AUGUSTA — On Jan. 3, the Maine Center for Disease Control and Prevention issued a health advisory to health workers, EMA directors and first responders, town offices and media, saying its agency had investigated 16 reports of gastroenteritis (stomach virus) outbreaks in Maine, with the Norovirus Genotype II (the most common around the globe) identified as the cause of eight. Southern Maine is bearing the brunt of the virus, with 56 percent of the reporting cases in York County, as of last week. Alongside it, influenza is moving through the state, bringing coughs, fever and headaches to the population.

According to the Maine CDC: "norovirus infections [stomach virus] are characterized by the abrupt onset of gastrointestinal symptoms, including nausea, vomiting, diarrhea, and stomach cramping. It is highly contagious and is transmitted in stool and vomitus. Exposure can result through direct contact with a person who is ill, by consuming food or liquids that are prepared or handled by an ill person, and through contact with contaminated surfaces or objects."

Then, there is influenza, with types A and B, moving across the country and state.

“We are certainly seeing a substantial amount of influenza-like illness, as well as confirmed influenza cases both in our outpatient practices and among patients requiring admission to Pen Bay Medical Center," said Dr. Cheryl Liechty, infectious disease physician at Pen Bay Medical Center, in Rockport, last month. "We have not had to close units or bring in extra physician staff.  However, this year’s flu season is off to a brisk start.  Flu vaccine is recommended for everyone over six months of age; there are very few reasons not to be vaccinated.  It’s not too late to get the flu shot from your healthcare provider or local pharmacy. I would strongly urge those who have not yet received the vaccine to get it now.  And, as always, was your hands, cover your cough, and stay home if you are ill.”

The message is the same at Waldo County General Hospital, where the reporting of widespread presence of flu — and peak season is not until February — has prompted that hospital to urge citizens to get a flu clinic.

"Here at Waldo we are seeing an increase in cases of influenza and flu-like symptoms both in the outpatient and inpatient population," said Rob Fowler, RN, Director of Quality, on Jan. 7. "We have reminded staff to be diligent in their infection control precautions and we are also reminding visitors to not visit while they are sick (i.e. cough, fever, etc.)." 

Belfast Public Health Nursing Association is offering a flu clinic Wednesday, Jan. 16, from 4 to 6 p.m. The cost per flu shot is $20, with cash and checks accepted. The shots will be given in the Education Center, the small white building to the left of the hospital. One does not need to schedule an appointment; walk-ins are welcome. For more information, call Shannon Robbins RN, Belfast Public Health Nurse, 338-3368.

And, then, there are the generic colds, causing sniffling, coughing, and general malaise.

Reports that this flu and virus season is well under way has state and federal health agencies issuing caution.

As of Dec. 29, the proportion of people seeing doctors across the country for flu symptoms was above the national baseline for the fourth consecutive week, having climbed sharply from 2.8 to 5.6 percent over the month of December, according to U.S. Centers for Disease Control, in Atlanta. At that point, 29 states and New York City were reporting high influenza activity. high ILI activity. States reporting high flu activity for the week ending Dec. 29 include Alabama, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, and Wyoming.

However, New Hampshire saw 12 flu-related deaths in December, according to television station WMUR.

Between Oct. 1 and Dec. 29, 2,257 laboratory-confirmed influenza-associated hospitalizations were reported, according to the federal CDC. "This is a rate of 8.1 per 100,000 population. Among all hospitalizations, 1,924 (85.2 percent) were associated with influenza A and 312 (13.8 percent) with influenza B. There was no virus type information for 19 (0.8%) hospitalizations. Among hospitalizations with influenza A subtype information, 475 (98.1 percent) were attributed to H3 and 9 (1.9 percent) were attributed to 2009 H1N1. The most commonly reported underlying medical conditions among hospitalized adults were metabolic conditions, cardiovascular disease, obesity, and chronic lung disease (excluding asthma). Among 36 hospitalized women of childbearing age (15-44 years), seven were pregnant. The most commonly reported underlying medical conditions in hospitalized children were asthma, neurologic disorders, and immune suppression. Approximately 40 percent of hospitalized children had no identified underlying medical conditions."

Norovirus gastroenteritis

The virus can also exist on surfaces for prolonged periods at a wide range of temperatures.

Ill individuals and those around them should wash hands frequently with soap and water. They can continue to transmit the virus for two to five days or more after symptoms have resolved. Infected individuals should refrain from food handling, patient or child care, and recreational water activity, until at least two days after symptoms have resolved, the CDC advises.

Food preparers with gastroenteritis should not work until 48-72 hours after their symptoms resolve, and strict hand washing after using the bathroom and before handling food items is advised.

Transmission of norovirus infection to and from patients/residents and staff in hospitals and nursing homes occurs readily, the CDC said, and cases of gastroenteritis should be reported to infection control professionals as soon as possible.

Students and young children should remain at home while symptoms are present, and wait at least 48 hours after last symptoms.

Follow US EPA guidance for proper cleaning agents effective against norovirus.

Influenza

Individuals afflicted with flu can spread it to others up to about six feet away. The flu, it is thought, is spread by by droplets as the sick cough, sneeze or talk. The droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose, the CDC says, at its website.