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The virus making hundreds of millions of people worldwide sick in any given year

“It’s not the food. It’s norovirus that came uninvited on unwashed hands.”

“The superfluous,” said Voltaire, the French philosopher, “Is a very necessary thing.” Alas, his thinking predated our understanding of the norovirus. The norovirus is one of the most common viruses on the planet, yet it seems to be doing nothing useful, let alone necessary. It’s just making hundreds of millions of people worldwide sick in any given year.

A lot of people made sick by norovirus think they have the flu. The symptoms are similar, but norovirus isn’t the flu at all. It’s a tiny, highly contagious virus that infects the stomach and intestines. It spreads through contaminated food, water, surfaces, and most usually, dirty hands.

The virus is found only in humans, not animals, and it doesn’t need much help to make trouble. A microscopic particle is enough to make you sick. Once ingested, it multiplies rapidly and exits just as quickly, shedding billions of copies that can infect others. It’s so efficient that it’s been called “the perfect pathogen.”

Most outbreaks emerge in familiar places like restaurants, daycare facilities, cruise ships, or long-term care homes. The virus is so hardy that it survives freezing, mild heating, and many cleaning products. Even alcohol-based hand sanitizers, so effective against most bacteria, don’t reliably stop it. Soapy water is the best prevention.

Symptoms of infection include sudden nausea, vomiting, diarrhea, and stomach cramps. It comes on fast, but is usually over in two, or three days. Most people recover without lasting harm, though the elderly, very young, or those with weakened immune systems can become dangerously dehydrated.

Unlike other viruses, getting it once doesn’t make you stronger. You might think that exposure would at least give your immune system a workout and lead to lasting protection. Unfortunately, norovirus doesn’t play by those rules. Your body does mount a defense and produces antibodies, but they fade quickly, usually within six months to two years, and only protect you from the exact strain that made you sick. Norovirus keeps changing. It mutates its surface proteins just enough to fool your immune system the next time around. That’s why you can catch norovirus again and again. There is literally nothing good about norovirus unless you count that it makes victims better appreciate good plumbing.

For all our medical advances, a virus invisible to the naked eye can still level us for days.

Scientists have been working for years to develop a vaccine, but so far, the virus’s habit of constant reinvention has stymied efforts. There are dozens of strains, and new ones emerge every few years.

Norovirus often strikes just after a family dinner. Within 24 hours, one person starts feeling queasy, another rushes to the bathroom, and soon everyone is apologizing, or looking for culprits in the cooking. It’s not the food. It’s norovirus that came uninvited on unwashed hands.

What can we do? The answer is old-fashioned but effective. Wash hands with soap and water for at least 20 seconds, especially before preparing food and after using the bathroom. Keep kitchen surfaces clean. Cook shellfish thoroughly, since oysters and clams can carry the virus if harvested from contaminated waters, and if someone in your home is sick, disinfect using a bleach-based cleaner and handle laundry and dishes with care. Norovirus may be hard to kill, but it doesn’t like hot water, chlorine, or good hygiene habits.

The larger lesson in all this is about humility. For all our medical advances, a virus invisible to the naked eye can still level us for days. Immunity isn’t always cumulative, and strength doesn’t always come from exposure. Sometimes, health depends less on what we can endure and more on what we can avoid.

This column offers opinions on health and wellness, not personal medical advice.

 

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Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation.  Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy.  Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa.  She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School.  She is also a graduate of Wellesley College.  She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University.  She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

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