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.

The Centers for Disease Control is urging doctors to prescribe antiviral medications to high-risk patients suspected of having the flu, even without a positive test. When given within 48 hours of symptoms appearing, antivirals like Tamiflu or Relenza can ease symptoms, shorten illness, and prevent serious complications.

Clinicians are not prescribing antiviral medications as often as in previous years, even though the 2013 flu season is causing more hospitalizations and deaths according to government figures. Complications from this year’s predominant flu strain are especially high among the elderly, causing half of hospitalizations and 90% of deaths so far.

With a sharp increase in both hospitalizations and deaths in the 2^nd week of January, the Centers for Disease Control (CDC) issued a physician advisory urging use of antivirals for more people–especially those at high risk–as soon as flu symptoms appear.

“When given promptly, they work,” CDC Director Thomas Frieden, MD, told a Jan. 18^th press briefing. “They can reduce symptoms, shorten the duration of illness, and prevent serious complications including hospitalization and death.”

Frieden also advised clinicians not to wait for test results or a positive ‘rapid flu test’ when probably flu appears in people at high risk for complications: anyone over age 65 or under age 2, or having any ongoing serious illness (including cancer survivors no longer in treatment).

Only halfway through the flu season

The number of influenza-related hospitalizations and deaths will rise in the coming weeks even as the  national average of new cases begins to slow, Frieden warned, partly because there is a lag time between when flu hits and when complications like pneumonia appear.

And even though flu rates are leveling out in much of the east and south, the outbreak is just beginning in California, Arizona, Hawaii, and Nevada. “Folks out West, you still have most of the flu season yet to come,” Frieden said.

What this means for you:

• Experts are still strongly recommending that anyone over 2 years old should get a flu shot for protection—of you and others—over the next several months.
• Even if you got vaccinated, you can still get a strain of influenza.
• If you begin to have flu symptoms and are “high-risk” or have contact with high-risk people, you should get antiviral medication with 48 hours. (High risk includes cancer survivors, even if you’re no longer in treatment. Even if it’s later than 2 days, you might still benefit, so call your doctor.)
• Flu symptoms include fever, cough, sore throat, body aches.
• You are contagious to anyone within 6 feet until you have been without a fever for 24 hours.  Stay home.

Sources:

• “CDC Urges Tamiflu RX to Curb Flu Death Rate,” Jan. 18 2013 Medscape
• Jan. 15 2013 CDC Health Advisory: Summary of CDC Recommendations for Influenza Antiviral Medications