I live in a city that charges for paper grocery bags, so we always bring our reusable ones. So for me this was the most random, yet notable, study of the week. It's weird and gives me a whole new respect for viruses that cause gastrointestinal illness.
A norovirus outbreak, affecting a girls’ soccer team competing at an intrastate tournament, was traced to a reusable grocery bag that held the team’s snacks, according to a report in the current issue of the Journal of Infectious Diseases
A norovirus is a virus that gets groups of people sick - it can travel like wildfire.
Here are the CSI-style details that emerged from the CDC investigation which are quite amazing:
- The reusable grocery bag was stored in a hotel bathroom of the first “victim” of the illness when she developed vomiting and diarrhea, presumably from exposure to the virus before the tournament.
- The norovirus, which caused the gastrointestinal illness, was spread through the air to the reusable bag. Yuck.
- Although approximately 2,000 children from Washington and Oregon attended the weekend soccer tournament, the outbreak was confined to a single group of 17 Oregon girls, aged 13-14 years and their 4 adult chaperones.
- The group shared hotel rooms and ate together at local restaurants.
- The index case (the first girl to get sick) moved to her chaperone’s room when she had vomiting and diarrhea throughout the night, and left for home with the chaperone in the morning.
- This meant she had no contact with her teammates or other chaperones after symptom onset, and no direct contact with the grocery bag or the food it contained.
- The reusable grocery bag holding the snacks was retrieved from the bathroom she used and brought to a different room, where it was handled by the team and other chaperones at lunch the next day.
- The other members of the affected party removed from this bag chips and cookies that were in commercial sealed packages, as well as fresh grapes, and consumed them hours after the index case and the chaperone had left the area.
- The chaperone who drove the first sick girl home later became ill, as did six other girls and chaperones in the group, 36-57 hours later.
- People who became ill all had in common; exposure to any item in the bag or the bag itself.
- Stool specimens from people who became ill were all positive for the same strain of norovirus.
- Swabs taken from the grocery bag 2 weeks after the incident also were positive for that strain of norovirus.
This is CSI style medicine. This outbreak happened because the virus became airborne in the bathroom when the first girls got sick, and settled upon the grocery bag and its contents. Then, girls who touched the bag or consumed its contents also got sick from norovirus. No other attendees at the tournament, patrons at the hotel or restaurants, or staff members reported any gastrointestinal illness.
What can we learn from this? If you think airborne (aerosol) exposure may have occurred from someone who is sick with a virus (with nausea and vomiting) everything should be thoroughly disinfected: both surfaces and objects.
Some of these viruses, like noroviruses, can find their way to us even without direct contact. We just need to have a little more respect for the amazing and sneaky way they find their way into our bodies.
- Dr. O
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