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Norovirus

 Poster: A snowHead
Poster: A snowHead
https://www.nhs.uk/conditions/norovirus/

I have recently been reading up on food poisoning, and particularly norovirus. I thought it might be appropriate to mention my conclusions here, as I suspect it might be a common occurrence in ski resorts. (due to the method of spreading and the fact that it is called a winter bug)

I do not know if I have ever had this virus, but I suspect I have, and I probably contracted it when eating out. (rather than in on my own and preparing my own food)

I read an article saying that in a restaurant, a diner vomited at the table and had norovirus. A follow up study of the diners at the table, at adjacent tables, and at table at the far end of the restaurant showed a 90% infection rate at the table, a 70% infection rate at adjacent tables, and a 25% infection rate at tables furthest from the vomit. I also read that children under 5 have very high rates of infection, and that it is commonly spread by faecal-oral transmission (I think this means people wipe their bum (or a childs bum) with the virus and do not clean their hands properly)

Personal hygiene, food hygeine, and avoiding foods which could contain or spread the virus (salads, uncooked foods, communal cakes and sandwiches laid out on a table, etc)

There are probably a lot of experts here on this topic, given the number of chalet operators.... Any comments?
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@Bigtipper, stating the obvious...or no sh*t sherlock!
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@Bigtipper, I have experienced if, I think, twice.

I would wish it on my worst enemy.

The first was in Murren, and I ended up being escorted to the local GP as I had started to black out immediately after vomiting. First time I went straight face first into the bowl by my bed, and would have drowned had it not been noticed. I lost consciousness about 4 times each way on a (normally) 5 minute walk.

We were in an apartment of 5 people and we all got it, in sequence. Extremely unpleasant. The GP said he had treated 1,300 people in the preceeding fortnight, which is rather a lot given the number of tourist beds in Murren.

The second was in Stockholm and I woke at 03h00 starting a 25 minute cycle, details of which need no explanation. At 06h00 I called reception in one of my 5 minute "free" windows to let them know I wouldn't be checking out as expected at 07h00. Somewhat unreasonably they said they'd need my room at 11h00. Brief, truncated, repetitive discussions ensued. I left about 13h00, green but stable.

I can well believe your article. It's not known as the "Cruise Ship" disease for nothing. Some strains I understand are named after the ship they were first encountered on...
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NB - the best solution is alcohol hand cleanser.
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@holidayloverxx, it may seem obvious to you, but it is not always a visible injury. It is not something you consider closely, when you eat out or holiday in a chalet and share communal areas. Of course, wearing gloves a lot will probably help.

If you live in a van on your own, hygiene is often something people say you are not good at. I disagree, in that often the most unhygienic places if you live in a van on your own is places where other people go. (young children in particular) You cannot infect yourself with viruses.

You can infect yourself with poor food preparation, and hygiene. However, avoiding foods which are high risk, and cooking it well, avoids most of the risk. Eating out is the greatest risk, and so choose wisely to avoid a holiday disaster. (I have lived and travelled in India for a month backpacking, as well as many less risky places)


Last edited by Anyway, snowHeads is much more fun if you do. on Fri 11-05-18 9:56; edited 1 time in total
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@under a new name, the NHS link above suggest warm soapy water is better for Norovirus than alcohol cleansers which are not very effective for Norovirus.
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@Bigtipper, interesting. No argument from me.
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Alcohol cleanser won't work. Anything less than OCD levels of hand washing in boiling water won't work. It won't kill you unless your immune system is already compromised.

Just bite your nails BEFORE you pick your arse and stay lucky.
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Don't go on a cruise. Colleagues who are now regular cruise-goers won't touch stair rails, lift buttons and stick to non-buffet food. One couple were on a ship that couldn't dock due to the level of noro on board. Alcohol cleansers aren't very effective for noro. It's a nasty couple of days, but it won't kill you if you're normally healthy.
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holidayloverxx wrote:
... or no sh*t sherlock!
Having contracted norovirus a few years ago I can confidently state that you would not need to be Sherlock Holmes to deduce that "no sh*t" isn't an appropriate phrase for this thread.

wink
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@rob@rar, Laughing Laughing
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I once experienced a whole Club Med (Val D'Isere) go down with Noro. Was bad, very bad. Me and my wife were practically the only ones to get through the week without getting infected. No idea why! The symptoms seemed to be a) you're feeling fine and are enjoying a drink at the bar, b) you turn green over a period of a couple of minutes c) you run for the toilet and are not seen again for 48 hours. Similarly my son's first school outing was hit by Noro, the teachers ended up with 23 puking children with diahrrea (aged 7 / 8 ), where the teachers themselves were puking and had diahrrea... not good!
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I had norovirus at the end of the 15/16 season. First time I'd thrown up in nearly 20 years. Deeply unpleasant and cost me 3 days skiing.

Of course ski resorts are an extremely suitable environment for it to spread - you may be immune to the "local" norovirus from your hometown but you're not immune to the variety that is resident in the resort or just arrived with a visitor from another part of Europe/US etc. It's the same reason why pretty much every seasonnaire gets a heavy cold in December or January.

In France, where I am, it's also still extremely common for assistants in bakeries and delis to handle bread and sandwiches etc. without gloves on. But what can you do, starve?

I found a research article at the time that suggested that adults were immune for 5-8 years after the first norovirus infection so hopefully my skiing won't get disrupted again for a few years yet!
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Steilhang wrote:
Me and my wife were practically the only ones to get through the week without getting infected. No idea why!

You were the carriers! Toofy Grin
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@Raceplate, I guess I shouldn't have sneezed on the salad bar then...
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Out hotel came down with it when we were in L2A, on the day that we'd had about 30cm of fresh snow overnight, in between visits to our toilet we had our friend (in a different hotel) calling us up telling us how great it was up on the mountain, like skiing off piste, whilst on piste, and how we should get up there soon. We weren't very happy with him Sad
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@Sack the Juggler, I bet you weren't.
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No one seems to have corrected the original posters comment re. 'food poisoning' & Norovirous. They are two totally different things. Food poisoning is a result of EATING or drinking a contaminated substance. Norovirous is communicated by touching something which has the virus on and then touching their own mouth etc. The most obvious way to differentiate between the two in any outbreak is note how people fall ill. If it's food poisoning several people will fall ill all at once. Norovirus they will become ill sequentially, one after the other. Far too many people are too quick to scream FOOD POISONING at the first sign of being ill.
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Old Man Of Lech wrote:
No one seems to have corrected the original posters comment re. 'food poisoning' & Norovirous. They are two totally different things. Food poisoning is a result of EATING or drinking a contaminated substance. Norovirous is communicated by touching something which has the virus on and then touching their own mouth etc. The most obvious way to differentiate between the two in any outbreak is note how people fall ill. If it's food poisoning several people will fall ill all at once. Norovirus they will become ill sequentially, one after the other. Far too many people are too quick to scream FOOD POISONING at the first sign of being ill.



But stuff like food buffets in hotels/ on cruise ships or low paid staff being obliged to carry on when ill are incredibly effective at spreading norovirus to many people simultaneously and hence being largely indistinguishable from food poisoning.

One reason that while I retain my faculties I have no intention of going on a cruise.
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Re, the low paid staff comment. All responsible employers insist on any ill employees being away from work for a minimum of 48 hrs free of symptoms before they return to work. Buffets have strict regulations about temperature control and length of time food heated food can be left on display. Well run and regulated cold buffets will have similar rules in place. It is down to the management to actively monitor these things. Having said that, I do realise there are probably too many that are not regulated well. Just be careful where and when you eat, AND take care of personal hygiene.
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@Old Man Of Lech, I did think about it when I read the post TBH, but completely forgot to mention it, as I didn't immediately post my own comments.


Quote:

AND take care of personal hygiene.

Which is the best way of stopping the spread of Noro.
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Bigtipper wrote:
I do not know if I have ever had this virus, but I suspect I have


If you're not sure you've had it, then you've not had it. With projectile vomiting and high pressure diarrhoea for 48-72 hours with stomach cramps on top, I went through 4 toilet rolls per day and never had any more than 10 minutes out of the loo for the first 36 hours. I was so tired that when I eventually stopped I slept for another 18 hours, and was only woken by my wife starting on the early symptoms Sad

This was on my first skiing trip in Andorra, and in a chalet of 16 people everyone got it over the course of 4 days, starting on the Monday morning. It was horrific, and the unlucky ones got it on the Friday and had to haul themselves out of bed at 5am for the flight home, dosed to the eyeballs on Imodium and sitting next to the coach door so that the driver could kick them out at the first sign of eruption.

I've had (confirmed) food poisoning and stomach bugs on several occasions, but while they were at 4-5 on a 10 point scale, norovirus was at 10.
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ousekjarr wrote:
Bigtipper wrote:
I do not know if I have ever had this virus, but I suspect I have


If you're not sure you've had it, then you've not had it. With projectile vomiting and high pressure diarrhoea for 48-72 hours with stomach cramps on top, I went through 4 toilet rolls per day and never had any more than 10 minutes out of the loo for the first 36 hours. I was so tired that when I eventually stopped I slept for another 18 hours, and was only woken by my wife starting on the early symptoms Sad

This was on my first skiing trip in Andorra, and in a chalet of 16 people everyone got it over the course of 4 days, starting on the Monday morning. It was horrific, and the unlucky ones got it on the Friday and had to haul themselves out of bed at 5am for the flight home, dosed to the eyeballs on Imodium and sitting next to the coach door so that the driver could kick them out at the first sign of eruption.

I've had (confirmed) food poisoning and stomach bugs on several occasions, but while they were at 4-5 on a 10 point scale, norovirus was at 10.


Laughing Laughing Laughing Sorry for laughing, but, so eloquently put. Brilliant.
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@ousekjarr, I am unsure because I generally get very few symptoms of any colds or viruses mainly due to high immune system response. I have had similar symptoms, but not on the scale you suggest. (rarely vomiting without alcohol contributing to the cause)

I am aware of skiing issues regarding colds and viruses, many of which I contracted prior to leaving for a ski holiday or on the plane where air is circulated amongst all the patients.

So maybe not norovirus, but difficult to say without diagnosis.

Norovirus is not transmitted only through food. It can be transmitted through food and water, but it is also very contagious through the air and close proximity with infected people. It is also transmitted through surface contact like other viruses.

I only mentioned it is a food poisoning issue as it was highlighted as a potential food contaminent.
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Very frequent outbreaks on Cruise Liners, rarely publicised by the operators, who have become very adept at dealing with it!
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Just back from India with Shigella (probably) or Giardia (based on evidence but not persistence). Now okay, and I know where i got it. I just took a chance. Self diagnosed and fine but travel is part of my life so I am prepared for it.


Most people that think they have Noro have actually got this. If it is Noro then basically everyone will come down.

I'm prepped with Antihistamines for mozzies + DEET + Inhailler + Antibiotics. Typically 8 bottles of Alcohol get (to be used after I was my hands with warm soapy water)/week.

Cant be too careful.
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A couple of Xmas's ago Kooky went down with it. 2 days later I had it, then her son, then her daughter had a milder version. Both of us ended up in a foetal position on the toilet floor for a few hours at the height of the symptoms. As a type 1 diabetic it threw in a few extra hurdles... as I was laying there I had a low blood glucose and had to call her in to open a glucose gel for me as I didn't have the strength LOL. Ahhh... all those hours of sitting on the loo with a bucket between your legs, sipping water which passed through the bowels unchanged only minutes later.

A hell of a way to lose weight quickly though.
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worst 14 hours of my life, ever.
I would rather give birth.


I lost all body functions, I couldnt even get up off the toliet floor to sit on the loo, just hot water like liquid burtsing out of both ends, sorry to be so graphic,and retching til it felt like my lungs were coming up.


it was a real shocker. I was told a normal alcohol hand cleaner wouldnt help so we bought a special Norovirus one.
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@Scarpa, @Kooky, me and eeyore had it the same week. I felt like crap for 3 weeks
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@ousekjarr,
Quote:

If you're not sure you've had it, then you've not had it.

Absolutely.
It is so nasty, I have had pigflu and food poisioning, and they are nothing in comparison to Noro.
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Short of having some analysis/cultures grown, I'm not sure you can determine easily what particular form of stomach bug/infection you have. Rotavirus (mostly children it seems) and other 'bugs' (some bacteria/toxins etc) some already mentioned can all present with broadly similar symptoms. And because everyone's`s immune system is slightly different, one persons response to 'a bug' may be more, or less severe. You can generalise to differentiate between viral, bacterial, parasitic infections and so on but its not a precise science unless samples are taken and analysed. Whatever the causal agent good personal hygiene, such as thoroughly washing hands with soap and hot water as frequently as possible and a common sense approach to where, and what you eat, will minimise the risk of infection. I`ve had enough truly horrid stomach 'bugs' to be very wary and have nothing but sympathy for anyone enduring the symptoms!
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Hells Bells wrote:
Don't go on a cruise. Colleagues who are now regular cruise-goers won't touch stair rails, ....


Probably good practice, but it flies in the face of standard 'elf 'n safety advice which encourages people to use the hand rails when using stairs. Some years back a colleague of mine working at another company's site was strongly reprimanded for going down stairs without using the hand rail rolling eyes . On a cruise ship I guess it's a question of the relative risks of contracting norovirus or tripping and falling on the stairs. Unless the ship is in stormy weather and rolling severely I expect the norovirus risk is substantially greater! Madeye-Smiley
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There was a Birthday Bash some years back when, over the course of the week, about 50% of the group went down with it.
As usual, there were the initial cries of 'food poisoning' but it soon became clear it was nothing to do with the food.
There's no logic who goes down with it though: el Hen decimated the en suite while I stayed clear of the bug altogether.

With so many snowHeads focused on the same issue, it was soon discovered that Sprite was, in this context the nectar of the gods, in that it somehow seemed to remain in the body longer than any other fluids, allowing a little re-hydration of the subject Toofy Grin


It is very common to do the rounds of ski resorts and some years it's worse than others.
One year it was particularly prevalent and a tour op I know, who specialise in school groups was getting hit week after week in one of their hotels.
They went as far as buying a £3000 machine used to fumigate the soft furnishings of posh hospitals. Shipped the outgoing group out a night early to a hotel in the valley - and disinfected the whole place.
The first bus arrives at the airport, to pick up the incoming group and one of the kids is already on the deck throwing up! rolling eyes
And that's much of the issue - when noro is doing the rounds in ski resorts, it's often doing the rounds of schools back home too.
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under a new name wrote:
NB - the best solution is alcohol hand cleanser.


The NHS, FDA and CDC don't agree Happy

Their more nuanced answer is that there is evidence they're effective when you've already washed your hands and removed debris. There are also some studies that show during norovirus outbreaks the use of hand sanitizers alone has encouraged the spread of the virus.

Norovirus is quite hardy, it survives quite high and low temperatures and can hang around on surfaces for a while.
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As already observed - yet another powerful reason to never go on a cruise. The "Navigator of the Seas" out of Southampton passed us yesterday in the East Solent. A vision of Hell....even without Noro.
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Quote:

There's no logic who goes down with it though

The dining room on that bash was half deserted. At 7pm each day you could work out who was next.
But not as deserted as the snowmageddon year.

We were in the apartment for 7 that year with only 1 bathroom. Some got it, some didn't. But then the whole outbreak was over as quickly as it started. 7 fighting over one big white telephone would have been carnage. In the end I think only 2 got it?

Also see negative reviews for other hotels for "food poisoning". Hotel Curling was one. Any hotel can get norovirus outbreak. And when it takes out 1/3rd of the town, you can hardly mark a hotel down for that.
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andy wrote:

Also see negative reviews for other hotels for "food poisoning". Hotel Curling was one. Any hotel can get norovirus outbreak. And when it takes out 1/3rd of the town, you can hardly mark a hotel down for that.


I do not blame any hotel for these issues. The staff maybe part of the cause, but the customers are the main etiology in my opinion.

For a while there was a clear association in my mind between going on a ski holiday with a tour operator, and getting a cold/virus/food posoning. It was not the tour operators fault, as usually the infection occurred prior to going on holiday or on the flight/transport over there.

I became a little bit paranoid about some people with germ virus warfare trying to spoil my holiday.

This in part led to travelling by ferry (avoiding air circulation in planes and crowded cramped spaces with strangers), and driving to resort. Also you must be very careful when going to supermarkets prior to holidaying as this is often where germs are spread from children. (public transport too)

I do have a fascination with DVDs which have germ warfare as the theme (The Omega man, I am Legend, Contagion, 26 weeks later and the sequel)

Living in a van on your own and travelling by ferry resulted in no virus infection prior to travelling. No virus infection during holiday. (some extended periods of months rather than weeks) However, I did encounter a few occurrences of food poisoning which were mild in my case. (resulted in one or two days of runny stools) These occurrences were associated with eating out (which I did very rarely), or drinking at a bar in resort. Eating or drinking in on piste restaurants had no such problem.

These associations, did change my behaviour. I seriously doubt that germ warfare in resort bars and restaurants is within the capabability of the staff who work there. It therefore must be just where the higher risk occurs.
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@admin, I remember coming down with it on the night meal up the mountain, 30 minutes earlier I was blasting runs (no pun intended) repeatedly, went in to the restaurant and the queasiness began. I then skiied down on my own with a head torch, just reaching the hotel before the vomiting began.
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