The spread of norovirus, better known as the winter vomiting bug, may yet to have peaked, the HSE has warned, as hospitals deal with an unseasonably high number of admissions.
Almost 400 cases of norovirus have been recorded in Ireland in the first 10 weeks of this year, the HSE said.
A total of 394 cases of norovirus have been reported so far in 2023, almost four times the number of cases for the same period in 2022, when 109 cases were reported.
Also known as the winter vomiting bug, norovirus is a virus that is easily spread between people and causes sudden onset of vomiting and diarrhoea.
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The figures come amid signs of fresh overcrowding in hospitals, with 665 admitted patients waiting for beds on Tuesday morning according to the latest Irish Nurses and Midwives Organisation (INMO) “trolley watch” count.
Some 535 patients are waiting in the emergency department, while 130 are in wards elsewhere in hospitals. In University Hospital Limerick alone, 106 patients are on trolleys.
Cork University Hospital is the second most overcrowded hospital in Ireland on Tuesday, with 63 patients on trolleys, followed by University Hospital Galway with 56 patients.
Young children and older people have been the most affected by norovirus, with half of cases aged over 65 years and 28 per cent of cases aged under 5 years.
The HSE’s Health Protection Surveillance Centre (HPSC), has asked people to be aware of the symptoms of norovirus and to learn how to stop the spread of infection as cases of the virus increase in Ireland.
Dr Paul McKeown, HSPC consultant in public health medicine, said that norovirus lasts for a long time on surfaces. “If you touch a surface contaminated with norovirus and then touch your mouth, this can make you sick,” he said.
“Cleaning your hands with soap and water is the best protection against catching norovirus and it is important to note that alcohol hand gels do not work against the virus. The recent upsurge in norovirus cases can be attributed to the pandemic lockdowns and people not being exposed to it as much over recent years. Therefore, people’s immunity wouldn’t be as high as previously.
“Because the restrictions of the pandemic period have been wound down, there’s so much more mixing and in that way we are also getting the spread, which is probably leading to his increase, an increase that we are seeing across the northern hemisphere,” Dr McKeown said.
“Whenever we get these upsurges, they tend to last for eight, 12, sometimes 16 weeks, so we are probably, hopefully into the first third or even half of this and we would expect the norovirus activity to begin to wind down over the next couple of weeks.
“In the US and the UK, they have seen quite high levels of norovirus that are continuing to rise. It is possible that levels of norovirus in Ireland will continue to rise further.”
Acute vomiting
Speaking on Today with Claire Byrne on RTÉ Radio One, GP Dr Máire Finn said the more vulnerable you are, the more likely you are to be affected by dehydration and the symptoms of acute vomiting.
“So small children we would be very careful about. Are they wetting their nappies? Are they taking in enough fluids if they are vomiting them out frequently? You still give them fluids so they keep having this kind of persistent rehydration or oral rehydration through any form of fluids,” Dr Finn said.
“But, if they are not wetting their nappy they are dehydrated and may be in trouble, may need a drip. The exact same applies to elderly people or people who are in any way kind of dependent. If they are not taking enough fluids in and they are vomiting, they will maybe shut down from a renal point of view and that is where we run into trouble.”
People who are ill with norovirus should stay at home and not go to work or school and should avoid visiting nursing homes or hospitals until 48 hours after their symptoms have gone, Dr McKeown said.
“This is the best way to protect other, often vulnerable people. If you or any family members develop forceful vomiting, do not visit your GPs surgery without phoning ahead first.
“It is often impossible to prevent norovirus however, taking good hygiene measures around someone who is infected can reduce your chance of getting infected,” he added.
To prevent the spread of norovirus, frequent handwashing is recommended, including before eating or preparing food and after using the bathroom.
Thorough cleaning and disinfecting of contaminated surfaces using bleach immediately after an episode of the illness and the immediate removal and washing of clothing or linens that may be contaminated after an episode of the illness are also recommended.
The HSE also recommend that vomit and/or faeces are flushed or discarded in the toilet and that the surrounding area is kept clean to prevent spread of the virus.
Norovirus infection is usually mild and lasts a day or two. However, young children and elderly people can become very sick, according to Dr McKeown.
People who get sick with norovirus can still spread the infection after their symptoms have gone, and there is no treatment for the virus.
Dr Finn added: “It’s interesting to know, the gels that we’ve all been gotten into the habit of using for coronavirus, they do not seem to be as effective for this, so bleaches and everything when you are washing your surfaces are very important.”
She also said that staffing can become an issue if norovirus gets into a hospital or nursing home.
“So they frequently put a ban on visiting when this is in a hospital or in an area, but do not be alarmed if that happens because if there is the winter vomiting bug in a hospital or in an area, it is best not to visit the hospital for your own sake and for the patients sake,” she said.
In her own practice, the GP has noticed an increase in upper respiratory infections in recent weeks.
“We actually had quite a number of sick people that needed to be hospitalised, which is unusual,” she said, before adding that “they weren’t Covid, all their antigens were negative”.
The INMO has requested that the HSE advise the public of long delays to be seen in emergency departments across all hospital sites.
Members of the public are being urged to visit the HSE website to find out more about the norovirus. In addition, new guidance on managing norovirus in residential care settings has been published by the HPSC here.
