That's one nasty flu

That’s one nasty flu
By Dan Hilborn, Burnaby Now assistant editor
Published Jan. 29, 2003

When that queasy feeling begins in your stomach and slowly works its way up to your head, you know it's coming.
January is in the middle of stomach flu season in British Columbia, but this year, more than any other, local health authorities are warning the public to be aware of a particularly nasty strain of the same old disease.
But the sudden surge in cases of what is called Norwalk-like virus, or norovirus, is really nothing unusual, except for the name, Dr. Robert Parker, deputy medical health officer for the Fraser Health Authority, said this week.
The disease that has spread through local long-term care homes and visiting cruise ships is the same ailment most people remember simply as the stomach flu, or what some of the English so charmingly refer to as 'winter vomiting disease.'
"I think it's always been around," Parker said. "Even 60 years ago, doctors saw people with stomach flu, and in a lot of those cases, this is what they'd be talking about."
So why is the disease gaining such a horrific reputation?
For starters, there is more of it around, Parker said. Secondly, health officials are getting far better at recognizing the disease.
According to the B.C. Centre for Disease Control, there was only one confirmed outbreak of Norwalk in the province in 1993. That same year, there were fewer than 10 total outbreaks of gastrointestinal disease.
But by the mid-'90s, the incidence of gastrointestinal disease began to rise steadily, going from 15 outbreaks in 1996 to about 45 outbreaks in 2000.
At the same time, the reported rate of Norwalk virus stayed fairly steady at fewer than 10 outbreaks per year.
But in the past two years, the incidence of gastrointestinal disease jumped dramatically, reaching about 70 instances, including 10 confirmed Norwalk outbreaks, across B.C. in 2001.
It rose to almost 160 outbreaks, including more than 80 confirmed Norwalk outbreaks, across the province last year.
Fully 33 per cent of all norovirus outbreaks in B.C. last year were in the Fraser Health Authority, the health region that stretches from Boundary Road to Boston Bar.
The symptoms are well known. Usually it starts with a queasy feeling in the stomach, then comes the vomiting and then, after one or two days, the afflicted person will develop a severe case of diarrhea.
The best defence is simple hand-washing, Parker said, and that's because the virus is very hardy and can float through the air, landing on surfaces such as countertops, walls and floors, where it remains active for a long time.
"It's very infectious, and probably the best way to avoid it is good hand-washing," the health officer said. "If someone in your house comes starts vomiting or has watery diarrhea, make sure they do lots of hand-washing, and someone disinfects all the surfaces in the house.
"It's also not a bad idea for the afflicted person to self- restrict their activities for a couple of days to get over it."
The Norwalk virus is usually not fatal on its own, but it could be a contributing factor in the death of a person who is already sick with a pre-existing heart condition or other disorder, such as cancer.
"In rare times, a person dies with this as a contributing factor," Parker said. "Usually, Norwalk is not as severe as the upper respiratory tract influenza, which comes around every year."
For people who are typically healthy, catching the Norwalk virus means a few days of extreme discomfort and dehydration. The best advice is to stay home, drink plenty of fluids and do lots of hand- washing and counter-cleaning.
Parker also said that health officials are hoping that the disease has reached the peak of a 10-year cycle, and there may be fewer cases this year. However, nobody knows for sure.
"There are three things going on with this disease, he said. "Number 1, we have better surveillance and Norwalk is being reported more often. The second is increased lab testing and, thirdly, we may be in a long-term cycle where we were on the upswing for Norwalk and that may start to decline. However, whether it's truly peaked or not, it's hard to tell."