By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

FEAR OF “STOMACH FLU” SHOULDN’T KEEP READER FROM CRUISE

Question: I am planning on going on a cruise in a few weeks, and I just heard about another outbreak of the stomach flu on a ship. What can I do to prevent this problem? Should I go on my cruise?

Answer: Before directly answering your question, let me clarify a few bits of nomenclature. What you call “stomach flu” is referred to as viral gastroenteritis by doctors. The actual viruses that are the primary cause of this disorder in humans have gone by several different names in the past, including Norwalk-like viruses and Caliciviruses. According to the Centers for Disease Control and Prevention, the term Norovirus was recently approved as the official name for this group of viruses.

Stomach flu occurs at home, in hospitals, in schools and daycare centers, as well as on cruise ships. Staying home from your cruise does not mean that you won’t get this infection.

The symptoms of a Norovirus infection are nausea, vomiting, diarrhea, fever and stomach cramps. People also feel tired, achy and can have a mild headache. The illness typically starts very suddenly, but only lasts 24 to 48 hours. The infected individual usually feels very ill. Despite the fact that most people call this the stomach flu, it’s not actually related to the influenza that you get flu shots for.

Viral gastroenteritis is usually not life threatening in otherwise healthy people, but frail adults and children can easily get dehydrated and become seriously ill. Getting medication to stop the vomiting can be helpful. Not only will this make you feel better, it’ll make it easier to “keep down” fluids, which can help prevent dehydration. Appropriate fluids are oral rehydration fluids (a special blend of glucose and electrolyte solution), juice and water.

Noroviruses are very contagious. The stool and vomitus of infected people carry the virus. Frequent handwashing is important, especially after vomiting or using the bathroom. This more than anything can help prevent the spread of the virus. It’s also very important to clean any contaminated surfaces immediately and to wash any clothing or linens that have been used by the sick person with soap and hot water.

Direct contact with someone who is ill, such as kissing or sharing food, drink or utensils, can also spread the viruses. You are contagious from the moment you feel ill until at least three full days after recovery. In some cases, you can be contagious for up to two weeks. Because there are so many different strains, you don’t develop immunity and can become infected multiple times throughout your life.

There is no vaccine to prevent this type of viral infection and no antiviral medication can be used to treat it. Washing your hands after using the toilet and before eating can lessen you chances of getting it. You should not prepare food while you are ill or for up to three days after you feel well.

Enjoy your cruise. You might want to take antidiarrheal medication with you, as well as some over-the-counter “sea sick pills,” which can help with nausea, no matter the cause. You should check with your family physician or pharmacist about possible drug interactions and dosage if you take other medications.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.