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Winter Bug Unleashes Its Misery

Protracted Vomiting Torments Sufferers

By Susan Levine
Washington Post Staff Writer
Friday, January 14, 2005; Page B01

If you're still eating breakfast while you read this, or catching a quick bite for lunch during work, that is good fortune and bad. Looking at life positively, it means you are not suffering from the miserable sickness that is the subject of this story. A couple of paragraphs of description, though, and there's no guarantee you won't start feeling queasy.

How else to explain the sledgehammer effect of an affliction with such a grossly apt moniker as "winter vomiting disease"? This highly contagious stomach bug, which mimics many aspects of food poisoning, is a norovirus that hits hardest this time of year.

For 24 to 48 hours, it lays waste to its victims.

"I was hugging the old commode," recounted Katherine Riddle of Oakton, the first in her family to fall ill in late December.

Riddle's only warning was a few minutes of dizziness while she was teaching an afternoon flute lesson at her house. "And then, boom!" she said. She ran for the bathroom and threw up. The lesson ended quickly, but her vomiting went on and on and on. "I was doing it for the rest of the night. It was incredible."

Across Northern Virginia, people have been calling in symptoms to doctors and public health departments since mid-December. Though no comprehensive numbers are available -- few jurisdictions mandate reporting of viral gastroenteritis, as physicians know it -- officials there say there seems to be no unusually high incidence this winter. Their counterparts in Maryland and the District concur.

Even so, Virginia state officials have identified 18 "outbreaks" cutting from east to northwest. Three assisted living facilities in Fairfax County are part of the total, including one hit this week. Staffs responded by closing dining rooms and switching to disposable utensils and plates. No residents were hospitalized, a county Health Department spokeswoman said.

An Alexandria elementary school classroom became a target last Friday, with nearly a dozen students absent. Characteristic of the way the virus races through the body, by Monday morning all were back in school and feeling fine.

Protracted vomiting is the virus's predominant symptom and the most distressing. It's usually accompanied by repeated diarrhea, abdominal cramps and a low-grade fever.

"It's a really awful illness for a day or two," attested medical epidemiologist David Blythe of the Maryland state health department.

Treatment requires patience and monitoring to prevent dehydration. At Shady Grove Adventist Hospital's emergency room yesterday, emergency physician Aaron Snyder saw seven to nine cases, a typical count. All received intravenous fluids, but none needed to be admitted. He sent each patient home with prescriptions for anti-nausea medication.

The virus is passed on primarily person to person, though food-borne transmission also occurs. "It's hard to get rid of because it's in the environment," said Kathy DeSnyder, an epidemiologist with the Alexandria Health Department. "You can touch a door handle and then touch your face and get it."

In 2002, such contact was one way sickness spread quite infamously on two cruise ships, affecting hundreds of passengers. And last summer -- proof that winter vomiting disease does not discriminate by season -- more than 100 teenagers attending a program at the University of Maryland at College Park became violently ill from the virus.

The keys to prevention: hand-washing -- lots of it; frequent wipe-downs of toys, doorknobs, countertops and other surfaces; and staying home until you're really well. "If you don't take the time, you will spread it," warned Lucy Caldwell, spokeswoman for the Virginia Department of Health.

In the Riddle family, there was no stopping it. Thirty-six hours after Mom started throwing up, oldest daughter, Lisa, did the same. "One would get it," Katherine Riddle said, "and then 36 hours later, another would get it."

Dad (Paul Riddle) followed Lisa, followed by twins Jennifer (sick on Christmas at grandmother's house in Vermont) and Erica (who spent her 12th birthday vomiting). Followed by 15-year-old Emily (though about that time Grandma began heaving, too).

"It was really sequential," Riddle said. Sequential and circular. After Emily, the bug had one more hit.

"I got it twice," Mom said. "I was so lucky."


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