The intestinal problems keep coming one after another. There have been cases of poisoning of hikers who consumed water that was probably contaminated with the Shigella bacteria. And since the beginning of July, hundreds have been affected by an epidemic of gastroenteritis on the trails of the famous GR20 in Corsica. This Tuesday evening again, a group of 16 Italian hikers had to be evacuated by the firefighters.
How can this phenomenon be explained? Could poor hygiene be the cause? How can we protect ourselves from it, and how should we react if we are affected? 20 Minutes explains.
Norovirus to blame
Italian hikers are not the only ones to have developed symptoms of gastroenteritis. Given the scale of the phenomenon, the Regional Health Agency (ARS) of Corsica conducted the investigation, and delivered its first results in a press release published on July 26. It reports that “between July 1 and 15, at least 236 patients were identified”, and “estimates that the epidemic probably began at the end of June, with a peak observed on July 12”. Fortunately, “no serious cases” were identified and only “seven short-term hospitalizations were observed”, reassures the ARS.
And according to its investigations, “the epidemic appears to be caused by a virus, probably a norovirus.” Noroviruses are “the main causes of acute gastroenteritis in humans,” says Anses, “and are characterized by the sudden onset of vomiting, nausea and/or diarrhea, sometimes associated with abdominal cramps, malaise, anorexia, fever, chills, aches and headaches.”
A highly resistant and contagious virus
Problem: “Norovirus, of which humans are the only reservoir, is very resistant: it survives refrigeration, freezing, and temperatures up to 60 degrees,” explains Dr. Martine Cotinat, gastroenterologist and author of I Cure Almost Everything With the Mediterranean Diet – Pillars of Health (ed. Thierry Souccar). It is so resistant that it is transmitted very easily. And this is all the more so since we are already contagious during the incubation period, even before having the symptoms of the disease, but also during and after. A sick person can thus transmit the virus over an extended period: the excretion of virus in the stool is so high that it can persist two to three weeks after the disappearance of symptoms, which is very problematic from the point of view of contagiousness.
But how can we explain that hundreds of GR20 hikers contracted it and needed to be evacuated? Could a lack of hygiene be the cause? “That may play a role, but we must not forget that you can be a carrier of norovirus and be asymptomatic, and massively transmit gastroenteritis without even knowing it. Inevitably, in a community, with communal and shared meals and toilets in shelters and other places frequented by GR20 hikers, all the ingredients are there for a wide spread of the virus. And some people, for genetic or immune reasons, are more sensitive than others to norovirus.”
In these particular conditions, on the trails of this GR, known to be the most difficult in France, the sporting adventure can quickly turn into a nightmare. “In this rather physical ordeal, hikers may already be insufficiently hydrated due to the effort and the heat, but if they get diarrhoea and abdominal pain in the middle of a hike, it is particularly inconvenient,” notes Dr Cotinat.
Know how to react
In this context of high viral circulation, it is important to know how to react and protect yourself against this virus which is transmitted by the fecal-oral route, that is to say by contact with contaminated stools. And “in practice, an infected person excretes the virus in their stools, recalls Dr. Cotinat. If they have poor hand hygiene, everything they touch (food, worktops, toilets, door handles, faucets and other surfaces) will be contaminated. Hence the importance of implementing hygiene measures to avoid transmitting the virus: this involves washing hands and surfaces. But also not sharing personal items such as towels, cutlery or toothbrushes. It is also important to prevent the infected person from cooking in a group.”
And if you are sick, how should you react? “The elderly, the sick or those following a salt-free diet should consult. Otherwise, first of all, you need to rehydrate, prescribes the gastroenterologist. And water is not enough: you also need salt and sugar intake, sugar promoting better absorption of salt. There are rehydration solutions for the most sensitive people, available in pharmacies. You can also make your own homemade rehydration solution. The recipe is simple.” Simply mix “1 liter of water, 6 teaspoons of sugar and 1 teaspoon of salt, confirms the Ministry of SportsThe solution can be stored for 12 hours at room temperature and 24 hours in the refrigerator.
Then, “you have to rest your intestines for at least a day or two,” she continues. “The first few days, you usually don’t have an appetite, but if you want to eat a little, it’s best to choose foods that don’t overstimulate your intestines, such as white rice, chicken or fish, and avoid fruits and vegetables that are high in fiber, as well as dairy products, which can increase diarrhea and intestinal pain.”
And to better resist gastroenteritis or to recover from it more easily, “the microbiota also plays a role,” says Dr. Cotinat. Contracting gastroenteritis can unbalance the microbiota, and conversely, a weaker microbiota can expose you to more severe gastroenteritis. You can therefore take a course of probiotics, both as a preventative measure, for example before going on vacation, and after contracting gastroenteritis: studies show that this can reduce symptoms and help the microbiota to rebalance itself.”
