Talk:Norovirus/Archive 1

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The early November / mid November doesn't make sense as the outbreak described as occuring "mid November" occured before the outbreak described as ocurring in "early November".

Apparently (based on Googling for information) Norwalk virus group = Norwalk virus family = Norwalk-like viruses = Noroviruses. However, I am not an expert. Can someone expert confirm this? -- User:213.253.40.180

I've found this too. And from what I've found "Noroviruses" is the new correct name, and we should rename the page, but I thought I should raise it here first. -- ciphergoth 09:04, 2005 Apr 10 (UTC)

The new name (noroviruses) is correct. Traditionally these viruses were called Norwalk or Norwalk-like viruses referring to the discovery of the virus by electronmicroscopy in the fecal samples from children involved in an outbreak of acute gastroenteritis at an elementary school in the town Norwalk, Ohio.

I don't see how this illness can be called both mild and acute.

^ Simply put, mild refers to the severity of the outcome. In this case mild means it's not life-threatening in most cases and rarely even puts much of a physical strain on adults in good health. In the medical field acute generally means that it is a passing illness. Acute, in this case, merely means the opposite of chronic. This is not an illness that people live with for any significant period of time like heart disease, diabetes, or emphysema. This comes and then it goes. That simple. —Preceding unsigned comment added by 76.252.11.43 (talk) 18:57, 12 October 2008 (UTC)

Severity and time course are different entities.

Indeed. New name for this group of viruses is Noroviruses. They are genus in a family Caliciviridaetogether with Sapporo-like viruses, Lagoviruses and Vesiviruses according to ICTV.

I deleted the line about Lister Centre (Lister Center at the University of Alberta has recently been quaranteened due to an outbreak of the Norwalk virus on site.) that was added due to the fact that it hasn't been confirmed if it was Norwalk. Also, looks like it was a fairly minor outbreak, regardless. Health measures beating Lister bug Darrel UofA 17:44, 3 October 2006 (UTC)

Trust the Gateway to prove me wrong...they've confirmed it is a Norovirus...if anybody wants to put the Lister part back in, by all means do so...I still don't think it's that important. 20:51, 3 October 2006 (UTC)

It seems moving this page to "Norovirus" has already been discussed. As no objections have been raised, I am going to do so sometime in the next few days. As this article refers to Noroviruses in general, yet is names Norwalk vrius group, which is not consistent with more current naming schemes, the change seems very appropriate and necessary. JeffreyN 19:56, 25 April 2007 (UTC)

Cruise Ships

This bit looked like it was written by a Carnival spokesperson: (Outbreak investigations by the U. S. Centers for Disease Control and Prevention have shown that transmission among cruise ship passengers is almost wholly person-to-person. Cruise ship water supplies have never been implicated.) I did a quick google search, and found plenty that condradicted this. So I changed it accordingly. -- Aaronwinborn 20:11, 16 March 2006 (UTC)

I have only anecdotal evidence, but I used to work on a number of ships during Norwalk outbreaks, and I can assure you that the main means of transmission is from things like door handles, handrails, lift buttons and the like. The water is not the transmission vector.

I changed the cruise ship back to the original, more factual statement "Outbreak investigations by the U. S. Centers for Disease Control and Prevention have shown that transmission among cruise ship passengers is almost wholly person-to-person. Cruise ship water supplies have never been implicated." Outbreak reports are available on CDC website. If you look at the number of passengers who become ill in most cruise ship outbreaks, it is a relatively small percentage of the total number of passengers. I am not sure about waterborne outbreaks, but I know that in foodborne outbreaks, the attack rate much, much higher than what is generally seen on cruise ships. EAH

- I think it is at best misleading to claim that transmission is almost wholly person-to-person. There are numerous cases of norovirus outbreaks on cruise ships that have been proven to have been caused by contaminated food (usually undercooked shellfish). What is the source for the claim that transmission is "almost wholly person-to-person"? That sounds like propoganda to me. What's your source, EAH? (You think everyone on a cruise ship eats from the *one* undercooked batch of shrimp?) The statement is only factual if it is *true*. What's the evidence? In any event, it's false. One norovirus outbreak on a cruise ship in Hawaii was traced to ice. Ice is water, so ice supply is water supply. Another was traced to shrimp. Most are never traced.

- My husband & I just got off the Norwegian Crown (~1,100 passengers, March 12 2007 sailing). Half-way into the 14 day cruise a letter was placed in the cabins stating that there were 118 reported cases. As there was another week to go, I am guessing that the infection rate was well above 10%. This ship visited no US ports and the ship is of Bahamian registry. I am guessing that they did not need to report to the CDC - or no? It was said that there had been cases in the previous weeks, but of nowhere near the infection rate seen during this cruise. Of note, those who came down with the illness (and their cabin mates) were out of quarantine less than 12 hours after sympoms abated.

- What is the point of this section on Cruise Ships? According to this BBC article - http://news.bbc.co.uk/1/hi/health/7169347.stm - 100,000 people a week are catching the virus every week at the moment in the UK alone. So what's the significance of a detailed list of minor outbreaks on cruise ships in particular? 82.108.160.130 (talk) 12:58, 3 January 2008 (UTC)

None. Just as there is no point in a section for each outbreak. Perhaps there should be a section for Notable outbreaks but even the latest UK outbreak (now reported as infecting 200,000pw) should not be listed, as the authorities say it's only a one in five year event. -- John (Daytona2 · talk · contribs) 23:05, 3 January 2008 (UTC)

I think it's legitimate to retain a section explaining the prevalence of norovirus on cruise ships with a few specific examples of notable outbreaks, but a long list of run of the mill outbreaks is pointless. Despite all the case histories there is no reference to outbreaks on Egyptian Nile cruise ships, which are anecdotally notorious.

complications?

I know this isn't a bulletin board, but my best friend just called me to say he's had it for the last three days and is quarantined. Thing is, he's had kidney failure in the past. He wouldn't listen to any advice I found for him anyway ;-| but can anyone fill me in on recovery time, residual effects etc? He figures he got it from fruit or vegetables at the market; I haven't seen any info on an outbreak locally, which there are sometimes in hospitals and old folks homes; are individual occurrences in the general population documented in any way?Skookum1 07:13, 10 July 2006 (UTC)

You could ask at the Wikipedia:Reference desk. --HughCharlesParker (talk - contribs) 18:58, 12 July 2006 (UTC)

Thx.Skookum1 21:11, 12 July 2006 (UTC)

- We're talking about one of the most common diseases humans get. There are many occurrences and outbreaks. It seems that right now there are several clusters of norovirus outbreak throughout the United States. (In fact, I just got over an outbreak and my sister is ill right now. Norovirus is the most likely culprit.) About half of the contagious diseases causing nausea or vomiting and diarrhea are caused by norovirus.

Whitehorse, Yukon

I think around 25 people have been infected here in Whitehorse, Yukon. They noticed it when a bunch of patients had all the same symptoms at the hospital and then nurses and doctors started calling in sick. It's not a really big deal so far- is it worth mentioning? ~~Supermal

Duration of symptoms

Personal and family experience suggests that some of the symptoms may clear in well under a day. In 2001 my household suffered an outbreak in which gastrointestinal symptoms were severe but of relatively brief duration, clearing in 8 to 12 hours. But fever, headache and lethargy persisted for up to 24 hours after the GI symptoms stopped, so that the sufferer tended to stay in his or her bed. Tony 01:54, 20 November 2006 (UTC)

THE CURRENT "OUTBREAK"

We are in panhandle Florida area and have an entire family unit/two separate households that have been stricken with it, and it won't go away, others around us-not family continue "coming down with it"-other than normal prevention measures, wash hands, clean food areas, wash hands, clean common bathroom areas, wash hands, etc., what else can be done to prevent further spreading!!??? it's a disaster, the numbers are overwhelming!!! God Bless any who get it!-not fun!! [:+{ 24.214.78.236 02:40, 4 January 2007 (UTC)

The washington post reports that only 4 were confirmed sick in the March 2 2007 in a hotel in Crystal City, but that anecdotally up to 150 might have been sickened:

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/01/AR2007030101626.html

Introduction

This article's introduction is far too detailed. It would be rather meaningless to the lay person: it sounds like it was lifted from a medical textbook. Perhaps it would help to add more about the social ramifications, and leave facts such as the number of base pairs in its gene sequence for a section in body. Clarkcol 22:39, 10 January 2007 (UTC)

I agree with Clarkcol. The introduction is very medical in nature and doesn't seem to fit as part of an encyclopedic article. Something like the Wikipedia's Malburg virus article is ideal. Trane X 09:51, 25 March 2007 (UTC)

Help edit related pages

Please see Wikipedia_talk:WikiProject_Medicine#Gastroenteritis_articles_cluster. Thank you! --Una Smith 00:40, 1 December 2007 (UTC)

Figure

The white distance marker in the electron microscopy image looks as if it is 50 nm. Whatever it is, it should be stated in the caption. Xxanthippe (talk) 22:22, 30 December 2007 (UTC).

• Yes, thanks for spotting this, caption corrected. Best wishes.--GrahamColm^Talk 22:33, 30 December 2007 (UTC)

Source

Here is an article on yahoo that talks specifically about norovirus. The name of the article is "Stomach Flu Spread By Contaminated Computer Keyboards". It might be helpful for sourcing this article. Royalbroil 20:14, 4 January 2008 (UTC)

Proposal - Notable outbreaks

As outbreaks occur on a regular basis I suggest that only the largest outbreaks on a worldwide scale are highlighted as notable. As to what is notable, I'd say a once in 20 year event. The existing events which do not meet this should be removed otherwise they act as a precedent for every outbreak to be listed. -- John (Daytona2 · Talk · Contribs) 15:32, 5 January 2008 (UTC)

• I agree, we could add to the list everyday. Certainly at the moment in the UK. Perhaps we should include one well referenced cruise ship example?--GrahamColm^Talk 15:51, 5 January 2008 (UTC)

• Good point, it's unreasonable to completely exclude them, even though the number are relatively small. One example would perhaps act as a useful case study of infection rate and reach in a high density environment with no outside influence. The Nokia incident can be placed in a 'See also' section. Since I have only just stumbled upon this article I will need to search the references for details of any 20 year events. Cheers -- John (Daytona2 · Talk · Contribs) 19:26, 6 January 2008 (UTC)

• Done -- John (Daytona2 · Talk · Contribs) 18:30, 11 January 2008 (UTC)

Sorry but I think this section now looks very poor. A section called 'Notable Outbreaks' which contains details of one spurious and low-level outbreak on a cruise ship is not worth having. Bobgateaux (talk) 19:41, 7 April 2008 (UTC)

I feel that the Norovirus outbreak in Boston (January 2007) should be added to this list. Over 3,700 patients were treated at Boston hospitals and the outbreak was considered to be the worst since 2002-2003 according to this article: http://www.boston.com/yourlife/health/diseases/articles/2007/01/17/intestinal_germ_leaves_trail_of_misery/

I had the virus in January along with many of my friends and we did not receive treatment from a hospital. Thus, I believe that the amount of infected Bostonians must have been at least over 4,000. —Preceding unsigned comment added by Orangeicicle (talk • contribs) 14:39, 3 October 2008 (UTC)

Proposed restructuring

I've added some references to this important article, but it is very poorly structured. All the essential points are covered, but the article does not flow. I have worked on Rotavirus and Hepatitis B virus and I suggest using a similar structure here.--GrahamColm^Talk 19:09, 11 January 2008 (UTC)

I've not seen them, and too tired to look, but since you've experience on these type of articles I'm happy for you to rewrite. Cheers -- John (Daytona2 · Talk · Contribs) 21:57, 11 January 2008 (UTC)

Hi John, thanks for your support. It's late for me too. I will work on the article in the morning. Best wishes, Graham. GrahamColm^Talk 22:32, 11 January 2008 (UTC)

I've just read through two months of historical edits to see the evolution of some specific passages, and boy, thanks for the hard work Graham. I have a specific question about two sections edited by Janvinje and then later by you, resulting in something lesser than what was before. One (re)added "stomach flu" as a common name of the disease, making it look as if your citation supported it. Does it? I am assuming not, and will make an edit accordingly.

The second section is http://en.wikipedia.org/w/index.php?title=Norovirus&diff=next&oldid=185269415 and the few edits after. I thought the citation of percentages of cases of gastroenteritis in toto vs. food-borne cases was interesting, but later edits skirt this citation. Could you work it back in? Orbis 3 (talk) 23:09, 25 February 2008 (UTC)

Treatment

Something unmentioned in the article is actual treatment of the virus. As with treating the common cold, the best advice that I can give is get plenty of rest (sleeping 10 to 16 hours on onset), drink plenty of water, chicken noodle soup and vitamin C. —Preceding unsigned comment added by 72.174.96.100 (talk) 03:36, 11 February 2008 (UTC)

• Thanks for this. Wikipedia does not give advice as such but as is the case with all diarrheal diseases the most important thing is to maintain hydration. There is no specific treatment for the infection. Graham Colm ^Talk 19:06, 12 October 2008 (UTC)

Bagram Bug

Just wondering if it would be ok to include Bagram, Afghanistan in the list of significant outbreaks. I came down with "the Bagram Bug" while in Afghanistan from 2002-2003 and as I recall several other troops (U.S. and Great Britain) came down with it and were knocked out of duty for at least a day or two. I was just informed that this is the cause of the Bagram Bug and suppose that I need to find sources to cite the fact before adding it to the list. Anyone have know any good and specific sources to cite (the problem is there are plenty of articles about the Bagram Bug but I haven't found any that ties the NLV to the bug, a medical officer told me about it and personal experience is not cite worthy. Thanks. —Preceding unsigned comment added by 69.133.42.16 (talk) 07:55, 7 February 2010 (UTC)

A&E -- (not defined) in section Course of disease and complication

What is A&E? There should not be any initials used that assume that others will know what they mean. Franklinjefferson (talk) 03:49, 9 March 2009 (UTC)

A&E stands for Accident & Emergency, it is the UK equivalent of ER. --Footix2 (talk) 10:46, 31 March 2009 (UTC)

Longevity

Can someone add whether the virus dies naturally without a host? We were all down this weekend. There is bound to be contamination in the house - but for how long? —Preceding unsigned comment added by 69.119.152.47 (talk) 20:54, 26 April 2009 (UTC)

I read that seven weeks is the longest Norovirus can survive in the environment. For the life of me I can't remember where I read it though. -OOPSIE- (talk) 03:18, 6 October 2009 (UTC)

I've added some info on the virus ability to persist outside the human body --Erlend Aakre (talk) 22:56, 27 February 2012 (UTC)

Sufficient Heating

Where it says, "Norovirus is rapidly inactivated by sufficient heating and by chlorine-based disinfectants...", should it say "Norovirus is rapidly inactivated by sufficient heating of food and by chlorine-based disinfectants..."? I took it to mean environmental heating until my partner pointed out that it probably meant food heating.
Pyotr Goulden (talk) 11:24, 10 January 2010 (UTC)

It means both; steam-cleaning is an efficient way of cleaning carpets following contamination by norovirus. All viruses are susceptible high temperatures because they are made mostly of protein. I agree that "sufficient heating" is vague. I seem to recall that being held at 56⁰ C for an hour inactivates the virus, and higher temperatures are much quicker, but I will have to find a reliable source for this before making any change to the article. Graham Colm ^Talk 11:55, 10 January 2010 (UTC)

Norovirus is an extremely common cause of gastroenteritis and it is about time we stopped listing outbreaks in this article. None of these outbreaks are notable; outbreaks of this infection occur frequently and everywhere in the world during winter months and often in the summer too. It is enough to say that norovirus is the commonest cause of outbreaks of viral gastroenteritis in adults in the world, and leave it at that. Wikipedia is not a newspaper. I suggest deleting this section and leaving an inline comment that says it should not be added back. Imagine listing every occurrence of outbreaks of the common cold in it's article. OK, norovirus is a nasty infection, but I can't see the point of an ever increasing list of outbreaks. There will be no end to this. If these outbreaks were long-lived and caused deaths then there might be a reason for including them; but they are not. It seems to me that in this case Wikipedia is being used as a blog; it is not, it is an encyclopedia. Graham Colm (talk) 19:37, 7 February 2010 (UTC)

A blog, it should not be, however, for the common person to try to attain an understanding of where and how these strains of virus can be exposed is very helpful in educating and preventing the spread of infections. Although I agree there should not be a long list of outbreaks, I do otherwise think that a few instances of the outbreak could be mentioned, especially to touch upon a few cases where causes are different in which they have to do with various food contamination, surface contamination, human-to-human contact, as well as geological factors. [E.Nunes, April 2012]

Vandalism

Undid references to some guy whose vandal friends (vandalism from IP 205.202.121.6) apparently thought it'd be fun to blame him personally as a cause of the Norovirus. Garykempen (talk) 15:43, 6 February 2009 (UTC)

Pathology

Do you think there should be more about why it has the effect it does -- what its interaction is with its human host and why it produces these particular symptoms. It could perhaps be done by linking to relevant other Wikipedia pages. —Preceding unsigned comment added by 77.100.77.248 (talk) 01:57, 7 January 2011 (UTC)

MMWR

A 2011 review [1] Doc James (talk · contribs · email) 19:28, 4 March 2011 (UTC)

Introduction

The introduction currently states that persons with AB blood type are more susceptible, and that AB and O blood types provide a degree of protection- it is not possible for AB to be both protected from, and have increased susceptibility to, norovirus.— Preceding unsigned comment added by 148.122.12.122 (talk • contribs)

Yes, there is a problem here. It is actually far more complicated, see: Shirato H (2011). "Norovirus and histo-blood group antigens". Jpn. J. Infect. Dis. 64 (2): 95–103. PMID 21519121.. It depends to some extent on blood group secretor status and the genotype of the virus. I will fix this later, meanwhile I am hiding the confusing text in the article. Graham Colm (talk) 21:02, 24 February 2012 (UTC)

The second paragraph states "severe illness is rare", but later the same paragraph states "causes over 200,000 deaths each year". Should the "rare" statement be qualified to avoid this apparent ambiguity? --John Haigh CA (talk) 18:39, 30 March 2014 (UTC)

PCR does work

I took out "However, routine methods to detect the virus on other food items are not readily available because of the variable nature of different food items affecting concentration and extraction of the virus and presence of factors that make polymerase chain reaction analysis techniques ineffective." ...because it's wrong, that's not what the study cited says at all. PCR works, albeit with modifications, and it doesn't say anything about other food items. 65.27.134.29 (talk) 02:03, 6 March 2012 (UTC)Ubiquitousnewt

Transmission via Skype

There's this funny line at the very end of the "Transmission" section: "In a 2012 study, it was noted that the virus can also be transmitted through Skype." That's really funny, but you should remove this, though. — Preceding unsigned comment added by 213.226.141.173 (talk) 23:55, 2 January 2013 (UTC)

Notovirus

What's a Notovirus supposedly found in mice in the US desert southwest? I can't find a reference anywhere. Bogus? Virgil H. Soule (talk) 07:56, 10 January 2013 (UTC)

But it seems to be sourced, you checked the source? OccultZone (talk) 22:57, 28 January 2014 (UTC)

Merge

"Norovirus" is a genus name, and there is only one species in the genus, namely Norwalk virus. The International Committee on Taxonomy of Viruses says we should use the name Norwalk virus when talking about it (see link at Norwalk virus). So I think this article should be merged with Norwalk virus. The title should be Norwalk virus, and most of the mentions of "norovirus" should be changed to "Norwalk virus" – unless it's talking specific'ly about the genus (in a theoretical sense, since there's no other species!). Eric Kvaalen (talk) 07:05, 21 November 2014 (UTC)

I disagree with this proposal. Government Health Authorities have yet to catch up with the ICTV. Signs in hospitals still use the term norovirus and the results Google and Pubmed searches for norovirus outnumber Norwalk virus by 3:1. Ironicaly, the ICTV changed the name from Norwalk to norvirus only a few years ago and the change back has not been met with any enthusiasm by healthcare providers. If we revert to using "Nowalk virus" at this time it will make WP look outdated to most general readers. Graham Beards (talk) 09:10, 21 November 2014 (UTC)

WP:COMMONNAME applies. No need for page move. JFW | T@lk 22:47, 25 November 2014 (UTC)

So we now have two articles about the same thing - the larger article being at the common but technically wrong name. -- Beardo (talk) 20:21, 5 August 2015 (UTC)

Need more historical evidence

The article states "named the "Norwalk agent" ... where an outbreak of acute gastroenteritis occurred ... in November 1968" This appears to be the first historical evidence of the virus, and yet now it is so prevalent. Is this saying that Norovirus did not exist in the (human) environment prior to this time? Or that the science of virology was able to isolate it in 1968 but not prior to that? Consider passenger liners and troop ships passed over the oceans for over 100 years earlier, and we all know how ships are prime targets for outbreaks. — Preceding unsigned comment added by 71.82.64.203 (talk) 04:50, 20 March 2016 (UTC)