Columbia County recently had three confirmed cases of the norovirus within nine days, part of multiple cases in a three-county area.

The confirmed cases were at Golden LivingCenter in Wisconsin Dells, the Good Samaritan Society Center in Lodi and the Poynette Elementary/Middle School. The dates reported to the Columbia County Health Department were between Jan. 16 and 25.

"It's unusual, but 80 percent of the norovirus cases do occur between the months of November and April. Because of the colder weather, people are more confined to spaces," said Susan Lorenz, Columbia County's health officer.

The norovirus, recognized as the leading cause of foodborne-disease outbreaks in the United States, causes sudden vomiting, diarrhea, abdominal cramps, nausea and headaches. It previously was described as "Norwalk-like viruses" or NLV.

Noroviruses spread from person to person, through contaminated food or water, and by touching contaminated surfaces, according to the U.S. Centers for Disease Control and Prevention.

Each facility contacted Lorenz promptly, she said, and worked very well to control the highly contagious stomach flu.

The cases are considered an outbreak in the county, but the term should not startle residents.

"In public health terms, a gastrointestinal outbreak means two or more people ill with symptoms that have a common factor that may have caused the disease, such as living in the same nursing home or attending the same school," Lorenz said.

In Sauk County, norovirus cases led to a quarantine of the Sauk County Health Care Center in Reedsburg on Monday.

Sauk County Public Health Director Cindy Bodendein said in the past month there have been five norovirus outbreaks at nursing homes and other residential facilities in Sauk County - two in Reedsburg, two in Baraboo and one in the Sauk Prairie area.

Since Jan. 30, eight residents and about 20 employees at the Sauk County Health Care Center in Reedsburg have been struck with the virus.

Officials say the number of cases exceeded a federal threshold, requiring that the facility be quarantined.

A news release on the county's website Monday requested that no one visit the facility until further notice.

According to the Wisconsin Division of Public Health:

• The virus spreads by direct person-to-person contact and environmental contamination. The virus enters through the mouth, multiplies in the body and is passed within the highly infectious vomit or fecal matter of an infected person.

• The most common symptoms are a sudden onset of vomiting, watery and non-bloody diarrhea, nausea, abdominal cramps and headache.

• The symptoms may appear from 12 to 60 hours after exposure to the virus, but usually occur within 24 to 48 hours.

• The virus remains highly infectious from the onset of symptoms and up to 48 hours after vomiting or diarrhea.

• There is no treatment for the illness beyond time and liquid replacement if needed. People usually recover within two to three days.

• Thorough hand-washing is the way to prevent the spread of the virus and becoming ill. Wash hands with hot water and soap after using the toilet and before touching food. If you don't have soap and water readily available, use alcohol gel hand sanitizer.

Lorenz said she can't emphasize enough the importance of hand-washing, she said, and to remain home until at least 48 hours after symptoms stop.

A flu shot will not prevent it, Lorenz said. Those are aimed at preventing respiratory flu, not the stomach flu.

People who suspect they may be infected should call the Columbia County Department of Health and Human Services at 742-9227.

Sauk County Health Care Center Nursing Director Juli Brandt said that among people who have become sick at her facility, the worst symptoms lasted 12 hours.

The U.S. Centers for Disease Control and Prevention estimates that noroviruses cause more than 20 million severe stomach illnesses, 70,000 hospitalizations and 800 deaths nationally each year.

Sauk County Health Care Center Administrator Kim Gochanour said none of the cases have been serious enough to require hospitalization.

She said the nursing home is working with state and county agencies to eliminate the virus and will make a formal announcement when the facility is again safe to visit.

An unusual string of norovirus outbreaks also has hit Dane County, including a suspected new outbreak of the foodborne illness in a church group, a health official said Monday.

At least 16 people from Mandrake Road Church of Christ in Madison reported norovirus-like symptoms such as vomiting and diarrhea last week, said Amanda Kita-Yarbro, epidemiologist for Public Health Madison Dane County.

The health department has investigated four other outbreaks since November, including one that sickened 28 people at Erin's Snug Irish Pub in Madison last month. In a possible outbreak last month at an Absolutely Art show catered by Madison's Bunky's Café, the cases could have come from elsewhere, Kita-Yarbro said.

The Wisconsin Division of Public Health reported a substantial increase in gastrointestinal illness outbreaks at long-term care facilities in fall 2010.

There were 84 outbreaks from September through December 2010, compared to only 18 during the same period in 2009 and 29 during the same period in 2008.

Just more than a month into 2012, the agency already has received 67 reports of suspected outbreaks of gastrointestinal illness at long-term care facilities. Thirty-eight already have been confirmed as norovirus, and testing is ongoing for many of the recent oubtreaks, said Beth Kaplin, spokeswoman for the state Department of Health Services.

The agency has not provided data for 2011.

"Norovirus is not a notifiable disease, so while we don't have a way to know exactly how many people are infected, we do get reports of outbreaks," Kaplin said, adding that outbreaks at facilities where food is served typically increase during winter months. "Many but not all of these outbreaks are confirmed as norovirus."

Capital Newspapers reporter David Wahlberg contributed to this report.

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Editor, Portage Daily Register