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In August, three hundred high school students showed up at the University of Maryland
College Park campus for a conference on medicine and health care. They got a dramatic lesson
in both after a hundred of them were struck with a sudden bout of food poisoning and had to be
Food poisoning. Stomach flu. Viral gastroenteritis. These are common names for those
all too common events in which groups of people are felled by the unforgiving symptoms of
nausea, vomiting, and diarrhea. These kinds of outbreaks often are associated with cruise ships,
conferences, summer camps, nursing homes, company picnics, and other organized gatherings
that feature a variety of prepared foods and salads. Lurking somewhere among the vacationers
This is the virus that seems to have hit the students at the University of Maryland.
of the gastrointestinal tract a day or so after being exposed to them. The result is sudden
vomiting, watery diarrhea and cramps, and sometimes a low-grade fever. The awful symptoms
last a day or two, and dehydration is usually the biggest personal danger from these infections.
But there's also a social danger to these viral assaults. Infected individuals can shed the
virus for up to two weeks after first becoming ill. That means the virus can be spread from
person-to-person, or from one person to food and drink. It's the "Typhoid Mary" syndrome in
which one individual manages to infect many others through poor hygiene, improper food
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The best way to guard against this virus is through old-fashioned, low-tech hand washing.
The hands that prepare foods should be clean, as should the countertops and containers where
foods are prepared and stored. That's the best guard against a virus that is so contagious just 10
tiny viral particles may be enough to start an infection and send you hopping from bed to
The University of Maryland incident was hardly unique. In January, the University of
North Carolina had a small norovirus outbreak among its students. In February, fifty-three
members of a Vermont swim club became ill from norovirus contamination of the pool water.
(That outbreak may have been started by a leaky diaper.) In 2002, the Centers for Disease
Control and Prevention (CDC) investigated twenty-one cruise ships after outbreaks of
gastroenteritis. Nine of the shipboard outbreaks were due to norovirus. In Ohio, health officials
are still trying to analyze an outbreak of gastroenteritis that affected over a thousand people at a
resort at the end of August. Noroviruses may be one of the microbial culprits.
How does one virus cause so many problems for so many people? Well, the norovirus is
a hardy beast. It can survive freezing, heating to 140 degrees, and typical levels of chlorine in
Not only are these viruses hardy, but there appears to be many different strains, or types,
of noroviruses loose in the world. As with flu and cold viruses, we develop some short-term
approximately 310 people each year. Most of these deaths are probably due to severe
dehydration and other underlying illnesses. The noroviruses are not major killers, but they do
represent a significant source of annual morbidity and economic loss. The CDC estimates that
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noroviruses cause about 23 million cases of acute gastroenteritis in the U.S. each year. In fact,
fifty percent of all foodborne outbreaks may involve noroviruses. That adds up to a lot missed
Scientists are working to better understand how these viruses cause illness and manage to
spread so quickly from person to person. There is even some very preliminary work being done
on vaccines against them. But until a vaccine or a preventive pill comes along we're going to
www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm.