Two outbreaks of gastrointestinal infection were reported this past week. Illness was associated with the Norwalk-like viruses, which cause diarrhea and vomiting.
There have been two outbreaks of Norwalk-like virus infection in the Maritime Provinces this past week . Mount Allison University in Sackville, New Brunswick, and St. Francis Xavier University in Antigonish, Nova Scotia have reported gastrointestinal illness among students and staff. More than 300 students and staff at Mount Allison, and 60 at St. Francis Xavier have experienced vomiting and diarrhea associated with Norwalk infection.
Measures to control the spread of Norwalk infection have included thorough cleansing of common areas like doorknobs, computer equipment (keyboards and mouses), counter-tops, bathrooms and food service areas; installation and distribution of numerous bottles of hand-sanitizers; and cancellation of numerous sporting and social events until the virus has finished making its rounds.
Viruses of all types love close living quarters where person-to-person contact and spread of infection can occur. Respiratory viruses like those that cause the common cold and influenza are spread in close quarters through the air by coughing and sneezing, and/or by hands contaminated with snot or other nasty respiratory secretions. Gastrointestinal viruses such as the Norwalk-like viruses are spread by hand as well, but the hands must first be contaminated with material containing the virus. Viruses that cause gastrointestinal infection are excreted in feces and emetic fluids; therefore, the hands that spread the virus to doorknobs, bathroom fixtures, telephones, foods, utensils and surfaces must have come in contact with feces and have remained there due to failure to adequately wash the hands.
You would expect that children would be great sources of viral infection, because their hygiene is somewhat unrefined; however, it is surprising that enough of us adults don't wash our hands after using the toilet or performing other personal functions, that we can effectively spread infection to hundreds of other adults. Do you wash your hands every time after using the toilet? Do the other members of your family and work environment consistently wash their hands after using the toilet? Do you open the exit door of public washrooms with your bare hands? If the answer to the last question was "Yes", and your answer to the previous question was "No" or "I don't know", how can you be sure that you haven't just contaminated your clean hands on the same door handle used by a previous visitor who didn't wash his/her hands?
The recent university outbreaks should encourage us to examine our own personal hygiene weaknesses. Wash your hands and take defensive measures against those who don't by introducing practices like using a piece of paper towel to open the door of the public washroom before leaving. Wash your hands after using common equipment such as telephones, especially when others in your home or work area are ill. Wash your hands after helping your child use the washroom, and teach him/her to wash thoroughly. Wash your hands after blowing your nose or wiping the snotty nose of someone else.
The two universities experiencing the spread of gastrointestinal illness have initiated extensive hand-washing campaigns, and have distributed hand-sanitizers. It is distrubing that we have to educate adults on the importance of hand-washing - perhaps this is something we should have thought about much earlier...like the elementary school level? We should also recognize that the most effective way to remove viruses from our hands is through washing them away - soap and water works great if it is used correctly - at least a 15-second scrub, rubbing your hands together, cleaning between your fingers and around your nails, and then rinsing off into the sink. Hand-sanitizers do not remove things from our hands - they either kill them or spread them around. Alcohol-based hand cleansers have become common in our healthcare institutions, and now apparently in universities, as a measure to improve compliance with hand-cleansing. Although alcohol is effective against bacteria, it is not effective against viruses. Unless the hand-sanitizer in use has anti-viral activity, at most we are diluting and spreading contaminating viruses over the surface of our hands when we use these as a measure to reduce the spread of viral infection. It concerns me that we may get a false sense of security from this practice. Thorough, consistent hand-washing is still the best way to prevent the spread of viral infections spread by hand.
