Norovirus Affects More Than 100

By Sonam Vashi Executive Editor and Dustin Slade News Editor

The University identified the illness that caused 101 students to seek medical treatment as norovirus, a highly contagious virus and the most common cause of acute gastroenteritis and foodborne disease outbreaks in the U.S., after patient samples sent to both a State of Georgia lab and an Emory Medical lab tested positive for the virus, according to a Nov. 15 all-Emory students email sent by Assistant Vice President and Executive Director of Emory University Student Health and Counseling Services (SHS) Michael J. Huey.

The number of new cases seen slowed on Friday, according to Huey's all-Emory email to students. Over the weekend, 12 additional students sought medical treatment at Emory University Hospital (EUH) or SHS, according to a Nov. 17 University press release, raising the Nov. 15 reported number of 89 students to a total of 101 cases handled by the University.

The total number of affected Emory community members is larger than 101 cases, due to those that have exhibited symptoms of gastroenteritis but have performed self-care and did not seek Emory medical treatment, according to Huey in an email to the Wheel. While five students were admitted for observation to the EUH Emergency Department, according to Huey, no students are currently hospitalized, according to the Nov. 17 press release.

Emory is still working to locate the source of the virus, but it is still unconfirmed at this time where it may have originated. Huey wrote in an email to the Wheel that they have yet to eliminate any possibilities as to what the source of the infection is, including the possibility that it could have been more than one source and more than one strain of norovirus circulating around Emory.

"At Emory, we are very fortunate to have internationally-recognized experts in infectious diseases and public health, and they have been assisting us from the first day," Huey wrote.

According to Huey, on the first night of the outbreak, all of the students that sought medical attention were freshmen. Due to their meal plans, each infected student claimed to have had one meal at the Dobbs Market the day before they began exhibiting symptoms.

"There are students who present to Student Health Services with gastroenteritis nearly every day of the year," Huey wrote. "But it is very unusual for multiple students to become sick simultaneously, which was the case in the early morning hours of Wednesday, Nov. 11."

Huey explained that after a direct consultation with epidemiologists from the DeKalb County Board of Health and Emory infectious disease experts, the remaining Dobbs Market food from Tuesday, Nov. 11 was isolated in an effort to prevent re-serving on Wednesday morning, Nov. 12.

Experts at the norovirus research lab at the Rollins School of Public Health obtained samples for testing from the isolated food from the Dobbs Market, according to Huey. He added that there was no specific commonality among food items eaten by students who became ill following the outbreak.

Huey wrote that even though the potentially contaminated food had been isolated, norovirus can be difficult to test for and the results from the Rollins lab can potentially come up inconclusive.

"Norovirus replicates aggressively in the human gastrointestinal tract and there can be millions/billions of viral particles in a stool specimen," Huey wrote. "The number of viral particles in a foodstuff is far lower, making isolation much more difficult. In addition, some foodstuffs have inhibitors that affect viral replication."

If the results are inconclusive, Huey wrote that an epidemiological study from DeKalb County Board of Health, which is comparing ill students with controls, could potentially help identify a common food source or a location for the norovirus' source.

The DeKalb County Board of Health declined to comment on the study, citing a pre-arranged agreement with Emory Communications that restrict comments to media.

According to the Centers for Disease Control and Prevention (CDC) website, norovirus can be spread through contaminated food or through students or food workers with norovirus illness. Huey explained that no Emory food workers were ill on Nov. 11 nor have any become ill since the subsequent daily checks.

Since the outbreak, Emory Dining has implemented additional safety measures, including deep sanitizing of contact surfaces in Dobbs Market, and will continue to change commonly-used utensils every 15 minutes, according to Senior Director of Emory's Food Service Administration David Furhman. He added that Emory Dining is also sanitizing other Campus Dining units on an ongoing basis.

Furhman added that separate from this incident, Sodexo employees at Emory have been trained in "safe food handling and sanitation." Furhman continued that the training is continually updated and these safety and sanitation practices are constantly being monitored.

"The management and staff at Emory Dining Services have been uniformly helpful, concerned, transparent and professional and we have worked together each day," Huey wrote in an email to the Wheel.​

Norovirus annually causes around 20 million illnesses and contributes to 56,000-71,000 hospitalizations and 570-800 deaths in the United States, according to the CDC website.

Most people infected with norovirus recover within one to three days, and ways to help prevent its transmission include proper hand washing and general hygiene, according to the CDC website. There is no vaccine or specific drugs to treat the virus, but "fluids, rest and prevention" are good tools for its treatment, according to the Nov. 15 all-Emory students email from Huey.

According to the Nov. 15 email, Huey emphasized that Emory's goal is to contain the spread of the virus and he outlined several prevention methods, including frequent hand washing, washing fruits and vegetables and avoiding hand-shared communal food. The email also urged students presenting symptoms to seek medical care and provided disinfecting protocols for any visibly contaminated surfaces or items.

Many students are relieved that it appears much of the damage is done. However, some are still taking precautions.

College freshman Ash Pettie hasn't eaten at the Dobbs Market since the outbreak started.

Other students avoided the Dobbs Market for a few days but have since returned.

College freshman Michael Demers said that, following the outbreak, he avoided eating at the Dobbs University Center and has washed his hands more regularly. He added that as long as the outbreak is contained and the appropriate parties are handling the situation, to him, it does not matter what the source of the outbreak was.

– By Sonam Vashi, Executive Editor, and Dustin Slade, News Editor

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