Let’s get one thing straight: a rash of sickness in Whitehorse is not, specifically, Norwalk virus.
A strain of norovirus — consider it the family tree of which Norwalk is but a single branch — has prompted the partial quarantine at Whitehorse General Hospital and kept a handful of students home from school with the chucks and scoots.
“We really shouldn’t be calling it ‘Norwalk agent’ anymore,” said Bryce Larke, the Yukon’s medical health officer.
“Norwalk is only one of a family of norovirus, and a laboratory only tells us that it is a norovirus,” Larke said Monday.
“Once this virus, which is highly contagious, hits a community, it’s not at all unexpected that we’re going to see it cropping up here and there.
“It’s a very unpleasant experience for those who have it.”
There’s no way of knowing how many people in Whitehorse exhibiting flu-like symptoms, such as vomiting, diarrhea and stomach cramps, have contracted norovirus.
“There could be a mild case of infection,” said Larke.
“Many don’t get reported.”
There have been almost 80 confirmed cases of norovirus at the Whitehorse General Hospital since October 1, but those numbers are misleading, he said.
“If you know about 77, there have probably been way more than that that have actually occurred.”
Outbreaks happen in waves.
The number of cases might die off for awhile, but could spike again during the Canada Winter Games next March.
Larke would not speculate where the Whitehorse wave is at.
Somehow, norovirus spread from the hospital to Porter Creek Secondary School, where three students were confirmed ill with norovirus on Friday.
A worker at a continuing care centre in Whitehorse also came down with the symptoms on Friday, and was sent home.
Then on Monday, the principal of Jack Hulland Elementary School — the feeder school for Porter Creek Secondary that often teaches students from the same families — reported two absent students who complained of noroviral symptoms.
“These were things we’d heard from the kids’ parents, that they’d been to the doctor and the doctor had said norovirus,” said Education department director Dave Sloan.
“We have no way of really checking without a lab test,” Sloan said Tuesday.
“We’re not seeing any change in our absenteeism. There doesn’t seem to be any kind of major proliferation in the number of cases.
“There hasn’t been any outbreak that we can detect.”
There are no plans for school closures.
If Education officials notice a spike in the number of absent students they will pass that information to the communicable disease control branch of Health and Social Services, which will determine the government’s level of response.
The Education department distributed information about norovirus to Whitehorse schools, but it is up to them, individually, to determine what should be distributed among students and their families, said Sloan.
And Education requested property management workers who provide janitorial services in Whitehorse schools to be extra vigilant, he said.
“You’ve got a large group of people, living in proximity, often using the same kinds of facilities, same bathroom facilities and so on, touching the same surfaces,” he said.
“The only thing you can really do with these is try and minimize the points of contact, keeping commonly used surfaces clean, like doorknobs or tabletops or anything related to food.
“The most common way to prevent these infections, strange as it sounds, is simple, effective hand washing.”
Norovirus outbreaks are not uncommon.
Canada’s public health agency reported 300 to 400 outbreaks every year since 2002.
Between 1998 and 2001 there were fewer than 100 outbreaks each year, but the agency knows that the increase is likely due, in part, to better reporting of the disease.
Norovirus spreads through stool and vomit.
It’s a hardy bug, capable of surviving up to 12 hours on exposed surfaces.
It’s also an absolute parasite, which means it can only multiply and reproduce within a living cell.
Once ingested, a single norovirus attaches itself to a cell in the stomach or bowels and injects its genetic information, called nucleic acid, inside.
The nucleic acid effectively hijacks the cell, using the cellular machinery to reproduce itself.
Then, the viral army bursts forth from the cell and starts infecting more cells.
Norovirus causes inflammation in the bowel. The body responds by trying to eliminate norovirus as quickly as possible, from either end.
“It’s a cunning virus,” said Larke.
“It can find its way from one host to the next host by a variety of means.”
It normally takes 12 to 72 hours from the time of infection, depending on the size of the dose, for a person to become symptomatic.
People may be contagious before they become symptomatic.
Touching a bathroom doorknob after an infected person who didn’t wash his hands after using the toilet could mean a three-day lead-time before norovirus starts to run.
But eating at a buffet featuring shellfish harvested from contaminated waters could lead to misery a lot sooner.
Cruise ships are susceptible to outbreaks, in part because of the menu but more likely because many people are living in close proximity and sharing the same kitchen and toilet facilities.
“Hand washing is the only real precaution that we have,” said Larke.
Noroviruses have no vaccines or antiviral medications.
Once infected, the symptoms typically persist until the body’s immune system fights them off after 24 to 48 hours, although people can remain contagious for up to two weeks.
“There is no sort of chronic infection state that remains, as we see with other viruses such as hepatitis B and so forth,” said Larke.
“Certainly while you’ve got it, you can feel pretty miserable.”
But noroviruses are not deadly.
The diseases they cause are self-limiting, which means they must run their course before the body can clear itself of the virus.
But they can cause dehydration or an imbalance in the body’s electrolytes.
“Unless you’re old or frail or debilitated, it does not usually cause serious health problems, and it would rarely require hospitalization,” said Larke.
That’s why it is imperative to keep norovirus from infecting continuing care facilities where vulnerable patients live, he said.
Larke has been in touch with colleagues across the country, and doesn’t believe the Whitehorse outbreak is cause for too much concern.
“I’m not downplaying or minimizing the suffering of people who are feeling unwell,” he said.
“I’m afraid it’s just that time of year and this particular season.”