Norovirus has been in the news, here in Seattle, as well as around other parts of the country this winter. University of Michigan has had a nasty outbreak of the virus in just the last couple of days. Norovirus is a highly contagious stomach virus, once rumored to be limited to cruise ships and other densely populated spots. But now it's popping up in office buildings, senior centers, schools, restaurants and shopping malls. Winter is peak season for its spread. So, I've been treating my daughter's illness as if it is norovirus, just to be on the safe side.
Prevention of spread of norovirus is essential
The key to preventing spread of the virus is isolating the patient, as soon as the first symptom is present, from the rest of the community (family, in our case), and keep them isolated for 1 or 2 days post symptoms, as the virus can still be spread, even when the patient begins to seem better, vigilance with personal hygiene (handwash, handwash, handwash -- more effective than hand sanitizer), and disinfecting all surfaces (textiles as well as hard surfaces) the patient could have spread germs through either direct contact or airborne particles, both while symptomatic and while seemingly well. The norovirus has a 1 to 2-day incubation period, meaning patients can transit the disease before the symptoms are obvious.
So, like I said, just like that, all of my day's plans changed.
My daughter shares a room with her sister. The first step was to set up a place where she could sleep and study, away from the patient. She moved into the family room for a couple of days. I've been designated as caretaker of the sick one, to prevent as few people as possible from falling ill.
Minimizing illness with the sick one
The main risk to norovirus is dehydration. One site I read said to wait 20 to 30 minutes after vomiting has ceased before introducing liquids (but of course, if vomiting persists beyond a few hours, or if the patient has other health complications, it's wise to seek a doctor's opinion early on). And then, only clear, non-acidic liquids. Orange juice is out (too acidic), apple juice is a maybe, if watered down in a 50/50 mix. Electrolyte solutions are good, especially ones like Pedialtyte. Watered down chicken broth is also recommended. And for some individuals, flat, non-caffeinated soda pop (like lemon-lime or ginger ale), in small amounts seems to help. You can speed up the rate at which soda pop loses its carbonation by pouring one glass into another, back and forth. I keep a 2-liter of lemon-lime soda in the back of the pantry for just this type of occasion.
So, we got my daughter through the night, on sips of flat lemon-lime soda. By morning, she was looking a bit better.
After seeing to her comfort in the morning, I set out to disinfect areas of the house where she had been, and get an early start on laundry. On facebook, I mentioned the CDC's recommendations for disinfecting, using chlorine bleach mixed with water, from about 1 teaspoon to 1 1/2 tablespoons of household bleach mixed with 1 cup of water. As the bleach doesn't have to be exact, I eyeballed, using the cap to the bleach container as a measuring spoon/cup, and poured into a glass measuring cup, then adding water. I dipped a rag into this solution and went around the house wiping off surfaces (CDC says to allow to air dry for 10 minutes). I did this every time my daughter got up. Also, the CDC says that alcohol-based hand sanitizers and 3% hydrogen peroxide are not as effective as chlorine bleach, against the norovirus.
Some things I may have overlooked, if it had not been for reading some info online:
- wear gloves when cleaning, emptying the trash containers, picking up tissues and dishes, and while gathering clothing and linens for laundry
- after taking off gloves, wash your hands again
- wash textiles as well as hard surfaces, this includes bath rugs, mats, towels, bedding and clothing in hot water and tumble dry
- run an empty cycle on the washing machine, using bleach in hot water to disinfect your washer. Norovirus can live inside your washing machine for a few days, after washing contaminated textiles.
- the virus remains contagious even after symptoms have subsided, for a few days (as few as 3 to up to 2 weeks, according to the health department -- hygiene of the patient is so important, to prevent spread)
- people who have norovirus should not prepare food for other people for at least 2 days after recovery
- if you have a dishwashing machine, use it for all dishes, cutlery and glassware. If there's a sanitize or hi-temp function on your dishwasher, use it. Hand-washed dishes are more likely to harbor the virus, as most of us can't tolerate the high temperature necessary to kill it, while hand-washing our dishes.
- replace all toothbrushes for family members who share the same bathroom as the patient (another good reason for buying super cheap toothbrushes from Dollar Tree -- I feel no regret having to use up an entire 6-count package of toothbrushes, due to this illness in the family)
- although alcohol-based sanitizers are not as effective as bleach, it's better than nothing. So I kept a baggie of 91% isopropyl alcohol saturated paper towels on the bathroom counter, for my daughter to clean up any mess after herself, wipe off door knobs, flush handles and faucet handles, then dispose of the used towel, each time she used the bathroom. This meant I didn't have to get out the bleach after every single time she got up.
The post-vomiting diet (sorry, there's no nicer way to put that)
When it appeared that all of the really nasty symptoms were over . . .
I'm sure you've all heard clear liquids are best for someone with a stomach virus. But this doesn't have to be limited to beverages. It can include gelatin, popsicles and bowls of broth, for a change of pace. And towards the end of that first day, I do well adding rice milk to the round-up (but not soy, almond or dairy milk). For my daughter, I got a batch of blackberry gelatin started in the morning (using frozen blackberries, simmered with water for a couple of minutes, strained to use only the juice, then sweetened, and set with plain gelatin), and I set a cup of brown rice to soak, to make rice milk later in the day. I also found a quart of homemade chicken stock in the freezer, to season mildly, and serve for her lunch. I'll see how she's feeling by late afternoon. If she feels up to it, I'll make some rice milk pudding for her dinner, as pudding is one of her favorite foods, and made with rice milk it should be easy to digest.
If it seems that she handled those foods okay yesterday, then today I'll add to this menu, with a couple of items from the BRAT diet (bananas, rice, applesauce, toast). I'll use the rice pulp from making homemade rice milk, to make a thin rice porridge for breakfast. And I'll make some applesauce from frozen apple chunks to go with chicken broth for lunch.
It's a lot of work, taking care of one family member who is sick. But one thing I do know, if others in the family get the same virus, it will be a whole lot more work for me. I'd rather put in my work, upfront, than drag this out for weeks.