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How 16 minutes prevented 36 hours of holiday vomiting and diarrhea
Holiday norovirus
By Theresa Watts
 
Ring, ring. “Hello?” “This is a message from the Clackamas County Health Department. If you picked up a food box, please listen to this message. We are investigating a stomach illness among folks who prepared the food boxes...”
 
Within 16 minutes, 40 people who picked up a holiday gift box from a church in Clackamas County received a call and text message from the Clackamas County Emergency Notification System (CCENS) letting them know of the potential for illness and what extra steps to take to protect themselves from foodborne-related disease.
 
The outbreak involved volunteers who assembled these gift boxes. About half of the volunteers developed nausea, vomiting or diarrhea that lasted about 24 hours, one to two days after assembling the boxes. The outbreak, which was reported on Christmas Eve, was quickly laboratory confirmed as norovirus.
 
“Even though it was initially unknown whether any person was ill while assembling the boxes, we didn’t want to take any chances and risk people eating the food getting sick,” State Outbreak Lead Epidemiologist Melissa Powell said.
 
Protect yourself from Norovirus
1. Wash your hands often
2. When you are sick, don’t prepare food or care for others
3. Rinse fruits and vegetables thoroughly
4. After vomiting or having diarrhea, immediately clean and disinfect surfaces and wash soiled laundry
5. When ill, stay at home to avoid further spread
 
Norovirus is very contagious. A person sick with norovirus can shed billions of particles in their stool or vomit. It takes as few as 18 particles to infect another person. Because norovirus is highly contagious, outbreaks have occurred anywhere the illness can spread from person-to-person or by consuming or touching things contaminated with the virus. In Oregon, outbreaks have occurred in nursing homes, schools, day-cares, hospitals, restaurants, summer camps and catered events. According to the Centers for Disease Control and Prevention, about 50% of food-related outbreaks are caused by norovirus.
 
Recognizing the high transmission risk, Powell and Clackamas County Health Officer Dr. Paul Lewis and Preparedness Coordinator Kathy Thompson quickly went to work. “In the past, we have called everyone who could have been exposed independently. Recognizing how labor intense this would be for this large outbreak and the need to act quickly, I proposed that we use our Clackamas County Emergency Notification System instead,” Thompson said. This system shares a recorded message to a list of contacts within seconds.
The investigators worked together to quickly develop the message that was sent by the CCENS. “It was important for us to have a message that did not raise fear. Rather, we wanted to emphasize taking extra precautions to thoroughly wash the food in the box,” Lewis said.
 
No one who received a food box reported gastrointestinal illness. Using the CCENS shortened response time, which in turn decreased the likelihood of recipients contracting norovirus. This is a good option for similar situations when a large group of people need to be contacted quickly.
 
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