A couple of years ago, PhD student Grace Tung Thompson demonstrated something incredibly gross: When a person vomits, little tiny bits of their throw-up end up airborne. You could ingest them just by breathing air in the same room. As if that weren’t disconcerting enough, if the person got sick from a virus, there could be enough viruses in the air to get you sick, too. Just try not to think about that the next time the person in the row behind you throws up on an airplane.
Thompson completed this research as a graduate student North Carolina State University under the supervision of professor Lee-Ann Jaykus. Thompson worked with an engineer and a gastroenterologist to build a vomiting machine—a scaled down model of the digestive system built to vomit under pressure and then contain aerosolized particles for collection and sampling. Bits of vomit become aerosolized when they are small enough to float on air.
Two years later, Jaykus told The Daily Beast, we still have no idea how to deal with this rather disgusting problem. "As for the aerosolization, that is a huge issue, because nobody really knows what to do about that.”
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Jaykus is also the scientific director with NoroCORE, a research group dedicated to studying and preventing the spread of foodborne illness caused by noroviruses. You’ve probably experienced it if you’ve ever had the “stomach flu” or “food poisoning.” Symptoms often come on suddenly and typically last a day or two. They can include violent diarrhea, vomiting, and stomach cramps. The virus is spread when you ingest something that has been contaminated with an infected person’s vomit or poop. The yuck factor is enough of a reason to worry about norovirus, but it’s also a major source of illness: An estimated 20 million people in the U.S. come down with viral shits-and-pukes each year.
There’s still a lot we don’t know about what happens to norovirus-infected vomit once it goes airborne. How long does it stay in the air? How far can it travel before it settles on surfaces, contaminating them as well? These are questions that stakeholders in the restaurant and cruise ship industries (where norovirus can spread viciously) are very interested in, but we don’t have any answers, says Jaykus. The vomiting machine could in theory help us get there, but the research is complex and so far, there hasn’t been the funding to tackle it.
But the evidence suggests that the problem of aerosolized norovirus is significant. In 2015, Canadian researchers published a study in the journal Clinical Infectious Diseases that found startling levels of norovirus in air samples from nursing homes in the midst of an outbreak. A healthcare worker could inhale enough norovirus to get sick in just five minutes in an infected patient's room, they found. Some hallways outside patient rooms were even contaminated.
So how do you get rid of airborne viruses? "There is no known technology that will eliminate norovirus if it's in the air,” Jaykus said, “and there really aren't a lot of technologies—safe technologies—that even are likely to work." Her research team recently experimented with misting antiviral compounds into spaces as an alternative to disinfecting surfaces individually, and it worked, but not completely. This technique, known as fogging, can only be used in spaces that can be cleared out and contained, like bathrooms, for example. "I think we need that technology, and that technology is really, really important, but how the heck we're going to develop it? I'm at a loss for words.”
From an individual perspective, the best you can do is get yourself far away from a vomiting incident; Jaykus recommends at least 100 feet. If you were in the middle of a meal at a restaurant and someone at the next table threw up, you’d probably be wise to stop eating, and to wash yourself and your clothes when you are able.
From the perspective of a restaurant owner, the best course of action is to do a really, really good job of the cleanup. Commercial vomit and fecal matter cleanup kits are catching on with bigger companies in the foodservice industry, says Jaykus. They provide personal protection, including disposable coveralls and respirator masks, in addition to the material required to pick up and wipe down the mess.
An earlier experiment with an different puke machine, known as Vomiting Larry, showed just how hard it can be to clean up a space contaminated with vomit. In a video, researcher Catherine Makison-Booth of the UK’s Health and Safety Laboratory attempts to clean up fake fluorescent vomit. Despite best efforts she misses lots of mess and ends up with vomit on her nose and mouth. It’s not pretty.
Holding your breath after someone vomits nearby isn’t a reasonable option, but there are ways to limit contamination and exposure. And if you are the unlucky person who ends up with the dirty work, for heaven’s sake, don’t touch your face.
