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02/04/2007The Norwalk virus: 'It's horrible and it's violent'
Megan Cox and her 5-month-old son Mason Cox, the only member of her immediate family not to contract the Norwalk virus. TRAVERSE CITY — Lori George didn't recognize the Norwalk virus by name, but she and her family are all too familiar with its symptoms. George suspects the gastrointestinal bug caused the illness that spread like wildfire through her Kalkaska family, afflicting her husband and three of her children. The sudden onset of nausea, vomiting and diarrhea hit them like a brick. "It's horrible, and it's violent,” said George, who managed so far to escape the sickness. "I have never seen my husband down so hard as when he had this. Normally if something comes in the house it's pretty mild.” The George family isn't alone. The Michigan Department of Community Health confirmed a statewide spike in suspected or confirmed outbreaks of norovirus, a group of related strains that include Norwalk. Brenda Brennan, an infectious disease epidemiologist with the state health department, said 144 outbreaks were reported in 2006, more than four times the 34 reports during 2005. That's well beyond the seasonal increase typically seen during the winter months. "There's definitely more,” Brennan said. "There may be more variants out there, but we don't know for sure.” Local health officials said they've observed a similar increase in the number of suspected Norwalk cases in northern Michigan, but most of them remain unconfirmed. "It's going through the whole community,” said Joshua Meyerson, medical director for the Northwest Michigan Community Health Agency. "My gut feeling is that it is a little worse than in years past. But I can't document that it is Norwalk.” Meyerson said most doctors rely on clinical diagnosis based on a patient's symptoms. Laboratory test results can take at least a week and the symptoms typically last one to two days. Norwalk outbreaks are most common in crowded environments such as schools, day cares and assisted living facilities. A suspected but unconfirmed outbreak sickened residents and employees in mid-November at an assisted living home in Leelanau County. Other Norwalk flare-ups in recent years included one in 2004 that closed a summer Boy Scout camp in Grand Traverse County for a week. In 2003, about 75 people got sick after attending a community potluck in Charlevoix County. More recently, Cheboygan Area Schools called off classes at East Elementary School on Jan. 26 after about 44 percent of students and 30 percent of teachers went home with stomach flu symptoms. Meyerson, who also serves as medical director for the health department that covers Cheboygan County, said no testing was done at the school to confirm it was a Norwalk outbreak. Megan Cox, of Traverse City, caught what she believes was Norwalk in October. Her husband and young daughter also got sick, along with several members of her extended family. "I just was absolutely wiped out,” Cox said. "It was very contagious.” Fred Keeslar, health director of the Grand Traverse County Health Department, said the virus is not one that must be reported to the state, so precise numbers are elusive. "There's a vast majority of cases we never know about,” he said. The Norwalk virus gained its name after an outbreak of illnesses in Norwalk, Ohio, in the 1970s. An estimated 181,000 cases occur nationwide each year, according to the Centers for Disease Control and Prevention. The highly contagious bug is often referred to as the "stomach flu” but is unrelated to influenza, so flu shots offer no protection. The virus is carried in human fecal material and can be acquired by touching contaminated objects or eating food prepared or handled by another ill person. The illness is not generally life threatening, but older people and patients with weakened immune systems are at greater risk for complications. There is no specific remedy, but doctors recommend rest and drinking plenty of fluids to avoid dehydration. Statistics show that about 90 percent of gastrointestinal illnesses nationwide are due to Norwalk, said Karen Speirs, an infectious diseases doctor at Munson Medical Center. But most patients wait out the symptoms without visiting a doctor. "We don't have a simple and reliable test that's available,” she said. Health officials recommend thorough and frequent hand-washing as the best defense against contracting the virus. Sick people should also avoid the workplace or group events and not prepare food for others while they are sick. George heeded that advice, hoping to prevent the sickness from spreading further in her family. "I've spent the last week doing nothing but disinfecting the bathrooms,” she said. Tina Soyring, a nurse with Traverse City Area Public Schools, said the district hasn't seen a significant increase in gastrointestinal illness. A group of students at one school fell ill with flu-like symptoms during the first week of September, but it wasn't identified as Norwalk. "We recommend parents keep their kids home until they are free of symptoms,” Soyring said. "We watch for any types of patterns and try to figure out what's happening.”
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