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The stomach bug

Stomach cramps, vomiting and diarrhoea are all symptoms of a norovirus, a small virus that is highly contagious between humans.

Stomach cramps, vomiting and diarrhoea are all symptoms of a norovirus, a small virus that is highly contagious between humans.

Vomiting, diarrhoea and stomach cramps are not the best one could wish for. However, these are very common at this time of year. Such illnesses are consistent from year to year, with most cases occurring from October to May. But specific peaks occur between March and April.

The most common cause of these symptoms is a norovirus, a small virus that is highly contagious between humans. Many people refer to this virus as the winter or gastric flu.

Noroviruses are very common and spread in closed spaces, such as restaurants, daycare centres and nursing homes. They are highly contagious and small amounts of viruses are enough to cause illness.

These viruses are very hardy in that they can survive in extreme temperatures and survive for a long time on surfaces.

Transmission of a norovirus can happen through food. The most commonly associated foods are raw or undercooked oysters and raw fruits and vegetables that have been grown or watered with contaminated water.

Once someone is infected, the virus can quickly pass from person to person through shared food or utensils, by shaking hands or through other close contact. The virus is also spread when someone who is sick vomits, after which the virus can spread through the air and contaminate surfaces.

Once someone is infected, the virus can quickly pass from person to person through shared food or utensils, by shaking hands or through other close contact

A norovirus is shed in high amounts in an infected person’s stools. If people do not thoroughly wash their hands after using the bathroom, they can pass it along to others directly or through surfaces touched by contaminated hands. A norovirus may have a prolonged infectious period that starts even before a patient gets sick. There is a short incubation period (up to two days) between the time people acquire the virus and when they get the symptoms.

People may be contagious during this period and while they have symptoms. When the symptoms resolve and the person appears to have recovered completely after a norovirus infection, they may continue to shed the virus for weeks in their stools and hence may be a source of infection to others.

Noroviruses are the most common cause of gastroenteritis in Malta, like other countries. The most common symptoms include vomiting and watery diarrhoea or both, usually with abrupt onset and with the illness usually lasting two to three days and resolving by itself. Most of these symptoms aren’t serious, but diarrhoea and vomiting can cause dehydration.

Children and the elderly are most susceptible to dehydration, as well as malnutrition from not getting enough nutrients. People who cannot keep up with fluid losses may require hospitalisation for intravenous fluids.

There is no specific treatment or medication for a norovirus. It is important that infected individuals remain well hydrated, drinking plenty of fluids. In most cases symptoms will subside in three days. However, if this is delayed, if one has symptoms of dehydration or has been vomiting green material, it is recommended to speak to a doctor.

Spread of a norovirus can be prevented. Once a person is sick, it is important for all members of the household to use good hand hygiene. Hands should also be washed before preparing food or touching the face, after going to the bathroom and before one prepares or cooks food.

Many studies have shown that washing hands with soap and water is the best and most effective way to reduce infection transmission. Cutlery and dishes should not be shared.

If a person is sick, it is important not to prepare food for at least two to three days after one feels better. It is also important to stay off work or school until at least 48 hours after the symptoms have passed. 

Unfortunately, these bugs are still causing a host of illnesses. However, we can prevent the spread of the virus by following simple precautions.

Dr Charmaine Gauci is Superintendent of Public Health.

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