The Centers for Disease Control (CDC) on Tuesday said that 186,708 hospital visits for diarrhea were reported the week before, and that although weekly visits have fallen for five consecutive weeks, they remained the highest in five years.
Since the start of this year, weekly hospital visits for diarrhea have consistently been the highest in five years, except in late January due to many clinics closing for the Lunar New Year holiday, but hospital visits in the week after spiked to a peak of 309,023, which is nearly double the highest weekly number in five years.
While the causes of diarrhea can vary, CDC data showed that up to 90 percent of the tested diarrhea cases were caused by norovirus — a highly contagious virus that is the leading cause of acute gastroenteritis.
Several food poisoning cases linked to norovirus have been reported this year, including a hot pot restaurant in Yilan County, where 82 customers were diagnosed with gastrointestinal illness after eating there; the CDC said five customers and five food handlers tested positive for norovirus.
Norovirus is not new, but a well-known common cause of vomiting and diarrhea. It is mainly transmitted through the fecal-oral route — meaning through direct contact with infected people, sharing food or utensils, or eating food handled by them, or by touching contaminated objects or surfaces — and is highly contagious even after symptoms subside.
Although the reason norovirus cases are spiking this year is unclear, some doctors said it might be associated with the relaxation of COVID-19 restrictions. During the pandemic, the public learned to maintain social distancing, wear a mask and practice hand hygiene, often by using alcohol-based hand sanitizers, to prevent respiratory illnesses, but as people relaxed their preventive measures and attended more social gatherings, a global surge in common communicable diseases has been observed in the post-pandemic period.
However, using alcohol-based hand sanitizers or restaurant workers spraying alcohol and wiping tables with the same towel without rinsing with soap water — which is a common, but not thorough, way of disinfection learned during the pandemic — might not be enough to protect against norovirus and other non-enveloped viruses, such as enteroviruses.
The CDC and doctors have repeatedly reminded people that proper hand washing — washing hands frequently with soap and water, especially before eating or handling food, and after using the toilet — is key to preventing norovirus infection, and that alcohol-based hand sanitizers are ineffective against the virus.
The CDC also urged restaurant and hotel workers to practice hand hygiene and food safety principles — keep clean, separate raw and cooked food, cook thoroughly, and keep food at safe temperatures — as well as pay attention to their health, including resting at home when experiencing gastroenteritis symptoms and returning to work at least 48 hours after they subside.
However, aside from the outbreak in Yilan, several previous food poisoning incidents were also found at establishments where food handlers tested positive for norovirus, indicating that they might have ignored public health advice and concealed their illness, risking the health of others.
Moreover, the epidemic period for enterovirus abnormally extended into autumn and winter last year, finally ending the longest enterovirus epidemic in a decade in January. Two newborn babies have died from enterovirus this year, and the CDC predicts enterovirus activity to start rising next month — as it typically rises in April and peaks in late May to early June.
It is crucial to raise public awareness on the importance of proper hand washing — with soap and water — while restaurants should be encouraged to provide sinks and soap for customers, and food handlers and caregivers of young children should especially be reminded of their responsibility to practice personal hygiene and proper sanitization — not only by spraying alcohol, but also not going to work when ill.
