Mass illness among children at Tbilisi kindergartens: norovirus explanation questioned
Tbilisi kindergarten children hospitalised
Norovirus has been identified as the cause of the mass illness among children in Tbilisi’s public kindergartens. Georgia’s National Center for Disease Control and Public Health said on 20 September that the epidemiological investigation is still ongoing and that further information will be provided once the final results are available.
However, many specialists said that the widespread symptoms reported among dozens of children from different kindergartens raised additional questions.
On 18 September, dozens of children attending public kindergartens were hospitalized overnight with vomiting and abdominal pain. Several kindergartens were temporarily closed.
Norovirus is one of the most contagious viruses and causes acute inflammation of the gastrointestinal tract, known as gastroenteritis. The infection often begins suddenly. Its main symptoms are severe vomiting, diarrhoea, abdominal pain and cramps. A low-grade fever, chills, headache, muscle aches and general weakness may also occur.
Symptoms usually appear 12–48 hours after infection. Most healthy people recover within a few days without specific treatment.
The National Center said that it is particularly important to replace lost fluids during this period. Anti-diarrhoeal and anti-nausea medication should only be taken as prescribed by a doctor. To reduce the spread of the virus, people should wash their hands with soap for at least 20 seconds and properly disinfect contaminated surfaces.
Commentary
Infectious disease specialist Maia Butsashvili believes that the scale of the cases could point to food poisoning.
She says norovirus is easily transmitted from person to person, including through the faecal-oral route, and can also spread via contaminated surfaces.
However, Butsashvili notes that if the cases were caused exclusively by person-to-person transmission, family members of infected children and other close contacts should already have been infected by this stage.
The specialist says it is essential to quickly establish whether there was a common source of a food product and who was involved in preparing and delivering food to the kindergartens.
She also says employees of companies and institutions supplying food to the kindergartens should be tested. Norovirus can be detected in stool for a certain period after infection, which, according to Butsashvili, can help establish the epidemiological chain.
“It is also necessary to establish whether a product that may have been contaminated is being used elsewhere, how many laboratory samples have been tested, and in how many of them the presence of norovirus was confirmed,” Butsashvili says.
Intensive care physician Ani Kavtaradze also said that the relevant authorities should explain:
How could the virus spread to 22 kindergartens at the same time, and why did more than 100 children in different parts of the capital fall ill at roughly the same time?
Kavtaradze’s main question is that children from different kindergartens clearly had no direct contact with one another. Therefore, she believes it is necessary to determine whether the outbreak could have been caused by a common food product or a problem in the supply chain.
What happened
The Tbilisi Kindergarten Management Agency confirmed on 18 September that dozens of children from public kindergartens in the capital had been taken to clinics with symptoms of intoxication. The children had elevated temperatures, and in some cases nausea and vomiting.
On the recommendation of epidemiologists, seven public kindergartens were temporarily closed.
The Investigation Service of the Ministry of Finance has also launched an investigation into the incident. Officials searched the premises of companies supplying food products to the kindergartens.
The investigation is being conducted under Article 198, Part 2 of the Criminal Code, which concerns the production and sale of products dangerous to human life and health when this poses a threat to life or health.
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