Norovirus Is a Terrible Gut Bug. The Olympics Could Make It Worse

This one’s going to be gross. Bear with me.

According to the South Korean news agency Yonhap, 1,200 security personnel at the Winter Olympics in PyeongChang have been confined to quarters after 41 of them started vomiting and experiencing diarrhea. Tests showed they were infected with norovirus, the last best reason you need to avoid cruise ships.

The games start Friday; the athletes are arriving. Olympic Villages are famously dorm-like—confined, close-quartered, with communal dining. Basically, it’s norovirus heaven. An outbreak among the Olympians could be catastrophic, widespread, and disgusting.

Norovirus is a gastrointestinal monster sometimes called the “winter vomiting bug.” Symptoms include what I mentioned earlier plus chills, pain, and fever. It’s rarely fatal; you just wish you were dead. Symptoms last up to about three days. And norovirus is really good at spreading. “Seventy percent of people get projectile vomiting, and once that happens in a public place it’s tough to control, because it splashes around,” says Chuck Gerba, a microbiologist at the University of Arizona. “Even one to ten viruses can infect you, and when you throw up millions get released. And we’re talking a billion viruses per gram of feces. Maybe ten billion.”

The virus can even aerosolize, floating into the air where people can inhale and ingest it. Outside the splash zones, the virus can ride on people’s hands to other surfaces where other people can pick it up. And it remains infectious on those surfaces for two weeks. You pretty much have to bleach everything to get rid of it, and isolate the sick (and, in the case of those security guards, people who might get sick).

So enclosed spaces are particularly prone to wide outbreaks. That means cruise ships, sure, but also dormitories, elementary schools, hospitals, and at least one really vile airplane ride. (Pro tip: When an entire tour group is projectile vomiting in the back of the plane, don’t be in an aisle seat, and don’t touch anything. Like, try to hover in mid-air. And hold your breath.)

It’s just…well, if you’ve ever read anything about Olympic Villages, you know that isolation is not exactly the thing people do. The athletes are young, in peak physical condition, amped up for competition, and in many cases away from parents and handlers and coaches for the first time in their lives. So they…hook up. They avail themselves of free condoms—110,000 of them, according to CNN. It’s a thing. These kids are not interested in staying in their rooms and avoiding skin-to-skin contact. Norovirus heaven, but even better.

In an official statement, the International Olympic Committee said that Korean public health organizations were going to handle all that per “international best practices,” including quarantines, sanitization, and educating people on prophylactic precautions.

Like any big group of people on travel, Olympic athletes already run a risk of getting sick. (Think about the “crud” that goes around during CES, or the kinds of diseases that sometimes spread during the Hajj and other mass gatherings.) Since at least 2008, epidemiologists and sports medicine experts have surveilled the Olympics to try to understand that risk. At the 2012 Games in London, for example, an international team saw 71.7 illnesses per 1,000 athletes—7 percent of athletes got sick, in other words. Of those, slightly more than 40 percent were respiratory infections. Gastrointestinal distress came in second. Women got sick slightly more often than men.

Of course, lots of travelers, classically, get diarrhea or other symptoms of gastroenteritis. About 30 percent of them are infected with some version of the bacteria E. coli, which means antibiotics can help. But, says Herbert DuPont—an infectious disease physician at the University of Texas who was on the team that first isolated norovirus in 1972—5 to 10 percent of people with Travelers’ Diarrhea have norovirus, and that’s a whole other thing. The only treatment is “go to your room and curl fetally around the toilet while sipping bottled water.” A small study suggested that Pepto Bismol might help a little.

So what’s the best way to keep the athletes healthy in the face of an outbreak? Pour bleach on everything, isolate the infected, make sure only well people are preparing food, and tell everyone to compulsively wash their hands and use 70-percent alcohol hand sanitizing gel. Also: No shaking hands when you meet the competition. “If they greet a new athlete, pat him on the shoulder, bump the fist, but probably don’t shake hands right now,” says DuPont.

Which, OK, sounds easy enough. They might have to come up with some different ways to bump other parts, too.

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