Outbreaks of acute gastroenteritis associated with norwalk-like viruses incampus settings

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, w ater, fomites, and person-to-person contact. They are a leading cause of ac ute gastroenteritis epidemics in industrialized countries. NLV outbreaks ar e characterized by a 12-to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infectio ns spread rapidly on college and university campuses because of close livin g quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact throu gh sports and recreational activities. The illness is generally mild and se lf-limited but an outbreak can strain the resources of campus health servic es and cause high absenteeism among both students and staff. Treatment is p rimarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of s trict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.