Widespread Outbreak of Norovirus Gastroenteritis among Evacuees of Hurricane Katrina Residing in a Large "Megashelter" in Houston, Texas: Lessons Learned for Prevention

Abstract

Our investigation underscores the difficulties in managing such outbreaks in crowded settings and the need for rapid, sensitive laboratory assays to detect norovirus. Additional research is needed to establish more effective measures to control and prevent this highly contagious gastrointestinal illness.

Emerging Disease Syndromic Surveillance for Hurricane Katrina Evacuees Seeking Shelter in Houston's Astrodome and Reliant Park Complex

“…An increase in reported vomiting and diarrhea among evacuees being evaluated in the clinics gave an immediate warning to the beginning of a gastroenteritis outbreak. 4,5 The cot survey data were used to confirm and monitor the course of the outbreak and gauge the success or failure of implemented control measures, which included hand-washing campaigns, distribution of alcoholbased instant hand sanitizer, and isolation of sick and exposed evacuees. 5 Additionally, volunteers conducting the survey instructed and in some cases assisted sick evacuees to report to the medical clinic for evaluation and possible isolation.…”

“…[1][2][3] Between September 1 and September 3, 2005, approximately 27,000 evacuees arrived at a megashelter created in Houston's Astrodome and Reliant Park Complex. 4 Transmission of communicable infectious diseases became an immediate public health concern. This article describes the surveillance system developed for tracking symptoms in the evacuee population as a means of identifying potential disease outbreaks.…”

Multicenter Comparison of Two Norovirus ORF2-Based Genotyping Protocols

“…In contrast to other gastroenteritis viruses, NoVs infect all age groups (3). The viruses are spread rapidly and can cause large outbreaks in a wide variety of settings, including health care facilities, restaurants, and schools (5,6,11,17,20,23,32). Since many countries do not have national NoV surveillance programs, the completeness and quality of reporting systems vary substantially.…”

Rational Design of Duplex Specific Nuclease for One-Step Isothermal Viral RNA Detection

“…Worldwide, Norwalk virus is the most common cause of gastroenteritis [40][41][42][43][44][45][46], accounting for almost 20% of these cases [47], resulting in 71,000 hospitalizations [48] and approximately 800 deaths per year in the United States [41,49]. The infectious dose of norovirus is extremely low, around 18 viral particles [50], making it highly contagious and readily transmitted in environments with close interpersonal contact [51][52][53]. Further, norovirus particles can retain infectivity in ground water for at least two months with viral RNA detectable for up to three years [54].…”