The Perfect Human Pathogen

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The Norovirus has been described as the perfect human pathogen. It causes 21 million illnesses each year and kills 800 people. Are you at risk?

This presentation provides background on:
How norovirus spreads
Norovirus Symptoms
Why Norovirus is so tough to contain
How to prevent norovirus outbreaks
Norovirus treatment options

Because of it's more recent discovery, the general public may not be aware of how common this illness is.

Published in: Health & Medicine

The Perfect Human Pathogen

  1. PATHOGENPATHOGEN The Perfect Human
  2. Highly Contagious Diarrhea The Norovirus alters the intestinal lining, causing cells to dump fluid, which gets washed out of the body along with many, many, many noroviruses. http://phenomena.nationalgeographic.com/2013/01/02/the-norovirus-a-study-in-puked-perfection/
  3. each GRAM of feces contains around 5 BILLION noroviruses ready to INFECT a new host. http://jid.oxfordjournals.org/content/205/11/1622.full
  4. but it only takes about 20 VIRUSES to establish an infection. http://www.ncbi.nlm.nih.gov/pubmed/21876931
  5. Highly Contagious Vomit Noroviruses hijack our nervous system to slow down the passage of food from the stomach into the intestines. http://www.mdpi.com/1999-4915/2/3/748
  6. when that STORED FOOD comes flying out of the mouth, it provides a vehicle for noroviruses to SPREAD.
  7. Easily Spread Airborne Noroviruses easily float through the air and settle on surfaces like food, countertops, sinks or toilets. http://jcm.asm.org/content/48/7/2552
  8. Tougher Than Bear Grylls Freeze, Cook or Clean noroviruses survive both freezing and heating and resist many common chemical disinfectants. http://phenomena.nationalgeographic.com/2013/01/02/the-norovirus-a-study-in-puked-perfection/
  9. noroviruses can SURVIVE on surfaces for up to 2 WEEKS. Maybe even years in still water http://blogs.scientificamerican.com/artful-amoeba/2012/01/17/misery-inducing-norovirus-can-survive-for-months-perhaps-years-in-drinking-water/ http://www.sciencedirect.com/science/article/pii/S0168160505005854
  10. Rapid Evolution Limited Immunity noroviruses are genetically diverse and evolve rapidly. That means we’ve only got a few months of immunity, and then we’re fair game for another brutal bout of projectile puking and diarrhea. http://www.ncbi.nlm.nih.gov/pubmed/16343580?dopt=Abstract
  11. What Doesn’t Kill You... ModerateVirulence noroviruses are only moderately virulent allowing a large pool of potential hosts to survive... and be reinfected. again. and again. and again...
  12. Recipe for an Outbreak 1 car dealership 1 Infected toddler 1 baby changing station Several Billion Noroviruses 2 big packs of dry paper towels 16 employees (12 sick) Ingredients: http://www.micro-blog.info/2013/07/this-is-what-happens-when-norovirus-sprays-from-a-toddler/ http://www.salahqutaishat.com/1/post/2013/07/the-st-hit-the-fan-at-an-auto-dealer-in-oregon.html http://www.ncbi.nlm.nih.gov/pubmed/23559462
  13. Recipe for an Outbreak Directions: 1. Bring an infected toddler to car dealership and liberally spray baby changing station with feces. Leave the mess for a dealership employees to cleanup.
  14. Recipe for an Outbreak Directions: 2. Clean up the baby changing station using only dry paper towels. Leave some infected feces (with billions of noroviruses) visible on the baby changing station. For additional outbreaks leave the feces visible for weeks.
  15. Recipe for an Outbreak Directions: 3. Return to the meeting, touch surfaces, handle food and infect 75% of your co-workers
  16. Treatment NOTHING! •antiviral drugs •vaccine •time •plenty of fluids Dehydration is the most common complication and in severe cases can require IV fluids. http://www.cdc.gov/norovirus/about/treatment.html
  17. But it is possible to PREVENT Norovirus outbreaks.
  18. Prevention The best way to help prevent norovirus is to practice proper hand washing and general cleanliness. http://www.cdc.gov/norovirus/preventing-infection.html WashYour Hands
  19. Prevention Remove vomit or diarrhea right away! Use soapy water to wash surfaces that contacted vomit or diarrhea and all nearby surfaces, such as door knobs and toilet handles http://www.disinfect-for-health.org/wp-content/themes/disinfect/pdfs/NorovirusIncident_8.5x11_Eng_Color.pdf Clean contaminated surfaces
  20. Prevention Rinse thoroughly with plain water Wipe dry with paper towels http://www.epa.gov/oppad001/list_g_norovirus.pdf Clean contaminated surfaces
  21. But DON’T STOP here. Norovirus can survive on surfaces after cleaning
  22. Prevention Disinfect surfaces by applying a chlorine bleach solution or EPA approved disinfectant Disinfect Surfaces
  23. Prevention Prepare a chlorine bleach solution (or disinfectant) Allow disinfectant to air dry for surfaces unlikely to have food or mouth contact Rinse all surfaces intended for food or mouth contact with plain water before use Disinfect Surfaces
  24. Cleaning and Disinfection Resources • Restroom Cleaning Procedures • EPA Approved Disinfectants • Baby Changing Station Sanitation Instructions • Industry Cleaning Tips
  25. Norovirus BREAKS BAD millions of times each year
  26. More Common Than the Cold? No. But... Norovirus is the most common cause of acute gastroenteritis in the United States https://www.osha.gov/Publications/norovirus-factsheet.pdf
  27. So What’s the Big Deal? It’s expensive! •21 million illnesses •2 million outpatient visits •400,000 emergency department visits •70,000 hospitalizations •800 deaths each year http://www.cdc.gov/norovirus/php/illness-outbreaks.html
  28. It’s more common than you think A.G.E. (acute gastroenteritis) •179 million episodes occur annually •50% caused by norovirus •NORS started tracking in 2009 •Most illnesses are not tied to a reported outbreak (1/3000) http://wwwnc.cdc.gov/eid/article/19/8/13-0482_article.htm
  29. The first identified OUTBREAK was in 1968 at Bronson Elementary school in NORWALK Ohio http://en.wikipedia.org/wiki/Norovirus
  30. That’s why it’s sometimes called NORWALK VIRUS. Norwalk virus is the species, where as norovirus is the genus (but there’s only one known species in the genus anyways).
  31. Discovery The 1968 outbreak of gastroenteritis at Bronson Elementary school in Norwalk Ohio prompted a lot of scientific study. But it wasn’t until 1972 that Dr Albert Kapikian discovered the virus behind that outbreak. http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lid/epidemiologysection/Pages/kapikian.aspx Dr.Albert Kapikian
  32. What Can YOU do? Report unclean conditions •Report unclean restrooms to management •Wash your hands regularly •Stay home when you’re sick (really, no need to be a hero, let someone else finish those TPS reports.) http://www.salahqutaishat.com/
  33. Photo Attributes • Photo Credit: <a href="http://www.flickr.com/photos/28634332@N05/5654415647/">NASA's Marshall Space Flight Center</a> via <a href="http://compfight.com">Compfight</a> <a href="http:// creativecommons.org/licenses/by-nc/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/47353092@N00/8102307987/">AJC1</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-sa/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/24315793@N02/3010888802/">Reggie Rachuba</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/ by-nc-nd/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/70591690@N00/2693551009/">ZeroOne</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-sa/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/34864797@N07/3473249591/">parkydoodles</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by- nc-sa/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/10819063@N06/3654276952/">tbSMITH</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc-nd/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/37129284@N02/5093910979/">greg westfall.</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/35703177@N00/3095149875/">The U.S. Army</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/93247490@N00/441858611/">Mark Lobo .</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc- nd/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/95492938@N00/81671961/">Kaptain Kobold</a> via <a href="http://co • mpfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc-sa/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/34838158@N00/3370167184/">alexkess</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc-nd/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/34838158@N00/3370167184/">alexkess</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by-nc-nd/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/93587218@N00/2452029695/">Mel B.</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by/ 2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/98005720@N00/4100788909/">Amarand Agasi</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by- nc-sa/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/45940879@N04/5421517469/">Kalexanderson</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by- nc-sa/2.0/">cc</a> • Photo Credit: <a href="http://www.flickr.com/photos/99479626@N00/3492602261/">Eneas</a> via <a href="http://compfight.com">Compfight</a> <a href="http://creativecommons.org/licenses/by/ 2.0/">cc</a>
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