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Norovirus Outbreak: Advice from the RMB Resident Doctor

Copyright: philipimage / 123RF Stock Photo
Copyright: philipimage / 123RF Stock Photo

Guess what? We are having a norovirus outbreak in Washoe County!

It doesn’t just happen on cruise ships. Most primary and urgent/emergency care providers have probably seen a few cases at least in the past few weeks, as the most up to date stats report 1330 cases in Washoe County, and that’s just the reported number, which is always lower than the actual number of cases present because not everyone infected seeks care or reports it.

It spreads like wildfire, and here’s a crazy stat for you – it’s estimated it only takes 18 viral particles to infect someone, so one gram of stool can harbor 5 billion infectious doses! Under normal conditions, we produce 100-250 grams of stool per day- and that’s not even considering the profuse diarrhea associated with this illness – so that’s a LOT of infectious potential! Not to mention that hand sanitizer doesn’t really cut it in clearing the virus from our hands, it creates a public health nightmare as far as how quickly and far reaching it can spread.

And there’s so much genetic variation in the types of norovirus that you can re-contract it multiple times throughout your life – it’s not just “one and done”. Oh and did I mention that up to 30% of people infected don’t have symptoms, but carry the virus and infect others? Yup, recipe for outbreaks like this one. And on a personal note, although no one in my family was tested for norovirus, we were the perfect example of this – in July, at just over a year old, my daughter came down with symptoms very similar to norovirus, with vomiting and diarrhea, and even vomited down the front of me a few times (mommy right of passage). Although I never had symptoms, my husband, nieces and their significant others all contracted the same illness within a 3 day period. Certainly, my daughter could have picked this up in public at some point, but she isn’t in daycare, so there isn’t quite as much exposure for her as some kiddos, and I think it’s more likely I silently picked up the virus from a patient at work and brought it home for everyone.

So my husband asks me – “Why do we care? It’s just a stomach bug” … Well, that is true, but if you’ve suffered with this, it’s not fun, and while the mortality (number of people who die) each year is just a few hundred for the 19-21 million infected, it’s the kids who bring it home to baby brother or grandma that we are most worried about. The people most likely to end up in the hospital with serious complications are children under 5 or the elderly, or people with compromised immune systems.

If you’ve got someone at home who has a poor immune system, or who you’re really concerned about contracting norovirus from another infected family member, consider quarantining them to one bathroom and enacting a very strict hand washing policy. Clean everything they come in to contact with with a bleach based household cleanser, and be sure to wash their bedding and clothing separately, in hot water. This may help avoid transmission, although as I said above, this is a highly contagious virus- which is why some of the affected schools have chosen to close for deep cleanings to slow the spread.

The bottom line is, the best thing to do if you or your children become infected is stay hydrated, wash your hands really, really well with soap and warm water, and stay home for 72 hours after your symptoms resolve. It’s a good opportunity to catch up on the sleep or Grey’s Anatomy marathon you’ve been missing!

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About Amanda Magrini

Amanda Magrini
Amanda Magrini, MD, is a board-certified family medicine physician at Northern Nevada Medical Group’s Los Altos location in Sparks. She completed her undergraduate degree at the University of Nevada, Reno and her medical training at the University of Nevada School of Medicine. Dr. Magrini has practiced family medicine for seven years, including residency, and enjoys her specialty, because she likes taking care of the whole family, from newborns to grandparents. She likes preventative medicine, helping people take care of themselves and the relationships she is able to form with her patients. Dr. Magrini grew up in Sparks, NV and likes that it is a safe place to live with great educational opportunities and beautiful scenery. She thinks Northern Nevada is a great place to raise a family and looks forward to raising her own children here. In her spare time, she enjoys outdoor activities such as hiking, biking, camping, boating, running and traveling the world. Dr. Magrini is also very close with her family; she is married to her high school sweetheart and values spending time with him and the rest of her family. Disclosure: "The author is a licensed physician practicing with Northern Nevada Medical Group, but all opinions expressed are solely the opinions of the author and do not necessarily reflect the views of Northern Nevada Medical Group or any other affiliates of Universal Health Services, Inc."

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