Ministry of Health Updates Guidance on Acute Gastroenteritis (AGE) Outbreak

Acute Gastroenteritis

Over the past few weeks several children and adults in the Federation have been diagnosed with acute gastroenteritis (AGE). Acute gastroenteritis (AGE) is a common infectious disease syndrome marked by irritation and inflammation of the stomach and intestines causing a combination of fever, abdominal pain, nausea, vomiting and/or diarrhea. AGE is caused by many infectious agents or germs; however, the most common cause is a virus, but it can be caused by bacteria.

This outbreak of AGE is not unique to St. Kitts & Nevis, but a similar trend is observed in several CARICOM member states. The Caribbean Public Health Agency (CARPHA) has noted a multi-country increase in reported cases of AGE in children and adults. Based on epidemiological information, the most likely cause of this AGE multi-country outbreak is Norovirus. Norovirus was confirmed on more than one of the cruise ships traveling in the Caribbean and the UK Health Security Agency reports a sharp increase in confirmed cases of norovirus in recent weeks. Norovirus can only be confirmed through laboratory testing. Samples were sent off to CARPHA for analysis on Monday March 27, 2023.

Norovirus (NOV)

Norovirus belongs to the Caliciviridae family, and the G11.4 variant accounts for 80 % of norovirus outbreaks globally since 1990. Norovirus (NOV) is highly contagious and causes the most outbreaks of non-bacterial acute gastroenteritis in all age groups. It causes outbreaks in schools, nursing homes, prisons, hospitals and in other settings.

The course of this disease is quite rapid with an incubation period of 24 to 48 hours. Affected persons usually experience vomiting and diarrhea for 12 – 60 hours. The signs and symptoms include low- grade fever, malaise, abdominal cramps, nausea, vomiting and diarrhea.

Dehydration can result if the vomiting and /or diarrhea persist without adequate fluid intake.

How is Norovirus spread?

Persons of all ages can get infected with norovirus by:
• Direct contact with an infected person, such as shaking hands with someone whose hands are contaminated with the virus;
• Sharing food or eating utensils with an infected person;
• Touching contaminated objects or surfaces (toys and doorknobs) then putting unwashed
hands in your mouth;
• Consuming contaminated food and water or drink;

Norovirus can be found in the feces / stool of infected persons up to 14 days after onset of symptoms. Norovirus is extremely stable and persistent on objects and surfaces and is resistant to commonly used sanitizers like alcohol gels.

Prevention and control of AGE caused by norovirus.

The following measures are highly recommended because they help to reduce the spread of norovirus. These public health measures include:

Stay at home if experiencing symptoms of AGE. Do not send your child to school or if an adult, do not return to work until 48 hours after symptoms have cleared. Also avoid visiting older adults especially if they are in hospital, or nursing home.

Practice proper hand hygiene, by washing hands with soap and water frequently and particularly after using the toilet, before preparing food and eating. Please note that alcohol gels do not kill norovirus.

Handle and prepare foods safely including washing fruits and vegetables thoroughly before preparing meals.

Do not prepare food for others or care for others if you are ill.
People First Quality Always

Clean and disinfect high -touch surfaces (toilets, taps, door knobs and counter -tops) regularly and thoroughly using bleach-based household cleaners or a combination bleach and water.

If an ill person vomits, the droplets will contaminate surrounding surfaces. Disinfect potentially contaminated surfaces with bleach-based household cleaners or a combination bleach and water.

Wash any contaminated clothing or bedding using detergent and at 600 C and it is recommended that you wear disposable gloves when handling contaminated items.
Treatment of acute gastroenteritis is usually supportive and aimed at avoiding dehydration. Parents are advised to monitor affected children very closely. Parents are advised to seek medical care urgently if your child is under age of 2 years regardless of symptoms and if child is over 2 years but has persistent abdominal pain, fever, vomiting and or diarrhea. Immuno- compromised persons, persons living with chronic gastrointestinal conditions and older adults should also seek medical care if impacted.
Let us all collaborate and contain this AGE Outbreak!
OFFICE OF CHIEF MEDICAL OFFICER March 28, 2023
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