Archive for the ‘United Kingdom’ Category

Squirrel Hayes school shut as pupils struck by norovirus bug

Dozens of pupils and staff at a school were struck down by a stomach bug – forcing it to close for five days.

Squirrel Hayes First School, in Biddulph, has confirmed that a ‘high proportion’ of the school’s 130 children suffered from sickness and diarrhoea after it was hit with the norovirus bug.

The Springfield Road school was forced to close on Friday, November 23 while a deep clean was carried out. It re-opened last Thursday.

Headteacher Erica Smith said: “The school was closed last week due to an outbreak of sickness and diarrhoea.

“Thanks to the hard work of staff and the local authority who performed a deep clean of the school, we were able to open last Thursday, which was earlier than expected. “While they were off school, all children had learning packs via the school’s website and through James Bateman Junior High School so they could continue their learning.

“Parents have been very positive about the action we took to close the school and help contain the infection, and we are pleased to be open again and back to normal.”

Robert Grant’s five-year-old son Leo was struck down with the illness. The 36-year-old, of Biddulph, said: “He came home on the Thursday and he was really sick.

“At first I thought it was just a little bug, but when the school closed I worried it was something more.

“Normally, when children are sick, they are still allowed to go into the school, but the school was completely closed off, which automatically made me think it was contaminated.”

Mr Grant added: “I still don’t know where it came from and the school won’t tell us, but it must have been a pretty bad outbreak for them to close it for so long.”

The news of the bug comes just two weeks after The Sentinel reported how two Staffordshire Moorlands schools suffered an outbreak last month.

Staff at St Giles Catholic Primary School in Cheadle and St Thomas Catholic Primary School in Tean came down with the bug after attending a joint training day.

It resulted in the closure of the Cheadle school for two days.

A spokesman for the Heath and Protection Agency (HPA) said: “Cases of norovirus, also known as the winter vomiting bug, are not uncommon at this time of year and the infection is particularly difficult to contain when it gets into environments where people mix in close proximity, such as schools. ”

“Although people usually recover without treatment in 24-72 hours, it is important to stay away from work, school or college until they have been free of symptoms for at least 48 hours.”




Cruise ruined for East Lancashire couple on ‘sick ship’

A couple who say they had their dream holiday ruined after catching a stomach bug on a “sick ship” are suing a luxury cruise operator.

David and Jane Sacks, from Lancaster Road, Haslingden, claim they became ill on board the Independence of the Seas, operated by Royal Caribbean and Celebrity Cruises.

Mr and Mrs Sacks said that during the 11-day cruise from Southampton to Spain, Portugal and the Canary Islands, they were unable to get off the ship at all of the destinations because they were feeling so poorly.

Mrs Sacks, a 69-year-old retired victim support office,r said: “I thought I was dying at one stage. I had never felt old before but I felt old and decrepid.”

After caring for his wife four days, Mr Sacks, a 76-year-old retired police officer, said he was also struck down by the bug.

He said: “It was a bad experience and one that has deterred us now from ever setting foot on a ship again.”

The couple are among 25 passengers who sailed on the ship between December 2010 and June 2011 and claim they were laid low by gastroenteritis. They have served a writ in the High Court seeking compensation.

The group has reported “multiple cases of gastroenteritis on previous cruises” on the vessel and claim they should have been warned they were boarding a sick ship and offered an alternative or a refund.

In documents lodged in the High Court, Charles Crow, the barrister representing the group, said: “The company, despite multiple cases of gastroenteritis on previous cruises, failed to effectively remedy the situation, whether by way of adequate cleaning or sanitisation or greater control in the preparation of food and drink.

“Royal Caribbean failed to allocate the passengers to a ship which was not experiencing an outbreak of gastric illness, or if no such ship was available, failed to notify them prior to emb-arkation and/or offer them a full refund.

“Had the passengers been made aware in advance, they would have been likely to have refused to travel and so avoided illness, loss and damage.”

A spokeswoman for Royal Caribbean said in a statement:: “Of the 25 guests that you refer to, not all of these guests experienced illness. The 25 guests were across five different sailings within a seven-month period from December 2010 to June 2011.

“In this time period, the ship sailed on 15 cruises, welcoming over 67,000 guests.

“Those affected by the short-lived illness responded well to over-the-counter medication administered on-board the ship and were not referred for additional treatment by the on-board medical teams.

“Our crew conducted extensive cleaning on-board the ship and guests were kept up to date on these additional measures prior to embarkation.”




UK babies to get Rotavirus vaccine to prevent stomach bug

Babies in the UK are to be vaccinated against a tummy bug which causes tens of thousands of cases of vomiting and diarrhoea each year.

Rotavirus infection is rarely fatal in the UK.

Using the vaccine has cut cases and reduced hospital admissions in other countries, including the US.

The Department of Health said the vaccine would be offered from September 2013 and would be given in two doses after two and three months.

The bug is very infectious and causes about 140,000 cases every year in the under-fives. About 14,000 will need hospital treatment.

Experts believe that vaccination would cut the number of cases in half and lead to 70% fewer hospital visits.

Prof David Salisbury, the director of immunisation at the Department of Health, said the virus “spreads very easily” and causes distress for children and families.

“Many people think of diarrhoea as something that all children get and that you have to put up with. But there is a way to protect children from this. I’d encourage all parents of young children to accept this vaccine when the programme begins next year.”

He added the vaccine – which is administered in drops – had been “used very extensively” with “huge trials demonstrating both its safety and its effectiveness”.

It is expected to cost £25m a year to vaccinate 840,000 children a year. However, the government believes cutting the number of cases will save the NHS £20m.

Prof Adam Finn, from the University of Bristol, said: “Rotavirus causes large epidemics of diarrhoea and vomiting in babies and young children every winter and with it, misery for thousands of families across the country.

“I’m pleased that another unpleasant illness that affects most children is going to be brought under control. It will also help hospitals cope in the busy winter months by reducing pressure on beds and front-line staff.”

Dr David Elliman, from the Royal College of Paediatrics and Child Health, said the vaccine would prevent a “huge amount of suffering” and save the NHS money.

“This vaccine will mean less pressure both on distressed parents who have to care for their children and of course the GPs and hospital services who are treating them,” he said.




UK: Norovirus Season Starts Early

Whether you call it Norwalk or Norovirus – the more descriptive `Winter Vomiting Bug’, or the less accurate `stomach flu’ – the virus behind millions of cases of gastroenteritis each year can pack more misery into 72 hours than should be allowed by law.

Long the scourge of crowded institutions – like nursing homes, cruise ships, hospitals and schools – the virus also circulates readily in the community, taking advantage of low levels of human immunity and its ease of spread.

After exposure and a short incubation period (12-24 hours), the victim usually experiences nausea, frequent vomiting & diarrhea, and stomach pain – and may also experience headache, fever, and body aches.

The illness generally runs its course in 1 to 3 (very long) days, and most people recover.

But among those who are aged or infirmed, the virus can take a heavy toll. According to the CDC, each year the norovirus:

– causes about 21 million cases of acute gastroenteritis (inflammation of the stomach or intestines or both)
– contributes to about 70,000 hospitalizations and 800 deaths, mostly among young children and the elderly

Last month in JAMA, a study of 407 norovirus outbreaks across 308 nursing homes showed an 11% increase in fatalities during times when a facility was experiencing an outbreak.

Already this winter, I’m aware of a couple of outbreaks here in Central Florida, and in the post-hurricane Sandy recovery, we’ve media reports that Viral outbreak at Hurricane Sandy evacuation shelter shuts 3 Brooklyn schools.

And from the UK today, reports that their `winter vomiting bug season’ has gotten off to an early start.

Earlier this week, the HPA posted the following notice on their Syndromic Surveillance site, indicating reports of vomiting were elevated, suggesting `community-based norovirus activity’.

One of the keys to prevention is good hand hygiene.

Unfortunately, unlike with many other bacteria and viruses, alcohol gel doesn’t do a particularly good job of killing the virus, as we discussed last year in CMAJ: Hand Sanitizers May Be `Suboptimal’ For Preventing Norovirus.

Which makes a good old fashion hand scrubbing with soap and water the best preventative.

The primary method of infection is via the fecal-oral route. The CDC describes it this way:

Norovirus and Food

Norovirus is a leading cause of disease from contaminated foods in the United States. Foods that are most commonly involved in foodborne norovirus outbreaks include leafy greens (such as lettuce), fresh fruits, and shellfish (such as oysters). However, any food item that is served raw or handled after being cooked can become contaminated with noroviruses.

Norovirus Spreads Quickly

Norovirus can spread quickly from person to person in crowded, closed places like long-term care facilities, daycare centers, schools, hotels, and cruise ships. Noroviruses can also be a major cause of gastroenteritis in restaurants and catered-meal settings if contaminated food is served.

The viruses are found in the vomit and stool of infected people. You can get it by:

– Eating food or drinking liquids that are contaminated with norovirus (someone gets stool or vomit on their hands, then touches food or drink).
– Touching surfaces or objects contaminated with norovirus and then putting your hand or fingers in your mouth.
– Having direct contact with a person who is infected with norovirus (for example, when caring for someone with norovirus or sharing foods or eating utensils with them).
– People with norovirus illness are contagious from the moment they begin feeling sick until at least 3 days after they recover. But, some people may be contagious for even longer.

The role of direct aerosolized human-to-human transmission of norovirus remains a bit murky, although there are numerous anecdotal reports that suggest that it happens.

The CDC – in a an MMWR report from 2011 called Updated Norovirus Outbreak Management and Disease Prevention Guidelines describes transmission thusly:


Norovirus is extremely contagious, with an estimated infectious dose as low as 18 viral particles (41), suggesting that approximately 5 billion infectious doses might be contained in each gram of feces during peak shedding. Humans are the only known reservoir for human norovirus infections, and transmission occurs by three general routes: person-to-person, foodborne, and waterborne.

Person-to-person transmission might occur directly through the fecal-oral route, by ingestion of aerosolized vomitus, or by indirect exposure via fomites or contaminated environmental surfaces.

According to:


Taranisia MacCannell, PhD, MSc ; Craig A. Umscheid, MD, MSCE ; Rajender K. Agarwal, MD, MPH ; Ingi Lee, MD, MSCE ; Gretchen Kuntz, MSW, MSLIS ;Kurt B. Stevenson, MD, MPH 3 and the Healthcare Infection Control Practices Advisory Committee (HICPAC)



23. If norovirus infection is suspected, adherence to PPE use according to Contact and Standard Precautions is recommended for individuals entering the patient care area (i.e., gowns and gloves upon entry) to reduce the likelihood of exposure to infectious vomitus or fecal material. (Category IB) (Key Question 1.C.4)

24. Use a surgical or procedure mask and eye protection or a full face shield if there is an anticipated risk of splashes to the face during the care of patients, particularly among those who are vomiting. (Category IB) (Key Question 3.C.2.a)

25. More research is needed to evaluate the utility of implementing Universal Gloving (e.g., routine use of gloves for all patient care) during norovirus outbreaks. (No recommendation/unresolved issue)

One of the reasons I keep a generous supply of exam gloves, and surgical (& N95) masks in my emergency kit.

And finally, earlier this year in Norovirus Sequelae we looked at a new study appearing in Clinical Infectious Diseases that found a link between norovirus infection and ongoing gastrointestinal complaints.

Researchers looked at the records of more than 1700 military personnel who were treated for AGE (acute gastroenteritis) during three known norovirus outbreaks.

By comparing them to controls, they determined that those with a history of AGE were at increased risk of developing chronic gastrointestinal disorders.

Since this was a fairly small study, and some variability was detected in outcomes across the three outbreaks studied, more research will be needed to confirm their findings and to determine how long these after effects may persist.

Still, this is one virus that you want to avoid catching, if at all possible.