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When it Comes to Germs, Norovirus is Public Enemy Number One

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Last week, the renowned Homeland Security expert, Colonel Randall J. Larsen, USAF (Ret) made a stunningly bold claim that the most prevalent threat to humans today is infectious disease. In light of the current situation of an epidemic flu outbreak, the rampant spread of antibiotic-resistant gonorrhea, and the horrific fungal meningitis outbreak linked to tainted spinal injections, he had good reason to make the statement.

But nothing epitomizes his words more than a virus that presumably took down the Secretary of State, Hillary Clinton, leaving her dehydrated and causing complications that left her injured and unable to work for a month. While the virus was never officially called by name, there is little doubt that the culprit was the villainous norovirus.

The noroviruses have likely been around for thousands of years, but their existence was only discovered in 1972 by Dr. Albert Kapikian while studying the infectious causes of a gastrointestinal outbreak in Norwalk, Ohio. Using an electron microscope, he found an incredible amount of small, round-structured creatures no more than a few dozen billionths of a metre in diametre. He was fascinated not only because he had found a new type of virus, but because the culprit caused one of the most egregious attack on the human condition.

The infection is short, lasting only 48 to 72 hours but during that time, one might believe they have been put into one of Ridley Scott's Alien movies. Within the first six hours after infection, abdominal cramps appear as the virus is finds a home in the gut. But this unease is just the beginning; the real terror starts when the virus production reaches a critical mass and literally rips off the gut lining. An incredible surge of water, dead cells and virus heads down the intestines causing a rush of diarrhea that cannot be stopped.

But that's not all. As the posterior push occurs, a message is sent through the vagus nerve to the brain that the body needs to purge whatever might have happened to cause the illness. The result is incredible projectile vomiting that would make Linda Blair squirm.

Not surprisingly, many tend to find shelter in their beds -- or bathtubs -- during the onslaught. But in hundreds of thousands of cases each year, the combined loss of fluids and the lack of any ability to replenish what has been lost leaves victims severely dehydrated and in need of medical help. It's not considered to be a life threatening condition yet worldwide, some 2.2 million people succumb to the complications of infection. While there are some experimental treatments in development, there are no effective solutions other than fluids and time.

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Back in 1972, the norovirus experience was rare but over the last four decades, the rise of cases has been dramatic. By the turn of the millennium, it was one of the most common causes of viral gastroenteritis. Outbreaks are now featured almost weekly in the news and it seems anywhere people gather; there is the chance for infection. In the last month alone, noroviruses have led to dozens to hundreds of illnesses on cruise ships, hospitals, restaurants, and schools.

As these stories imply, the viruses are hiding everywhere and turn up in the most unlikely places including the furthest regions of Eastern Russia, the Amazonian regions of Brazil, and even the world of Disney. Compared to any other agent or action that falls under the classic definition of terror, the noroviruses are by far a leader.

But there are thankfully a few ways to thwart this perfect villain. To keep foods safe, the best route is high heat, which is a natural consequence of cooking. On surfaces, the use of norovirus-killing disinfectants, such as bleach and hydrogen peroxide is always recommended. And if contamination is expected on items such as bags or clothes, wash them with hot water. Then there is the most important means to prevent infection: keep the virus outside of the body. Achieving this is fairly simply although the solution is often ignored.

Hand hygiene.

Washing hands with soap for 20 seconds followed by rinsing and drying will keep hands safe. In addition, the use of a hand sanitizer with alcohol for at least 20 seconds may also help to kill the virus. This is especially important for foodhandlers who are a major cause of norovirus outbreaks. If every person who worked with food throughout its continuum maintained proper hand hygiene, a significant percentage of the cases would simply not occur. Unfortunately, the message continues to be unheard and the cases continue to rise.

Thanks to Col. Larsen, there may be a new approach to help keep norovirus at bay. In view of the extent and the impact of norovirus infections, it may be well time to change the message from one of encouragement to one of consequence to our personal and even public security. I suggest we start with a paraphrased version of a very well-known saying from the previous decade: "Wash your hands or the noroviruses win."

I'm sure Hillary Clinton would approve.