UK poised to combat norovirus and Ebola

Preventing the spread of infection is a challenge all hospitals and healthcare settings will be desperate to demonstrate they are performing well on, as the fight against Ebola continues and the spread of the disease shows no sign of slowing down.

Norovirus outbreaks

With winter approaching, however, the task of fighting infection is not only a priority due to the rise of epidemics abroad, but also because of the frequency of norovirus outbreaks – or the ‘winter vomiting bug’ – cases of which have risen significantly over the last few years.

Controlling norovirus presents a particular challenge to hospitals and care homes in that the virus is especially dangerous to older people and capable of spreading quickly within environments where people live in close proximity.

Last year cases of norovirus were estimated as rising by 63 per cent, affecting around 1.2m people and, with cold weather on the way, outbreaks have already been reported in Devon, Redditch and Raigmore, with many hospitals issuing pleas requesting that anyone showing symptoms should isolate themselves.

York Hospital, for example, has issued this statement: “In order for us to protect vulnerable patients it is essential that, if someone develops symptoms of norovirus, they avoid visiting friends or relatives in hospital or care homes.

“It is usually through this route that the infection is spread and once it is in a hospital it means bays have to be closed reducing the number of beds available to other sick patients. So if you've got vomiting or diarrhoea, please don't come!"

Medical research

So far health services have been unable to prevent cases of the virus increasing each year, but there may be some hope ahead thanks to University of Cambridge research into experimental antiviral drugs.

In October, a Wellcome Trust funded study was published detailing the results of tests with a drug called favipiravir, which has been used to lower the effects of norovirus in mice.

Professor Goodfellow, who led the study, comments: “Norovirus is an unpleasant bug that spreads quickly. Most of us will have experienced it at some point and will know that the only option is to ride out an infection, drinking plenty of fluids. But some patients get infections that can last months or years, and this has a real impact on their quality of life. The ease with which infections spread, particularly in places such as hospitals, schools and cruise ships, and the potentially serious health problems norovirus can cause people with weakened immune systems means that we desperately need a way to treat infection.”

First author Dr Armando Arias adds: “Our work in mice is very promising and shows that favipiravir can make the virus mutate itself to death. It suggests that as well as treating infected individuals, the drug may also be useful in preventing infection during an outbreak. The next steps will be to test whether this drug is safe and effective at treating patients, too.”

Containing Ebola

Regarding Ebola, on the other hand, health teams have been quick to reassure the public. Despite being the largest outbreak the world has known, the Department of Health is confident that the threat to these shores remains ‘very low’ and that, even if there are to be more than just the one reported case of Ebola in the UK, there is not a high likelihood of infection spreading.

The NHS Choices website states: “In past outbreaks, infection control measures have been very effective in containing Ebola within the immediate area. The UK has a robust public health system with the trained staff and facilities necessary to contain cases of Ebola.”

So the disease continues to spread in Guinea, Liberia and Sierra Leone due to a lack of modern health facilities, although health professionals still emphasise that vigilance is need to make sure that isolated cases do not lead to unnecessary loss of life.

Dr Paul Cosford, director for health protection and medical director at Public Health England (PHE), comments:

“Anyone who is well but may have been at increased risk of contact with the Ebola virus will be given printed information and a PHE contact number to call in case they develop symptoms. People infected with Ebola can only spread the virus to other people once they have developed symptoms, such as a fever. Even if someone has symptoms, the virus is only transmitted by direct contact with the blood or body fluids of an infected person.

“It’s important to remember this is just one part of the screening process. PHE is also working with the international community and local health authorities to ensure robust exit screening remains in place at airports in Sierra Leone, Guinea and Liberia, which will pick up anyone who is symptomatic before they leave these countries.

“Although no system can completely prevent a case of Ebola coming into the UK, enhanced screening in high volume ports of entry will ensure that individuals at risk know exactly what to do if they start feeling ill, and can receive the expert advice they need immediately.

“Overall the risk of Ebola in the UK remains low, and we have a world-class domestic health system that is ready to respond if we do see a case in the UK.”