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Foodborne Illness

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Submitted By tashira
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The foodborne illness I chose would be: Norovirus (formerly Norwalk virus)

1. What is the infectious agent that causes this infectious disease?
Norovirus agent is caused by nonenveloped, single-stranded RNA viruses of the genus Norovirus, which have also been referred as Norwalk virus or small round-structured viruses of the family Caliciviridae. Other genera within the Caliciviridae family include Sapovirus which also cause acute gastroenteritis in persons as well. Norovirus can be divided into at least five geno groups designated GI---GV based on amino acid identity in the major structure protein. The strains that infect humans (referred to collectively “human noroviruses”) are found in GI, GII, and GIV. Since 2001, GII.4 viruses have been associated with majority of viral gastroenteritis outbreaks worldwide. Recent studies have demonstrated that these viruses evolve over time through serial changes in the VP1 sequence, which allow invasion of immunity in the human population.

2. How is this infectious agent transmitted through food or water? Transmission occurs primarily through fecal-oral route, either through direct person to person contact or indirectly via contaminated food or water. Norovirus is also indirectly through aerosols or vomitus and contaminated environmental surfaces and objects. Having contact with someone who is infected with norovirus (for example, caring for or sharing food or eating utensils with someone with norovirus illness). Norovirus is a highly contagious virus. Anyone can get infected with norovirus and get sick. Also, you can get norovirus illness many times in your life. One reason for this is because there are many different types of noroviruses. Being infected with one type does not protect you against other types.
3. What is an example of a real life outbreak of this foodborne illness in the United States?
GII. 4 viruses caused 395 of the 552 outbreaks. The number of outbreaks increased from 4 in October 2009 to a peak of 110 in January 2010 and then decreased to 31 in May 2010. New Orleans outbreak was first identified in October 2009 and caused 56%. In February 2010 the number of outbreaks decreased to 84, but the proportion of GII. 4 New Orleans remained high. The next month outbreaks in New Orleans accounted for 75% of the outbreaks. Health officials confirmed Friday that a fast acting gut bug known as norovirus is responsible for an outbreak of illness that sickened more than 200 people gathered for a cheerleading championship in Washington State. A Washington state Health Department spokesman says the latest count stands at 229.
4. What are the clinical symptoms, duration of the disease, and treatment if any? People with norovirus are contagious from the moment they begin feeling ill to at least three days and as much as two weeks after recovery, according to the Centers for Disease Control and Prevention. Some people with norovirus infection may show no signs or symptoms. However, they are still contagious and may unwittingly spread the virus to others. Signs and symptoms of norovirus infection vary, but generally involve abdominal cramps and nausea, followed by vomiting and watery diarrhea. Either vomiting or diarrhea can be present alone. The most common norovirus-induced illness is gastroenteritis involving inflammation or infection of the stomach and intestinal tract. Other symptoms consist of weight loss, malaise, and low-grade fever. There is no specific treatment or medication for norovirus. It is important that infec ted individuals remain hydrated, drinking plenty of fluids. Fluids containing electrolytes and sugars should be encouraged. Over the counter antidiarrheal medications may be used according to directions but should be avoided in severe abdominal pain. Norovirus cause acute gastroenteritis in persons of all ages. 5. What steps can be taken to prevent further outbreaks?
Practice proper hygiene; wash your hands carefully with soap and water especially after using the toilet and changing diapers and always before eating, preparing, or handling food. Alcohol-based hand sanitizers can be used in addition to hand washing. But, they should not be used as a substitute for washing with soap and water. Wash fruits and vegetables and cook seafood thoroughly before preparing and eating them. Cook oysters and other shellfish thoroughly before eating them. Be aware that noroviruses are relatively resistant. They can survive temperatures as high as 140 degree Fahrenheit and quick steaming processes that are often used for shellfish. Clean and disinfect contaminated surfaces. Healthcare facilities including nursing homes and hospitals are the most commonly reported settings of norovirus in the United States and other industrialized countries. Strict control measures (including isolation or cohorting of symptomatic patients, exclusion of affected staff, and restricting new admissions into affected units) are disruptive and costly but might be required to curtail outbreaks.

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