Officials are currently scrambling to contain an outbreak of norovirus among security staff at the Winter Olympics. So far, nearly 200 people have gotten sick.
In the days leading up to the opening ceremony of the 2018 Winter Olympics in Pyeongchang, South Korea, an unlikely competitor arrived to steal the show: norovirus, a nasty stomach bug. The outbreak, which has occurred primarily among security guards, sent officials into a frenzy.
As of Tuesday, there have been 199 confirmed cases; 154 of those people have returned to work while 45 remain in quarantine, according to the latest statement from the Korea Centers for Disease Control and Prevention. So far, the majority of cases (108) have been at the Horeb Youth Centre, a dormitory where security staff members are residing during the games. However, there have also been 38 cases in Pyeongchang and 53 cases in Gangneung, the coastal city where indoor ice sports such as figure skating are taking place.
In response, 1,200 members of security detail were quarantined, and officials drafted members of the South Korean army to fill in as staff, BuzzFeed News previously reported.
So what is norovirus, how does it spread, and how can you prevent yourself from getting infected? We reached out to an expert to find out.
On Thursday, it was announced that the outbreak had reached the first athletes, two skiers on the Swiss team.
The two freestyle skiers are Fabian Boesch and Elias Ambuehl, according to Swiss media. The pair have been moved away from the rest of the team to recover and avoid spreading the virus, according to the BBC.
Norovirus, often known as the "winter stomach bug," is a highly contagious viral infection that causes A LOT of diarrhea and vomiting.
Norovirus is the most common cause of gastroenteritis, which is an inflammation and irritation of the gut. "The organism goes into your gastrointestinal tract, where it causes a lot of inflammation in the stomach and intestines," Dr. Floyd L. Wormley Jr., a professor of immunology and microbiology at the University of Texas at San Antonio, tells BuzzFeed News. This can lead to nausea, abdominal pain, vomiting, and diarrhea. Norovirus can also cause muscle aches and a low-grade fever, Wormley says, but these aren't as common as the hallmark symptoms: LOTS of watery diarrhea and vomiting, everywhere.
Symptoms usually start around 12 to 48 hours after initial exposure to the virus, but some people who get infected may have no or very few symptoms.
"Generally, the illness only lasts 24 to 72 hours and it will go away on its own, so you should feel fine in a few days," Wormley says. There isn't any specific treatment for norovirus other than supportive care, aka lots of rest and fluids, since it's very dehydrating.
If the diarrhea is bloody, it's probably not norovirus and you should see a doctor. "This is most likely an infection with bacteria, such as E. coli or shigella," Wormley says.
Norovirus typically spreads through contaminated water or food, or contact with contaminated people and surfaces.
Norovirus typically spreads by the fecal-oral route, Wormley says, which means people contract the virus from consuming food or beverages contaminated with fecal matter, or from touching their hands to their mouth after coming into contact with a contaminated surface (the bathroom sink, counter, doorknobs) or while cleaning up after a sick person. It can also spread directly from person to person when you are in close contact.
"It only takes 10 to 20 virus particles to infect someone, and when you're contagious you're shedding millions and billions of disease particles," Wormley says. So you are most contagious when you have symptoms, but you can still transmit the virus to others after symptoms go away and you feel fine." The virus can be found in your stool for up to two or three weeks after," Wormley says.
So outbreaks often occur in environments where tons of people are crowded together, such as cruise ships, or...you guessed it: the dorms at the Olympics.
Norovirus outbreaks have also been linked to schools, public bathrooms, and kitchens where food is prepared for the masses. It doesn't take much for norovirus to spread, so one sick person can lead to a massive outbreak.
As we mentioned, norovirus has been known to spread like wildfire on cruise ships, but also planes and buses. "When you're traveling, you might already be dehydrated and this can exacerbate the norovirus symptoms, so you have to be careful," Wormley says. However, norovirus is not the same as traveler's diarrhea, which is usually caused by bacteria.
The infection typically isn't life-threatening, but you should see a doctor if your symptoms become severe or if you are considered "high risk."
"Most people don’t need to be hospitalized, but some people can become severely dehydrated and others are at risk for more complications," Wormley says. You should go to the hospital if your symptoms do not go away after three days or they worsen. Severe symptoms include a high and persistent fever and signs of dehydration (dizziness, not being able to urinate, sunken eyes, etc.). You should also seek medical care if you contract norovirus and you're considered "high risk," which means the very young, the very old, and people who are immunocompromised, Wormley says.
If you go to the hospital or urgent care for norovirus, you'll probably just get an IV bag to replace your fluids — and no antibiotics. "A common misconception with norovirus is that you need to go to your doctor and ask for antibiotics but this is a virus, so antibiotics won't work," Wormley says. So just remember to stay hydrated and ride it out. "You might feel like you're going to die but you probably aren't," Wormley says.
You can protect yourself and others from norovirus by washing your hands and avoiding or limiting contact with infected people.
"Handwashing and sanitizing should be your best friend," Wormley says. So make sure to wash your hands properly (with soap and water for at least 30 seconds) after you use the bathroom or public transport, before you eat or prepare food, and before you touch your face. You also want to avoid putting your hands in your mouth or biting your nails at all times, Wormley says, because this can transmit virus particles directly into your body.
If you're caring for a sick person, you should sanitize everything and wear gloves, Wormley says. You should also limit or avoid contact with said sick person, even if it's your partner or child. "When you vomit you can release aerosols and these can infect someone if they are close enough," Wormley says. Oh, and no kissing your sick partner for a while, especially if they were vomiting. And if you're sick, try to stay home and do not prepare food for other people.
And if you recover from norovirus, remember that you aren't in the clear — you can still spread the illness...and you can get reinfected after a few months.
As we mentioned, norovirus is a highly contagious bug and you can still be contagious after your symptoms go away. So make sure you exercise caution for a week or two after you get better. And sorry, but there's no long-term immune protection with norovirus. "When you get norovirus, you only have immunity for a couple of months so you are still susceptible to get it later in life, especially since there are multiple strains," Wormley says.
UPDATE
This story was updated to reflect the fact that the norovirus outbreak has reached Olympic athletes.
Caroline Kee is a health writer for BuzzFeed News and is based in New York.
Contact Caroline Kee at caroline.kee@buzzfeed.com.
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