Norovirus Outbreaks: Where Are You Most At Risk?

(NEXSTAR) — Outbreaks of norovirus are currently on the rise across the country — and slightly earlier than in previous years.

Health officials say the timing and volume of these outbreaks are not entirely unexpected as the latest outbreaks coincide with the easing of pandemic restrictions.

“Prevention measures implemented during the COVID-19 pandemic were likely effective in preventing norovirus outbreaks,” Marisa Lubeck, a health communications specialist at the Centers for Disease Control and Prevention (CDC), previously told Nexstar. “As pandemic restrictions have eased, the number of norovirus outbreaks has returned to levels similar to pre-pandemic years.”

Nevertheless, illnesses caused by norovirus infection can be a concern, especially during outbreaks involving young children, the elderly and people with compromised immune systems.

Perhaps even more concerning is the fact that long-term health facilities and hospitals are the most common setting for norovirus outbreaks in the United States, and can come from a variety of sources, including residents, employees, visitors, or contaminated food. For example, between 2009 and 2013, 62.7% of all outbreaks reported through the CDC’s National Outbreak Reporting System (NORS) occurred in healthcare facilities.

The elderly are also considered the most at-risk community, as they generally experience longer, more severe illnesses that, in rare cases, can sometimes be fatal, the CDC said.

Prevention and timely intervention are especially important in such settings, as there is currently no treatment for the infection itself, but for its symptoms. One of the most concerning symptoms – dehydration – is the “most common complication requiring medical attention” in patients in long-term care facilities, as noted in a study by researchers from the Australian National University and the CDC.

Aside from healthcare facilities, the most common setting for a norovirus outbreak is a restaurant or catered event. Outbreaks arising from food supply facilities such as these accounted for about 22% of all reported outbreaks between 2009 and 2013, according to the CDC.

Infected workers who spread norovirus particles are “often the source” of the outbreaks, according to the agency, and can easily contaminate food through contact. In most cases, infected food service workers handle ready-to-eat foods, although it is also possible for workers to contaminate cooked food.

Outbreaks are also somewhat common in childcare facilities and schools, as well as colleges where students may be more at risk for exposure in dormitories or other shared living or study spaces.

Cruise ships are not a common environment for norovirus outbreaks, despite widespread beliefs to the contrary. Cruise Lines International Association (CLIA) — an industry association made up of major cruise lines — has even tried to dispel the misconception that norovirus is a “cruise ship disease,” citing previous CDC reporting that showed outbreaks on ships account for less than 1% of total reported outbreaks in the US

However, the CDC notes that outbreaks on cruise ships can be “particularly difficult to control” because passengers share recreational and dining areas.

Despite being “challenging to get under control,” there are far fewer norovirus outbreaks on cruise ships than in long-term care facilities or restaurants, according to the CDC. One such outbreak that received widespread media attention in 2006 affected about 700 passengers on the Carnival Liberty cruise ship, seen here during a cleanup in Fort Lauderdale, Florida. (Joe Raedle/Getty Images)

Regardless of where the outbreak occurs, sick individuals and those caring for them (or who live closely with the sick) should practice good hygiene and take precautions, Dr. Scott Harris, the state health officer for the Alabama Department of Public Health, who spoke to Nexstar’s WIAT in response to reports of recent rising cases.

Among other things, doctors recommend disinfecting shared surfaces and washing hands regularly, especially after using the bathroom or before preparing food. Otherwise, there is a significant risk of spreading the disease to vulnerable groups.

“If you’re in an institution like a hospital or nursing home where you have really vulnerable people, you know you can have serious consequences because of that,” Dr Harris said.

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