Norovirus Outbreaks Linked to Use of Hand Sanitizer

We have long been cautioning about the use of alcohol-based hand sanitizers and the related risk of antibiotic resistance. Now, MedScape reports that use of hand sanitizers in place of washing up with soap and water is, specifically in nursing homes, a leading risk for the spread of Noroviruses.

The information is based on a study just presented at Preventive Medicine 2011: Annual Meeting of the American College of Preventive Medicine. The study was conducted by David Blaney, MD, PhD, from the Centers for Disease Control and Prevention (CDC) and sought to locate those “risk factors for widespread Norovirus outbreaks in long-term care facilities (LTCFs) in New England,” said MedScape.

The study strongly suggests that changes be made, noted MedScape, for instance, by either substituting soap for hand sanitizers or training nursing home staff in how to better use the products in order to prevent the spread of Norovirus.
New England saw approximately 35 Norovirus outbreaks in the three years prior to the study period, with outbreaks increasing sharply to 54 and then 124 from 2006 to 2007, explained MedScape. Of interest, the spike corresponds to when two new Norovirus strains “GII.4 noroviruN: Minerva and Laurens” surfaced, added MedScape.

Noroviruses are a group of viruses that cause swelling in the linings of both the stomach and intestines, according to the CDC. A highly contagious, severe gastrointestinal illness commonly referred to as the so-called “stomach flu”.

Norovirus spreads quickly and is transmitted easily from person to person through the vomit and feces of people who are sick with the illness; contact with only a few particles can make a person ill. People become infected by ingesting contaminated food or liquids; touching contaminated surfaces or objects, and then placing their hand in their mouth; and having direct contact with an infected person.

Norovirus can survive for weeks on surfaces at room temperature, is difficult to eliminate, and can only be killed with chorine bleach. Alcohol-based hand sanitizers and other preparations are not too effective and Norovirus are not helped with antibiotics.

Once infected, people may feel very sick and vomit many times a day. Sometimes people are unable to drink enough liquids to replenish the liquids lost due to vomiting and diarrhea and can become dehydrated and require special medical attention.

According to the CDC, the symptoms of Norovirus also include diarrhea and some stomach cramping. Sometimes people also have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people the illness is self-limiting, with symptoms lasting just one or two days. Diarrhea tends to afflict children; vomiting is typically found in adults. Symptoms can present anywhere from 12 hours to days later.

People are generally considered to be contagious from when they feel ill to about three days after their symptoms subside; however, the virus can still be active in their vomit or stool for two weeks or more.

Nursing home infections are widely known to be more common in long-term care facilities, pointed out MedScape, due to close or shared living quarters, incontinence issues, potential poor hygiene habits, and sharing toilets.