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Every year on the AT (Appalachian trail) Norovirus sweeps through like wildfire and the problem only increases as trail density increases.

What are the best methods for minimizing risk of contracting Norovirus on the AT?

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    Note that the way norovirus is likely to be transmitted is the same as the way you are most likely to get other bugs such as giardia, i.e., person-to-person transmission from people who have bad potty hygiene. (Getting giardia from untreated water in pristine wilderness areas is largely a myth.) So take the same generic set of precautions for all of these bugs. Wash your hands, and don't share utensils.
    – user2169
    Apr 8, 2016 at 15:50

5 Answers 5

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TL;DR

It's very difficult if not impossible.


Norovirus is very, very contagious. It can be spread:

  • close contact with someone with norovirus – they may breathe out small particles containing the virus that you could inhale
  • touching contaminated surfaces or objects – the virus can survive outside the body for several days
  • eating contaminated food – this can happen if an infected person doesn't wash their hands before handling food

source

If your in very close proximity with people and there is an outbreak of norovirus you will likely get it. This is even more true outdoors as the main way to contain it is to separate infected people. Below is a list of the recommended practices for how to prevent catching it:

Preventing norovirus

It's not always possible to avoid getting norovirus, but following the advice below can help stop the virus spreading.

  • Stay off work or school until at least 48 hours after the symptoms have passed. You should also avoid visiting anyone in hospital during this time.
  • Wash your hands frequently and thoroughly with soap and water, particularly after using the toilet and before preparing food. Don't rely on alcohol hand gels, as they do not kill the virus.
  • Disinfect any surfaces or objects that could be contaminated. It's best to use a bleach-based household cleaner.
  • Wash any items of clothing or bedding that could have become contaminated separately on a hot wash to ensure the virus is killed.
  • Don't share towels and flannels.
  • Flush away any infected poo or vomit in the toilet and clean the surrounding area.
  • Avoid eating raw, unwashed produce and only eat oysters from a reliable source, as oysters can carry norovirus.

source

The items highlighted in italics are likely impractical on the trail.... this doesn't leave you many choices... If one of your party contracts this virus. Expect to be visiting your local convenience a lot in the near future...

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    A note on alcohol gels, handwashing, and "killing" the virus. Handwashing also does not "kill" the virus. Thorough proper hand washing (the kind you can't do on the trail) has a very good chance of removing it from your skin. Water hot enough to kill the virus would not be suitable for washing. On the flip side, some sanitizers are effective as Noro is resisitant, but not immune to alcohol. The problem is that most sanitizers are too low of a percentage and the gel acts as a buffer to further insulate the virus from the alcohol. Apr 8, 2016 at 15:21
  • @RussellSteen So, would it work if I washed my hands with rubbing alcohol?
    – Kyle
    Apr 11, 2016 at 16:39
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    @Mr.Derpinthoughton -- It's complicated. Noro is actually really hard to prevent. If you can get the dirt off your hands (it also protects the virus), then 90% rubbing alcohol should kill Noro. Apr 11, 2016 at 16:53
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Acquire it 6 months or less before your trip on the AT. There is some controversy but it seems you can probably count on immunity from an exposure to last 6+ months.

Some of the best places to acquirer Norovirus (that are easily accessible) are daycare centers and nursing homes. Volunteering at one or more of these institutions, is win/win you get to help others, and you get exposure to the nasties before you hit the trail. If you see a cruise ship on the news, you might be able to get to the dock for unloading and acquire it there.

Enjoy working through the bout of Norovirus at home, before your trip.

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  • @ab2 humor is secondary in this answer, if you don't want to suffer from Norovirus "on the AT", the one and only option is acquire immunity before you go, There is currently only one one way to acquire immunity, as indicated by the inline reference. Apr 15, 2016 at 15:29
  • You should take credit for witty writing! To continue with being serious, one should know the probablilty of contracting Norovirus on the AP under the conditions (when, with whom, which portions of the trail) one will hike, and compare it with a 100% probablility of deliberately infecting oneself if one tries really, really hard as per your suggestions. I don't know just where my tipping point would be -- less than 50% but more than 5%.
    – ab2
    Apr 15, 2016 at 21:20
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The best strategy is to probably hike an alternate hike. Instead of the traditional NOBO GAME route with a start date at the end of March, you could go SOBO, or do a flip flop, or start early or late. By avoiding the crowds, you reduce your risks. You can also avoid shelters and hostels.

Good hygiene, plenty of rest, and a proper diet are also useful for fighting viruses.

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In the civilized world you wash your hands regularly, and food handlers should so and additionally wear gloves so if they carry any pathogen, it's not transmitted to the food.

We don't have that luxury during outdoorsman activities such as hiking, but we do have two tools we can use to limit exposure.

Carry and use hand sanitizer. Use it before and after greeting someone, and before and after touching anything along the trail.

Do not let anyone else handle your food. If you are camping or hiking in a group, and you have an assigned cook (whether permanent or a different cook each meal) that person should if able wash their hands thoroughly, if not they should use hand sanitizer and wear gloves.

If you touch ANYTHING other than food with the gloves, you discard them and put on a new pair.

After the meal, everyone should thoroughly wash their own dishes before packing them up.

After you don all your gear to begin hiking again, sanitize your hands so you don't wipe your eyes with contaminated hands.

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    Just as an FYI hand sanitizer does not kill all microbes. Many virus' have tough protein shells that can resist the alcohol. Many people think hand sanitisers are better than washing their hands. They're not. Washing your hands (properly) is the most effective way to remove microbes, etc from your hands.
    – user2766
    Apr 8, 2016 at 14:56
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    @Liam agreed, but out on the trail, it's the best we have.
    – Escoce
    Apr 8, 2016 at 14:58
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    Infact norovirus is totally immune to alcohol gels so this isn't going to work I'm afraid
    – user2766
    Apr 8, 2016 at 15:05
  • @Liam from the CDC. "Alcohol-based hand sanitizers can be used in addition to hand washing. But, they should not be used as a substitute for washing with soap and water." So washing hands is the best idea, but hand sanitizers do help some or they wouldn't mention it at all.
    – Escoce
    Apr 8, 2016 at 15:18
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    "Infact norovirus is totally immune to alcohol gels‌​ " -- There's new information on this: stopthestomachflu.com/Home/…. Noro is resistant, not immune. The problem is that most gels are not strong enough. Apr 8, 2016 at 15:38
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While the following won't absolutely prevent it, it will help:

  • Set up a hand washing station in camp. The easiest one of these is a perforated ladle made from a pop bottle. Size the holes so that it runs water for 10-15 seconds. Provide a foam soap dispenser that has an anti-viral in it. Have a dedicated bucket. The station is set up on a tree near the centre of camp. In use the person come up to the station, puts a squirt of foam on his hands, rubs thoroughly, then dips a ladle of water, hooks the ladle to it's loop on the tree, and rinses his hands under it.

  • Sleep alone.

  • Camp at non-designated spots.

  • Go at a different time of year.

  • No one touches your water bottle but you. No one fills it for you, reaches it out of your pack for you.

  • Ditto your eating utensils.

  • Everyone who handles group food does so with clean hands.

In passing: Why is the AT notorious for this, but the pacific crest trail is not? The implication is that there is a local carrier present, so you are getting it through mouse droppings, or bird droppings.

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    The notoriety has to do with density. I don't know about the prevalence of Noro on the west coast, but I do know the PCT is much less densely populated than the AT during peak season. More people means more vectors. As far as I know, bird are not a vector for Noro, and I can't find any literature saying they are. Can you elaborate on why you think people are getting Noro from bird droppings? Apr 15, 2016 at 14:20
  • I'm just mentioning it as potentential alternate vectors. There are large areas of the Sierra and also major parks in the Canadian rockies, along with portages in the BWCA that have what I consider to be very high densities of traffic. (In all of these you meet people every few minutes) However even the AT is sparse compared to a mall in any city. So why AT and not elsewhere. Apr 16, 2016 at 16:44

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