Spread of norovirus reduced

Following last year’s record-breaking number of campus gastroenteritis cases, which surpassed the number of cases in any of the previous 10 years, the number of students affected by symptoms of the virus in 2013 so far has plateaued at half of last year’s levels.

Over the course of February 2012, 275 students checked into University Health Services at McCosh Health Center with symptoms of the illness, which typically causes vomiting and diarrhea. As of Feb. 26, 2013, the number of students who have been seen at McCosh for gastroenteritis symptoms had plateaued at 115.

From February 2006 to February 2011, the number of students at McCosh who exhibited symptoms of gastroenteritis in February had declined from 100 to 45.

Though 2013’s count is significantly lower than last year’s, it is still double the number of cases reported two years ago.

University Spokesperson Martin Mbugua said the University has continuously taken proper measures in response to the virus. However, he also said the attention caused by the 2012 gastroenteritis outbreak contributed to improvements in the numbers.

“It is possible that more members of the community were more cautious and took the measures that we had implemented last year, therefore creating a more effective effort by the community to prevent the spread of illness,” Mbugua said.

UHS issued a Campus Health Alert on Jan. 18 in response to unusually high levels of gastroenteritis on campus. The New Jersey Department of Health and Senior Services confirmed that a sample of those cases had tested positive for norovirus, the most common causative agent of gastroenteritis on college campuses. Norovirus also caused last year’s outbreak.

Last year, UHS transported five students from McCosh to University Medical Center at Princeton because McCosh lacked the facilities to give them proper care. According to Mbugua, McCosh has been able to provide sufficient care to students afflicted with gastroenteritis this year.

Feb. 14, 2012 saw 33 students enter McCosh Health Center exhibiting symptoms of gastroenteritis, the highest number of students to be seen at the health center in connection with the illness in one day. In 2013, Feb. 8 saw the highest number of students enter McCosh for gastroenteritis symptoms.

According to epidemiologist and Wilson School lecturer Joseph Amon, the number of students with gastroenteritis tends to peak in January and February. Amon said he believes that the overlap with winter break is not coincidental and indicates that students may be bringing the virus from home. He also said that virus outbreaks often occur in places such as universities, where people are clustered together.

Amon pointed out that norovirus is notorious for being easily transmissible and difficult to sterilize.

“There are times when cruise ships are taken out of service entirely because [the virus] will jump from one crew to the next,” Amon said. “They need to take it out of service and completely try to scrub it down. But it’s hard to do that with Princeton.”

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Amon made a similar comment last year regarding that year’s larger outbreak.

“Princeton is kind of a long-term care facility, a cruise and a restaurant rolled into one,” he said at the time.

According to Amon, because the virus inevitably resurfaces every year, the University should be ready for it and post educational materials to increase public awareness of the illness.

He suggested that the University may remedy the spread of the virus by identifying when and where the first few cases appear and attending to them. According to Amon, these cases are often not very severe and are not reported to McCosh, so any preventative measures of this nature would require extending the efforts beyond health centers.

The Princeton Regional Health Department suspected that the source of last year’s outbreak was foodborne after finding that several sick students had dined at Panera Bread on Nassau Street.

But Amon questioned the idea that the virus originated from only one source.

“To really be able to say that … this originated from a single source, you need to have a study with a comparison population and look at the probability of other causes,” Amon said. “The specific origin of a norovirus outbreak in this kind of setting is never one kind of cause. It’s coming from a lot of different places, and it’s escalating through person-to-person contact.”

Although some health officials question the effectiveness of Purell hand sanitizers against the spread of a virus, Amon believes that Purell dispensers have had a positive effect on campus.

“If you see them by the keyboard or if you see them daily, it reminds you that they’re out there for a reason,” Amon said. “In addition to using them, I also should be washing my hands, or in addition to using them, I should also be thinking about how often I’m touching things and putting my fingers in my eyes and mouth. There’s an element of it that is both the effectiveness of the antibiotic and also the usefulness of it as a reminder to people.”

The most successful preventative measures on campuses are educational, Amon explained. He encouraged promotional posters informing students to wash their hands regularly and to recognize early symptoms so that they may remove themselves when infected.

Mbugua also emphasized the importance of hygiene.

“The most important thing is, first of all, that each member of the community takes steps to be constantly washing their hands,” Mbugua said. “From the University side, we made sure to increase cleaning of high contact surfaces such as doorknobs and stairwell rails.”