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Noroviruses -- severe stomach flu, typically including nausea, vomiting, diarrhea and cramps -- were once associated with cruise lines. While the act of taking a cruise has no relationship to the virus, the close quarters on cruise ships are ideal for quickly spreading the highly contagious viruses. So too are college campuses.
At Georgetown University last week, at least 192 patients were treated for symptoms while university officials undertook an intense effort to clean campus facilities used by students who were infected. Noroviruses are not typically life threatening, but they are extremely uncomfortable for those experiencing them and disruptive to campuses. They must deal with significant numbers of ill students who are sick for several days at the same time, while trying to encourage students to avoid activities that might spread the sickness further.
As is customary in these cases, the university called off numerous athletic events -- including a football game against Colgate University, as well as matches in swimming, cross country and field hockey.
Across the country at the University of Southern California, about 75 students are sick with what the university announced Saturday was a "highly contagious gastrointestinal virus." Symptoms are similar to those of a norovirus, and a spokesman said that medical officials suspect a norovirus, but are awaiting confirmation based on lab results. The university urged students who were not feeling well or who have had contact with sick friends not to attend the football game Saturday in person, but to watch on television. Officials at both Georgetown and Southern Cal said that they knew of no particular connection between the two outbreaks except that large campuses are the kind of place where they spread quickly.
In 2008, outbreaks of norovirus have been confirmed at the Oregon State University, the University of Connecticut, the University of Denver and Villanova University.
The reason colleges experience these outbreaks is simply that they are "large gatherings of people," said Chad Henderson, president of the American College Health Association and director of the health service at the University of Rhode Island.
Henderson said that the best way to prevent outbreaks is by encouraging frequent hand-washing. Many institutions are adding containers of hand sanitizer wipes in various campus facilities, and Henderson said that trend should grow. In recent years, elementary and secondary schools have stressed the need for hand-washing and sanitizing, and Henderson said he thought that more vigilance on these issues in higher education would limit the number of norovirus outbreaks. The problem isn't that college students specifically aren't good about washing their hands frequently, he said, but that "Americans are not good at it."
Outbreaks at other campuses are a good time to push the issue, he said. Students will hear from their friends at affected campuses, and that's an opening to both reassure and educate, he said.
James Turner, president-elect of the college health group and executive director of student health at the University of Virginia, said it is inevitable that there will be other outbreaks, but that quick responses and education campaigns can minimize them. An outbreak can start anywhere, he said, but if college students wash and don't share utensils or glasses, chances for a quick spread can be cut a bit. He said that he thinks college students are generally good about these issues, but that there are notable lapses.
"I think where it potentially falls down is large crowded parties where there is close personal contact," he said, and students who might not normally do so will end up sharing drinking glasses or cigarettes.
Information about noroviruses may be found at the Web site of the Centers for Disease Control and Prevention. The CDC says that there is no current medication to treat noroviruses. While those who have them can feel extremely ill, vomiting many times a day, the noroviruses typically pass in a few days, without long-term damage. At Georgetown last week, only one person was hospitalized -- and that person has since been released.
Given that students who are sick en masse rarely praise their administrations, it may be notable that the student newspaper at Georgetown, The Hoya, ran an editorial Friday praising the response of the university to the outbreak. "All in all, Georgetown is taking responsibility and trying to fix this miserable mess," the editorial said.
These days, of course, once students recover, they immediately mark the event. A new Facebook group is called "I survived the norovirus at Georgetown Univ 2008 -- Yippie!!"
