a viral trip…
TRANSCRIPT
A Viral Trip…
Daisy Ooms Medical Doctor in Communicable Disease Control
Public Health Authority Kennemerland, the Netherlands
André Jacobi Policy Advisor
Dutch National Institute for Public Health and the Environment
A Viral Trip
• Interactive discussion
• Aim and objectives
– To stimulate cooperation
– Underline the need for preparedness at Points of Entry.
A Viral Trip
• Split up in four groups
• The moderator will guide you
Message 1
A Boeing 777-300ER, in which 350 passengers are seated, is on its way to an international airport in your country (estimated time of arrival in 3 hours).
On board of the aircraft
• The cabin crew has noticed several passengers suffering from stomach cramping, vomiting and frequently using the toilet.
• Now ill passengers occupy all lavatories; some passengers could not make it to the lavatory in time, which has resulted in vomit and defecation on the ground.
• The cabin crew has notified the pilot about the situation.
Message 2
After arrival the aircraft has come to a standstill. The passengers want to disembark as soon as possible.
Norovirus
“winter vomiting disease”
“stomach flu”
Characteristics • Common cause of gastroenteritis
• Highly contagious
• Multiple ways of transmission
• Stable in the environment (survives up to 2 weeks)
• Resistant to routine disinfection methods
Transmission • Faeco-oral route mouth gut (replication) faeces
• Foodborne – Unhygienic preparation of food – Shellfish from contaminated water.
• Waterborne
• Human-to-human – Hands – Air (aerosolization with vomitus) – Environmental (contaminated) surfaces
Clinical symptoms • Incubation period: 12-48 hours
• Acute onset of symptoms
• Self-limiting disease – Duration of illness: 12-60 hours
– No specific treatment
– Prevention of dehydration (especially in risk-groups: the young and elderly)
• vomiting
• nausea
• headache
• diarrhea
• abdominal cramps
• mild fever
Disinfection
• Stable in the environment: Norovirus survives up to 2 weeks outside the host.
• Resistant to routine disinfection methods
• Disinfection – Cleanse: to reduce viral load
– Disinfectant:
• Alcohol: not effective
• Chloride: not allowed to use in aircrafts
• ???
Conclusions
• Norovirus is a common cause of gastroenteritis
• “Mild” and self-limiting disease no real threat for public health
• But: highly contagious (food, vomit and faeces)
• Resistant to routine disinfection methods challenge for aviation!
• Risk of contamination of passengers on subsequent flights for two weeks