As we approach the end of October, there is an increase in cases of gastroenteritis, and many of these have been officially identified as being caused by norovirus. The accredited laboratory, iWaterfood of the Hygiene Laboratory of the Department of Medicine of the University of Patras, which is a reference laboratory of the EODY and the Ministry of Rural Development, has already accepted samples due to the occurrence of cases of acute gastroenteritis from various regions of the country. “We have taken samples of food and water for analysis, with the aim of full epidemiological tracing of the sources of contamination. With the use of molecular detection methods, we are able to accurately and briefly identify the norovirus and other pathogenic microorganisms, providing reliable information that contributes to limiting the spread of the virus” explains Apostolos Vantarakis, Professor of Hygiene at the Hygiene Laboratory of the Department of Medicine of the University of Patras and the agronomist Doctor Raphael Fokas.
Mr. Vantarakis and Mr. Fokas then analyze all the parameters concerning the specific virus, the conditions of its transmission and the prevention measures.
Norovirus, also known as “Norwalk virus”, is one of the main viruses that cause gastroenteritis. According to the latest epidemiological data, norovirus is responsible for approximately 18% of global cases of acute gastroenteritis, which makes it one of the most common viruses associated with this disease. It is easily contagious and can affect communities and groups of people in a very short time.”
TRANSMISSION
As far as its transmission is concerned, this is “mainly through the fecal-oral route and through the ingestion of contaminated water or food and contact with contaminated surfaces. It can also be transmitted through the air during the vomit of an infected person, making its secondary (person-to-person) transmission even easier in closed spaces. It has emerged as a frequent cause of gastroenteritis outbreaks in environments such as cruise ships, where close contact between passengers and crew favors the spread of the virus.
It is noted that an epidemic in closed spaces can affect more than 25% of passengers.
Although norovirus cases occur throughout the year, its incidence increases significantly during the winter season, from November to March. This outbreak is due to the fact that closed spaces where people come into close contact facilitate the transmission of the virus. During the holiday season, the situation worsens as social gatherings increase, creating ideal conditions for the diaspora. The country’s tourist areas in particular are particularly vulnerable, as large numbers of visitors congregate in confined spaces, where adherence to strict health measures can be difficult. The virus causes proportionally more cases in people living in the community or in outpatients (24% and 20% respectively) than in hospitalized patients (17%), in whom other factors are more often responsible for gastroenteritis. This highlights that the virus spreads more easily in non-hospital settings.
THE SYMPTOMS
Symptoms of norovirus infection usually appear within 12 to 48 hours of infection. They include diarrhoea, nausea, vomiting (in a large proportion) and abdominal pain lasting about 1-3 days. In some cases, a headache and mild fever may also occur. But even after they recover, people remain contagious for some time. Norovirus usually does not cause serious complications, but it can be dangerous for certain groups of the population, such as young children, the elderly, and people with underlying health problems. Due to severe diarrhea and vomiting, the patient may become dehydrated. Immediate fluid intake is essential.
PREVENTIVE MEASURES
To limit its spread, it is vital to implement basic prevention measures. Washing hands with soap and water is the most basic and effective measure. Citizens should wash their hands thoroughly, especially after using the toilet and before preparing or eating food. Also, it is important to avoid contact with people showing symptoms of gastroenteritis. In catering establishments, food should be prepared and served in accordance with good sanitary practices. Particular attention should be paid to perishable foods, such as raw seafood, fruits and vegetables, which may become contaminated during the production or preparation process. Shellfish, for example, must be cooked well, as high heat can kill the virus. It is also important that surfaces, especially in common areas, are cleaned and disinfected regularly. In cases of epidemics, the disinfection of premises is deemed necessary to limit the spread.
By being vigilant and taking appropriate measures, we can help manage and effectively deal with the situation, and of course taking preventive samples could help prevent similar situations.
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**Interview with Apostolos Vantarakis and Raphael Fokas on Norovirus and Gastroenteritis**
**Editor:** Thank you for joining us today, Professor Vantarakis and Dr. Fokas. As we approach winter, there seems to be an increase in gastroenteritis cases linked to norovirus. Can you explain what norovirus is and why it’s particularly concerning during this time?
**Apostolos Vantarakis:** Thank you for having us. Norovirus, often referred to as the “Norwalk virus,” is one of the primary causes of gastroenteritis worldwide. It is especially concerning in the winter months, from November to March, when conditions in closed spaces promote its spread. This is exacerbated during the holiday season when people gather in large groups, making transmission much easier.
**Editor:** You mentioned that norovirus is highly contagious. What are the main transmission routes we should be aware of?
**Raphael Fokas:** Norovirus spreads mainly through the fecal-oral route, which can occur by consuming contaminated food or water, or through contact with contaminated surfaces. Additionally, the virus can become airborne, particularly during vomiting episodes, which significantly increases the likelihood of person-to-person transmission in crowded areas, such as cruise ships or communal living spaces.
**Editor:** What symptoms should people look out for if they suspect they’ve been infected with norovirus?
**Apostolos Vantarakis:** Symptoms typically manifest within 12 to 48 hours after exposure and include diarrhea, nausea, vomiting, and abdominal pain. In some cases, individuals may also experience headaches or mild fevers. While norovirus infections are usually not severe, they’re particularly risky for young children, the elderly, and individuals with underlying health conditions due to the risk of dehydration from severe diarrhea and vomiting.
**Editor:** Given the high risks associated with norovirus, what preventive measures can individuals and communities take?
**Raphael Fokas:** The most effective prevention method is proper hand hygiene. Washing hands thoroughly with soap and water, especially after using the bathroom or before eating, is crucial. Additionally, ensuring that food is cooked properly, disinfecting surfaces, and avoiding close contact with infected individuals can significantly reduce transmission risk.
**Editor:** Thank you both for this important information. Any final thoughts as we enter this high-risk season for gastroenteritis?
**Apostolos Vantarakis:** Stay vigilant about hygiene practices and encourage your community to do the same. If you experience symptoms, it’s best to stay home to prevent spreading the virus further.
**Raphael Fokas:** Yes, and remember that staying hydrated is key to recovery. We encourage everyone to be proactive about their health during this time.
**Editor:** Thank you for your insights, Professor Vantarakis and Dr. Fokas. It’s been a pleasure having you with us.
Not usually severe, they can be dangerous for vulnerable populations such as young children, the elderly, and those with underlying health conditions due to the risk of dehydration from severe diarrhea and vomiting.
**Editor:** Given the rise in cases, what preventive measures would you recommend to the public to minimize the risk of infection?
**Raphael Fokas:** The most effective way to prevent norovirus spread is through proper hand hygiene. Washing hands thoroughly with soap and water after using the bathroom and before preparing or consuming food is crucial. Additionally, avoiding close contact with anyone displaying symptoms of gastroenteritis is critical. In food preparations, especially in restaurants, it’s important to follow strict sanitation practices, particularly with perishable items like seafood and produce. Lastly, frequent cleaning and disinfecting of surfaces, especially in shared spaces, can significantly curb the virus’s spread.
**Editor:** With winter approaching, are there any specific high-risk environments that people should be cautious of?
**Apostolos Vantarakis:** Yes, closed environments such as cruise ships, nursing homes, and schools often experience outbreaks due to close contact among individuals. During the busy holiday season, public gatherings and events can also create ideal conditions for norovirus transmission, so people should remain vigilant in these settings.
**Editor:** Thank you, Professor Vantarakis and Dr. Fokas, for shedding light on this important health issue. We encourage everyone to stay informed and take the necessary precautions to protect themselves and their communities.
