Has anyone seen an eyeball?

We had a bit of a crisis here last week. One of our employees, in the microbiology team, got sick. No one knew it was coming because he’s such a quiet chap by normal standards, a bit of a loner really. I’ve walked past him several times without even realising he’s there. It was awful. There was no warning, he just projectile vomited, like a scene from The Exorcist. It was all over the floor and up the walls. What’s worse, the poor guy vomited with such force that he lost an eyeball.  We’re still looking for it.  It’s not the first time he’s been sick at work either but he’s a good sport and hasn’t complained so we aren’t inclined to record it in our sickness data because we see him as a bit of an outlier and not representative of the healthy workforce we have here at HSL.

Meet Larry.

Larry has had an interesting career. He worked for many years as a successful resuscitation dummy in first aid training. He was a hard worker too. He’s been jumped on, had his mouth probed with dirty fingers, his chest cavity has been crushed by overenthusiastic and overweight first-aiders, and he’s nearly been suffocated several times by people who blew into his mouth AND his nose at the same. No doubt he has helped save many lives. Larry thought he was settling down for a nice retirement, albeit an inactive one, given that he has no legs.

And then he met Cat Makison-Booth. He should have known better. 

Cat, seen here filming for a BBC documentary on her work, is one of our microbiologists at HSL and is leading our innovative work around Norovirus.

Cat needed to be able to replicate the way that human beings vomit when infected with Norovirus and was looking around for a suitable dummy to help. Unfortunately for Larry, he didn’t move out of the way quick enough (difficult, with no legs).

A bit like Robocop, Larry found himself strapped to a gurney while surgery took place. His chest was removed and replaced with an artificial stomach, all secured with a wooden frame that held him firmly in place. When he woke from surgery, something was sloshing around his insides and the next thing he knows, he’s projectile vomiting and has been doing it ever since. The poor guy:  he spent his working career on his back pretending to be unconcious, and now he spends his semi-retirement wishing that he was. It’s a tough life.

He should be proud though, the work he is helping with is important. Norovirus is nasty. Picked up by eating the wrong thing (I didn’t know that oysters are a potential source of Norovirus as well as pearls) or by touching a contaminated surface. Symptoms typically last at least 48 hours and include projectile vomiting and diarrhoea (we’ve asked Larry if he’d like to have a bottom half attached but he just looked at us with suspicion).  

Norovirus is incredibly infectious. There are around one million virus particles in just 1 ml of vomit. When you think that the average person can vomit up to 1.35 litres and that it takes just 10-20 particles to cause an infection, you begin to understand why it causes such problems across industries. Healthcare is the most publicised. In addition to the patient safety issues an outbreak of Norovirus can cripple bed capacity in a hospital through ward closures. Other industries also suffer though. In fact, anywhere there is a confined space such as oil rigs, schools, conferences, submarines and cruise ships, there is the potential for infection to spread. The financial burden to the economy is huge and around £100m per annum in healthcare alone. It’s so infectious, that some governments deem it a potential bio-weapon.

It’s hardy stuff too. It can survive up to twelve days in the environment and many disinfectant products, such as alcohol-based hand gels are not effective in killing it.  You also shed the virus for 48 hours after your symptoms have stopped, which is why it spreads so quickly because people come back to work when they are feeling better and infect colleagues. Oh, and unlike, say, chicken pox, you can get re-infected with norovirus and there is no vaccine. So, all in all, something to avoid.

All of which is why the work that Cat is doing is so important, because it fills a gap in the science which is: When someone infected with Norovirus vomits, how much of the physical environment is contaminated?  The answer, as it turns out, is a lot. Here’s a link to video of Cat explaining how Larry works, and then him doing his thing.

Don’t feel sorry for him, he’s got a holiday coming up. The spread of virus is up to 7.8 square metres. What’s more, the naked eye can’t see the smaller particles of vomit. You can only see them in the video because Cat uses a fluorescent marker when filling poor Larry’s stomach. This light or the marker isn’t available to people decontaminating the environment, so you tend to find that the main spillage is cleaned – the bits you can see – but that there are significant levels of virus left in the environment.

So, Cat’s work goes on, developing the science underpinning decontamination of the Norovirus environment and has applications for most industries in the UK.  And as for Larry, well, it’s not so bad for him. He made it onto the Letterman show, which was exciting for him. Also we do feel terrible that he lost an eyeball as part of his routine work.  So we’ve booked him a nice two week holiday.

On a cruise ship.