Health department received reports of illness from at least 37 hikers and campers over the past several weeks, though the actual number is expected to be higher, officials said.
“This is a very concerning and rare occurrence, magnified by the extreme remote nature of Kalalau Valley,” Curt Cottrell, an administrator for state parks, said.
The trail was closed Wednesday after health officials received several reports of gastrointestinal illnesses from hikers, and Thursday health department said test results from four patients confirmed they had contracted norovirus.
The state’s department of land and natural resources said dozens of backpackers had reported gastrointestinal illness, and one person was evacuated but no one had been hospitalised. “All it takes is one person to spread the virus, which can be on surfaces, in soil and in water,” said department spokesman Dan Dennison.
Norovirus is highly contagious and typically causes vomiting, often accompanied by fever, abdominal cramps and diarrhoea as the stomach or intestines become inflamed. It spreads easily, and is common in tightly packed spaces, but it can also be transmitted across contaminated surfaces. Most people recover after several days, but severe infections can occur in young children, older adults and people with weakened immune systems.
Kalalau Trail allows up to 80 people with permits to camp overnight, and composting toilets are available. One way that norovirus can spread is through contact with fecal matter.
The open air might help dilute the virus “but mostly it’s just being around people that are ill and shedding the virus” that aids in spreading it, said Donald Schaffner of Rutgers University. The spread in a ventilated environment such as a trail “is possible due to virus transmissibility and challenges to hand hygiene and sanitation,” department of land and natural resources said.
“Hiking is one of the activities that is a risk” for the virus, said Stuart C Ray, professor at Johns Hopkins School of Medicine. “The problem is people don’t have good access to clean water, and they can’t wash their hands.” Alcohol wipes do not kill the virus, he added.
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