There are places and foods to avoid or to at least to approach more carefully if you want to dodge this winter’s outbreaks of norovirus. Some involve a new strain, likely causing the uptick in cases. Norovirus is nasty and highly contagious, often called “the vomiting disease” by the English for its stomach pains, nausea, diarrhea and yes, much up-chucking. Its not the flu, which is a respiratory illness, so norovirus is not stopped with a flu shot.  With only ten viral particles, it can make you sick. Norovirus is called by other names including stomach flu, food poisoning and “cruise ship flu,” just to name a few. Maybe the virus should have more names, because the public might not yet understand where they are in most danger. Try these: “nursing home” and “hospital” flu or perhaps “party,” “restaurant” and “school” flu — all of these places are as or more associated with norovirus than are cruise ships. Topping the list of dangerous places for noro, according to the federal Centers for Disease Control and Prevention (CDC) in Atlanta, are all sorts of long-term care facilities that include nursing homes, assisted living facilities, and the like. In a CDC study, 59 percent of the cases of norovirus in 2010-11 were associated with long term-care versus 4 percent for cruise ships. About half of all foodborne illness is caused by norovirus “In fact, norovirus is the leading cause of illness from contaminated food in the United States,” according to CDC. It says foods commonly involved in outbreaks of norovirus illness are:

  • Leafy greens (such as lettuce),
  • Fresh fruits, and
  • Shellfish (such as oysters).

“But, any food that is served raw or handled after being cooked can get contaminated,” warns CDC. Food handlers are most contagious when they are actually sick or during the first three days of recovery. Food handlers are advised to wash their hands “carefully and frequently” with soap and water, wash fruits and vegetables and cook shellfish thoroughly, clean and disinfect kitchens, utensils, counters, and all surfaces, and wash table linens, napkins, and other items thoroughly. Restaurants are associated with norovirus outbreaks twice as often as cruise ships. Many, however, are not escaping norovirus this winter, as outbreaks are being experienced coast-to-coast. Among those reports from around the U.S. and Canada are these: British Columbia—The province saw 25 outbreaks of norovirus in December, the biggest spike it has experienced since 2006. Both Royal Columbian and Vancouver General Hospitals were associated with outbreaks, defined as clusters of three or more cases. Both hospitals have closed or restricted units. California—Marin County public health reported norovirus contributed to the deaths of two elderly patients that sickened 59 residents of the Redwoods, a residential care facility in Mill Valley. San Luis Obispo County reports three outbreaks of norovirus involving a new strain, believed to have originated in Australia. Nearby Santa Barbara County reports only typical seasonal outbreaks of the virus, but not involving the new strain. Georgia—Two nursing homes in southwest Georgia are associated with at least 75 cases of norovirus, according to the Southwest Public Health District. The facilities are located in Albany and Thomasville, and the ill include both residents and staff. Maine—In a new advisory, the Maine Center for Disease Control and Prevention (Maine CDC), reported at least 16 outbreaks in the last two months, most located in southern Maine and half from York County. Norovirus Genotype II caused half of the outbreaks involving 2 or more individuals. Oregon –A dozen Emergency Room nurses and four doctors are among the norovirus victims in Oregon where the Providence Portland Medical Center has recorded 75 cases in its ER since Christmas. West Virginia—Health officials say norovirus is making it way through the Ohio Valley, but they are not calling it a specific outbreak. They are asking people who experience symptoms to avoid visits to hospitals and nursing homes.