This may come as no surprise to those who already have suffered, but a number of area clinics are reporting a recent rise in stomach bugs causing nausea, vomiting and diarrhea.
The technical name is gastroenteritis. And the most common culprits are noroviruses, which cause more than half of reported gastroenteritis outbreaks.
“We have seen a spike in what I would say is gastroenteritis,” said Dr. Michael Greene of the Alegent Creighton Clinic in Omaha's Old Market.
While it's the season for such illnesses, he said, cases have been “a little more so than normal for this time of year.” Alegent Creighton, in fact, has noted an uptick throughout its system.
At the University of Nebraska Medical Center's family medicine clinic, Dr. Mindy Lacey said she, too, had seen an increase.
Children's Physicians had some clinics seeing an increase and some holding steady, a spokeswoman said.
Health officials in Nebraska and Iowa are well aware the bug is out there. Recently, norovirus has gotten added attention with reports from the federal Centers for Disease Control and Prevention of a new Australian-born strain that health officials are watching closely, waiting to see whether it will increase outbreaks.
But getting a more detailed picture of norovirus' impact can be tricky. It's not an illness that health care providers are required to report. Therefore, they don't routinely test for it, and health departments typically don't track it.
When states do get reports, it typically means a building — such as a long-term care center or a school — has a cluster of cases and is looking for help, said Dr. Joann Schaefer, Nebraska's chief medical officer.
So far this season, the state has received reports of 19 outbreaks, 13 confirmed with lab tests.
“I would say it's par for the course and it's that time (of year),” she said. “The message we'd want to get out is if you're experiencing those symptoms, you've got to stay home from work, you've got to not handle food ... and you've got to wash your hands.”
Indeed, washing hands with soap and water for at least 20 seconds — sing “Happy Birthday” twice — is recommended over alcohol-based hand sanitizers.
Cases in Iowa, too, appear to be typical for the season, said Dr. Patricia Quinlisk, medical director of the Iowa Department of Public Health.
“We're seeing the uptick that we expect this time of year,” she said. “But I don't know that it's anything unusual or unexpected.”
Norovirus and other stomach bugs, experts remind, should not be confused with influenza, which is a respiratory illness characterized by fever, headache and muscle aches.
Iowa on Friday reported continued high and widespread influenza activity for the week ending Jan. 26. Thirty-four schools, the highest number this season, reported absences of 10 percent or more because of illness.
In Nebraska, influenza activity continued to be widespread, according to Friday's report, but tracking suggested a slight decrease in cases.
Schaefer said health officials don't know whether the new norovirus strain, identified in Australia last March, has arrived in Nebraska.
The Sydney strain has spread rapidly in the United States, the CDC reported. From September through December, it was responsible for 53 percent of the outbreaks reported to CaliciNet, a tracking network.
Relatively few particles of the highly contagious virus are needed for a person to become infected. Once that happens, symptoms can come on relatively quickly. If an ill person throws up, particles can become aerosolized. Researchers have tracked the virus up to 30 feet from the source, Schaefer said. Particles can survive on surfaces for days.
“When we put out instructions on containment,” she said, “we put a lot of emphasis on cleaning up for a long distance.”
Greene, the Alegent Creighton physician, said parents at home caring for a sick child should wash hands frequently, decontaminate surfaces — Clorox or Lysol wipes can do the job — and even wear a mask if the child is experiencing vomiting or diarrhea.
A sick person can shed the virus for two or three days even after they feel better, said Lacey of the UNMC clinic. Those who have been ill should avoid preparing food during that time.
The main concern with norovirus, Greene said, is dehydration. The very young and very old are particularly vulnerable, so caregivers should watch for signs. Six to eight wet diapers a day is the norm for infants. If an older child hasn't urinated in eight hours, seek medical advice.
There's no treatment for norovirus other than keeping up fluids. Oral electrolyte replacements such as Pedialyte are best for young children.
What's clear is that neither bug, norovirus nor influenza, has been easy on Midlands residents. “It's hitting everybody really hard this year,” Lacey said.
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