A new virus causing diarrhea and vomiting has spread rapidly nationwide, causing an increasing number of outbreaks of what many call the “stomach flu,” according to a Jan. 24 2013 report issued by the CDC (Centers for Disease Control).

The new norovirus strain (named GII.4 Sydney) is highly contagious, and seems to cause more hospitalizations than other gastrointestinal viruses. It hits suddenly with diarrhea, abdominal pain, vomiting, fever, chills, and headache. Most people get better in one or two days, after the stomach or intestinal inflammation eases, but they are still contagious for 3 more days..

Dehydration is Danger

Even healthy people can get dehydrated with this illness if you don’t drink enough liquids to replace the fluids lost from throwing up or having diarrhea many times a day. Special rehydration drinks (such as Gatorade) are best, because they contain nutrients and minerals lost in diarrhea or vomiting.

Norovirus infection can quickly become serious  in young children, the elderly, and people with other health conditions if they become seriously dehydrated. Symptoms include urinating less often,  a dry mouth and throat, and feeling dizzy when standing up—which, for elderly or weakened individuals, greatly increases the chance of a fall during a rush to the bathroom.

Highly contagious

People ill with a norovirus are contagious from the moment they begin feeling sick until at least 3 days after they recover. Some people may be contagious for even longer. So even if you feel better, remember that you can still be infecting others. This is a hardy virus which can survive in food and especially on surfaces for quite awhile–such as bathroom appliances, door handles, bedding, and even on pets.

The CDC recommends that when norovirus hits a household:

(1)    Handwashing is the first defense, scrubbing with soap and water or alcohol-based cleanser before and after cooking and eating, using the bathroom, coming in contact with anyone who is ill, touching your pet, and especially before and after treating a cut or wound or caring for your catheter, port, or ostomy.

(2)    If you are ill, do not prepare food for yourself or others while you have symptoms and then for 3 more days;

(3)    Clean and disinfect contaminated surfaces. After throwing up or having diarrhea, contaminated surfaces should be immediately cleaned with a bleach-based disinfectant.

(4)    Wash laundry thoroughly: any clothing or linens that may be contaminated with vomit or stool should be handled carefully (ideally, wearing gloves, not agitating them to avoid spreading virus, and washing hands after handling). Wash with detergent on the longest possible cycle, and then machine dry.

 Cancer patients, especially if getting chemotherapy, should take special precautions

The CDC also provides clear advice for cancer patients, stating that if you get a fever during your chemotherapy treatment, it’s a medical emergency because infection during chemotherapy can be life-threatening.

And of course for patients with colorectal cancer or having an ostomy, dehydration also can become serious quickly. The CDC advises cancer patients to take your temperature any time you feel warm, flushed, chilled, or not well. If your temperature is 100.4°F (38°C) or higher for more than one hour, or 101°F (38.3°C) or higher for any length of time and you are on chemotherapy especially, call your doctor right away, even if it happens in the middle of the night.

You and anyone who comes around you, including all members of your household, your doctors, and nurses, should clean their hands frequently.

Sources: “Emergence of New Norovirus,” Jan. 25 CDC Morbidity and Mortality Weekly Report ;  “New Norovirus Strain Hits US,” Jan. 24 Medscape ]; “CDC Researchers Spot Increase in New ‘Stomach Bug’ Strain,” Jan. 24 HealthDay News; general tips to “Prevent the Spread of Norovirus,” and “Preventing Infections in Cancer Patients,” Centers for Disease Control.

Irinotecan (also called CPT-11 and/or Camptosar) is often used to treat advanced colorectal cancer. But it causes diarrhea in most patients–severe in 30 percent—that often limits the dose a patient can tolerate.

Now researchers at the University of North Carolina at Chapel Hill have found a way to block one specific troublemaking enzyme thought to play a big role in causing the diarrhea.

Irinotecan is complicated: After it has killed tumor cells, the drug is filtered out of the bloodstream by the liver, where it’s changed to an inactive compound and discharged into the intestine to be excreted. But in the intestine, the drug can be reactivated by an enzyme that is made by bacteria that normally live in the gut. The reactivated toxic drug then damages the intestinal lining—leading to severe diarrhea.

Matthew Redinbo, PhD, and his team wanted to block the enzyme that reactivates irinotecan, yet not kill the intestinal bacteria, because it’s vital for digestion, vitamin manufacturing and fighting infections. Sorting through a database of 10,000 chemical compounds, the research team found four chemicals that, at least in a test tube, blocked the enzyme without harming the bacteria. They tested one compound in mice: Those given irinotecan plus the compound had far less severe diarrhea than mice given just irinotecan.

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Since diarrhea is a significant problem for patients with colon cancer and even more for rectal cancer patients when treated with chemotherapy and particularly with radiation, it can become a serious issue which decreases quality of life.

There are many drugs which have been used to treat diarrhea. Sometimes they work, and often they don’t.  Similar to many other symptoms, it really depends what is causing the diarrhea. If it is an infection such as C. difficile, obviously you need an antibiotic. If it is caused by an obstruction, you need to be admitted to the hospital.  Patients who have inflammatory bowel disease need specific prescription medication. It is critical to rule out any major underlying problems associated with diarrhea prior to starting to use remedies. Read the rest of this entry »