, reported that a total of 145 students, faculty and staff have reported symptoms that are consistent with a viral gastroenteritis (Norovirus) over the last two weeks.

Stool samples tested at MedStar Georgetown University Hospital and others sent to the DC Department of Health have confirmed the presence of Norovirus. While the bug is known, what is unknown is the source. To date there is no confirmed link to a food source or any of the dining areas on or off campus.

In other college news, in Rochester, New York, a spokesperson with the Rochester Institute of Technology (RIT)  said approximately 50 students were sickened by Norovirus.  Most cases were resolved within a day or two without the need for medical treatment. 

The Monroe County Department of Public Health on Thursday determined Norovirus as likely responsible for the outbreak on the Henrietta campus.  Again, to date there is no confirmed link to a food source or any of the dining areas on or off campus.

The Utah Department of Health says dozens of people attending business conferences in Park City were confirmed to have contracted Norovirus, a sickness that causes flu-like symptoms.

Officials say people attending two separate business conferences came down with the sickness. They believe the outbreak is over, but they still want everyone to be careful and report suspected cases.

Summit County health officials say the most common place to get the Norovirus is where large groups of people gather. It is often seen occurring on cruise ships. In Park City it occurred at two large business gathering where people ate catered food.

The Utah Department of Health says dozens of people attending business conferences in Park City were confirmed to have contracted Norovirus, a sickness that causes flu-like symptoms.

Officials say people attending two separate business conferences came down with the sickness. They believe the outbreak is over, but they still want everyone to be careful and report suspected cases.

Summit County health officials say the most common place to get the Norovirus is where large groups of people gather. It is often seen occurring on cruise ships. In Park City it occurred at two large business gathering where people ate catered food.

Several outbreaks of Norovirus have been reported across the state according to the Montana Department of Public Health and Human Services.

The department reports Norovirus is the most common of the viruses that cause gastroenteritis.

Symptoms include diarrhea, vomiting, nausea and stomach pain.

Riverstone Health recommends people in day care, schools and health care stay home for 48 hours after symptoms have resolved.

Food service workers should stay home for 72 hours.

“In that period just following the illness, you’re still shedding the virus but it tends to decrease over time,”said Kim Bailey, a Registered Nurse and Communicable Diseases Manager for Riverstone Health. “So we really want for people especially food service workers to stay home during that period when they’re still shedding the virus quite a bit.”

Bailey says the vomit from someone with Norovirus can be very infectious.

“When people throw up, it gets aerosolized and little particles get thrown into the air,” said Bailey. “And that is infectious to other people that are in the room.”

To prevent the spread of Norovirus, Riverstone Health recommends washing hands with soap and water for 20 seconds and cleaning “high touch” surfaces with a solution of one-third cup of bleach to a gallon of water.

North Carolina State University will use a $25 million grant from the U.S. Department of Agriculture’s National Institute of Food and Agriculture to strengthen food safety by studying human noroviruses across the food supply chain in an effort to design effective control measures and reduce the number of virus-caused food-borne illnesses.

Human noroviruses are the most common cause of food-borne disease, responsible for more than 5 million cases in the United States each year. Noroviruses spread from person to person, through contaminated food or water, and by touching contaminated surfaces. Molluscan shellfish like oysters, clams and mussels, fresh produce and foods that are extensively handled just prior to consumption are at greatest risk for contamination.

Dr. Lee-Ann Jaykus, a professor in the Department of Food, Bioprocessing and Nutrition Sciences at N.C. State, is the lead investigator of this five-year project. Her group, called the USDA-NIFA Food Virology Collaborative, consists of a team of more than 30 collaborators from academia, industry and government. The team will work to increase understanding of the viruses; educate producers, processors and food handlers on safe handling and preparation of food; and develop control and management strategies to reduce food contamination before and after harvesting.

North Carolina State University will use a $25 million grant from the U.S. Department of Agriculture’s National Institute of Food and Agriculture to strengthen food safety by studying human noroviruses across the food supply chain in an effort to design effective control measures and reduce the number of virus-caused food-borne illnesses.

Human noroviruses are the most common cause of food-borne disease, responsible for more than 5 million cases in the United States each year. Noroviruses spread from person to person, through contaminated food or water, and by touching contaminated surfaces. Molluscan shellfish like oysters, clams and mussels, fresh produce and foods that are extensively handled just prior to consumption are at greatest risk for contamination.

Dr. Lee-Ann Jaykus, a professor in the Department of Food, Bioprocessing and Nutrition Sciences at N.C. State, is the lead investigator of this five-year project. Her group, called the USDA-NIFA Food Virology Collaborative, consists of a team of more than 30 collaborators from academia, industry and government. The team will work to increase understanding of the viruses; educate producers, processors and food handlers on safe handling and preparation of food; and develop control and management strategies to reduce food contamination before and after harvesting.