5:37 p.m. January 31, 2013

The Norovirus Is Coming For You. Here's How To Stop It

Norwalk agent. Small, round-structured viruses. Viral gastroenteritis. Acute nonbacterial gastroenteritis. Winter vomiting disease. Stomach flu. All of these lovely-sounding descriptors refer to one evil little shit of a calicivirus, a virus that is currently spreading through the U.S. like a Justin Bieber suicide rumor on twitter.

Meet the norovirus.

Noroviruses are the most common cause of epidemic gastroenteritis, which is to say, they are the number one culprit in mass breakouts of violent vomiting and the gotta-poops. Though often referred to as stomach flu, noroviruses are not influenza viruses and don’t give a shit about your respiratory system. They do, however, really fucking like your small intestine. Symptoms include diarrhea, vomiting, nausea, stomach pain, headache, and bodyaches. Half of the lucky suffers get a fever. As the CDC notes, if you have norovirus illness, you can feel extremely ill. If the restrained, level-headed folks at the CDC start throwing words around like extremely, I take notice. I do not want norovirus.

“At first I thought it was the flu - aches, fever, and chills - and then the evacuations and stomach cramps started,” recalls Darren Mckeeman, a tech executive from San Francisco, norovirus endurer, and all-around good sport. (You might not be surprised how many people are reticent to discuss their butt explosions with me.) “I could not stand up without episodes of syncopy [fainting], and I got dehydrated really fast.” This from a healthy adult male, who noted that he never gets sick, but had just recovered from actual flu when norovirus hit. “For me to get sick with anything is unusual, but this was astounding in how horrible I felt.”

In the United States alone, approximately 21 million astoundingly awful illnesses per year are attributable to norovirus. Periodically, there emerges an epidemic strain. Enter GII.4 Sydney.

See, noroviruses are classified into five genogroups, GI through GV, which are further comprised of 34 individual genotypes. Gastrointestinal suffering is typically only caused by GI and GII, with most of the toilet agony outbreaks caused by the GII.4 norovirus strains.

In the past decade, we’ve seen new GII.4 strains emerge every two to three years or so; these strains replace the prevalent GII.4 strain and often result in increased outbreak activity. Last March, a new strain of GII.4 norovirus popped up in Sydney, Australia, and has been zipping around the globe like, well, like a norovirus.

Since hitting the U.S., GII.4 Sydney has caused over half of the reported norovirus outbreaks. Thus far, there's no suggestion that this is a particularly virulent strain, but its relative newness does mean that more people will be susceptible to it, which could result in more people falling ill.

Which raises the question: What the fuck is a norovirus?

In 1968, after an occurrence of winter vomiting en masse at an elementary school in Norwalk, Ohio, the thusly named Norwalk virus became the first of the noroviruses to be identified as the culprit behind an outbreak of gastroenteritis. From there, we came to learn all manner of fun and charming facts about this incredibly difficult to kill, astonishingly easy to spread RNA virus.

Norovirus is small. It consists of a single strand of RNA that is surrounded by many copies of a single protein, which assemble to form a protective coat or capsid. If you look very, very closely, the virus looks a bit like the Blob in a tutu.

Noroviruses are impervious to silly things like a quickie with the hand sanitizer and a casual hand wash. Even a wipe down with your eco-friendly antibacterial counter cleaner won’t do the trick. This charming trait is due to the fact that the norovirus lacks a viral envelope. In viruses that have them, the envelope is used to aid in entering the host cells, which is great for the virus. However, the envelope makes the viruses sensitive to heat, desiccation, and detergents which means viruses with an envelope - like influenza, HIV, and herpes - are easier to sterilize than non-enveloped viruses. Non-enveloped viruses are hardier, with increased survival outside hosts, and you can’t destroy them as easily.

If that wasn’t bad enough, norovirus sheds like a shaggy dog in August. One of the things that makes it so maddening from a disease control perspective is that people infected with norovirus begin shedding the virus before they get sick. Steve working the salad bar prep shows up for work, chipper as fuck, just after giving his hands a half-hearted post-dump rinse. He feels great, chops vegetables all morning, then goes home and shits his brains out for a few days. And everyone that ate salad ingested the dastardly viral particles that clung to his hands after his ceremonial pre-shift bowel movement.

(The fecal-oral norovirus transmission route just makes everything a little bit worse, doesn’t it? Although, you can also get it from the vomit of an infected person, I’m not sure if that makes things any better.)

So, how do you get rid of noroviruses? Glad you asked!

It’s incredibly important that you follow my brilliant and scientifically sound anti-norovirus protocol because noroviruses are highly infectious. We’re talking anywhere between ten and 100 viral particles would be enough to give you the raging vomits. Using the lower estimate of infectiousness, that means that a one millimeter line of viral particles, sitting pretty across the width of a fine tip pen, would theoretically be able to infect 370 people. Viral particles lined up the width of a toilet seat could infect 173,863 people. (Think about that next time you’re poppin’ a squat in the gas station bathroom.)

The NSFWCORP Norovirus Cheat Sheet:

When Your Symptoms Start

You must: Drink lots of fluids to combat the dehydration that is about to ruin everything good about your life.

You might want to: Make everyone around you wear tyvex suits so that they don’t get sick and you can pretend that you’re just cooking on Breaking Bad.

Don’t even think about: Cooking actual food. Just don’t.

Once Your Symptoms Subside

You must: Bleach the motherfucking hell out of everything you can possibly bleach. Use a mix of a quarter cup of bleach and two and a quarter cups of water on anything that may have come into contact with your disease splatter. Let the bleach solution sit on surfaces for at least 10 minutes. Also wash all clothes and linens that you’ve come into contact with using the hottest, longest cycle you can, then machine dry them. Cackle like a villain as you enjoy the sweet, sweet vengeance that you are enacting on the cause of your misery.

You might want to: Stay the hell away from everyone you like until you’ve stopped shedding the virus, around three days after you return to normal poops and stop blowing chunks on the regular.

Don’t even think about: Slacking off on the handwashing. The virus can stay in your poop for two weeks or more, so keep scrubbing like you’re a goddamn surgeon.

To Keep From Getting Norovirus

Just wash your damn hands like you mean it, people. It takes at least 30 seconds of enthusiastic hand-rubbing and fingernail-scrubbing with soap and hot water to remove viral particles.

Back channel chatter

There is a scribble about this dispatch in the backroom, with two contributors.