Science
'I don't want him to go': An autistic teen and his family face stark choices
Christine LyBurtus was aching and fearful of what might happen when her 13-year-old son returned home.
Noah had been sent to Children’s Hospital of Orange County for a psychiatric hold lasting up to 72 hours after he punched at walls, flipped over a table, ripped out a chunk of his mother’s hair and tried to break a car window.
“There’s nothing else to call it except a psychotic episode,” LyBurtus said.
The clock was ticking on that August day in 2022. The single mother wanted help to prevent such an episode from happening again, maybe with a different medication. Hospital staff were waiting for a psychiatric bed, possibly at another hospital with a dedicated unit for patients with autism or other developmental disabilities.
But as the hours ran out on the hold, it became clear that wasn’t happening. LyBurtus brought Noah home to their Fullerton apartment.
“When he came back home, it kind of broke my heart,” said his sister, Karissa, who is two years older. “He looked like, ‘What the heck did you guys put me into?’”
Christine LyBurtus makes a snack for Noah.
(Allen J. Schaben / Los Angeles Times)
The next night, Noah was back in the ER after smashing a television and attacking his mother. This time, he was transferred to a different hospital for three weeks, prescribed medications for psychosis, and then sent to a residential facility in Garden Grove.
LyBurtus said she was told it would be a stopgap measure — just for three weeks — until she could line up more help at home. But when she phoned to ask about visiting her son, LyBurtus said she was told she couldn’t see him for a month.
“He lives here now,” someone told her, she said, and the staff needed time to “break him in.”
LyBurtus felt like she was being pushed to give up her son, instead of getting the help her family needed. She insisted on bringing him home.
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Autism is a developmental condition that can shape how people think, communicate, move and process sensory information. When Noah was 3, a doctor noted he was a “very cute little boy” who played alone, rocked back and forth, and sometimes bit himself. Noah’s eye contact was “fleeting.” He could speak about 20 words, but often cried or pulled his mother’s hand to communicate.
The physician summed up his behavior as “characteristic of a DSM-IV diagnosis of autistic disorder.”
When he was in elementary school, LyBurtus stopped working full time outside the home and enrolled in a state program that paid her as his caregiver. She relies on Medi-Cal for his medical care, and much of his schooling has been in Orange County-run programs for children with moderate to severe disabilities.
Noah does not speak but sometimes uses pictures, an app on a tablet, or some sign language to communicate. When a reporter visited their home last year, Noah bobbed his head and shoulders as he listened to music on his iPad. He flapped his hands as LyBurtus made him a peanut-butter-and-banana smoothie, and then dutifully followed her instructions to chuck the peel and put the almond milk away. It was a good day, LyBurtus said with relief.
But on other days, LyBurtus said her son could be rigid; his demands, unpredictable. “Some days he’s fixated on having three pairs of pants on … Some days he wants to take seven showers. The next day, I can’t get him to take showers.”
Christine LyBurtus greets Noah as he arrives home from school.
(Allen J. Schaben / Los Angeles Times)
When frustrated, Noah might erupt, banging his head against walls and trying to jump out the windows of their apartment. He had kicked and bitten his mother when she tried to redirect him. In the worst instances, LyBurtus had resorted to hiding in the bathroom — her “safe room” — and urged Karissa to lock herself in the bedroom.
As Noah grew taller and stronger, LyBurtus stripped bare the walls of her apartment to try to make it safe, installed shatterproof windows and removed a knob from a closet door to prevent Noah from using it as a foothold to scale over the top of the closet door. She made sure to flag her address for the Fullerton Police Department so it knew her son was developmentally disabled.
“I’m just so grateful that my son never got shot,” LyBurtus said.
Each of the 911 calls was the start of a Sisyphean routine. Noah “has been challenging to place in [a] mental health facility due to behavioral care needs with severe autism,” a doctor wrote when he was back at Children’s Hospital of Orange County yet again.
Noah leaps into the air inside his Fullerton home. At left is Terrence Morris, one of Noah’s caregivers.
(Mel Melcon / Los Angeles Times)
As the family tried to get through each crisis, LyBurtus was also facing a common struggle among parents of California children with disabilities: not getting the help they were supposed to receive from the state.
LyBurtus was getting assistance through a local regional center, one of the nonprofit agencies contracted by the California Department of Developmental Services. She said she’d been authorized to receive 40 hours weekly of respite care — meant to relieve families of children with disabilities for short periods — but was sometimes receiving only 12 to 16 hours.
She was also supposed to have two workers at a time, LyBurtus said, but caregivers were so scarce that she was scheduling one at a time in order to cover as many hours as she could.
In the meantime, Noah wasn’t sleeping and she was going through so much laundry detergent and quarters that her grocery budget was drained. At one point, she wanted to go to a food bank, but there would be no one to watch him.
“I could not be anymore tired and frustrated!!!!” she wrote to her regional center coordinator. “Is the only way Noah is going to get help [is] if I abandoned him and surrender him to the State!?!?”
Christine LyBurtus said she’s struggled to find the right care for Noah.
(Allen J. Schaben / Los Angeles Times)
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Across the country, surging numbers of young people have landed in emergency rooms in the throes of a mental health crisis amid a shortage of needed care. Children in need of psychiatric care are routinely held in emergency departments for hours or even days. Even amid COVID, as people tried to avoid emergency rooms, mental health-related visits continued to rise among teens in 2021 and 2022.
Among those hit hardest by the crisis are autistic youth, who turn up in emergency rooms at higher rates than other kids — and are much more likely to do so for psychiatric issues. Many have overlapping conditions such as anxiety, and researchers have also found they face a higher risk of abuse and trauma.
“We’re a misunderstood, marginalized population of people” at higher risk of suicide, Lisa Morgan, founder of the Autism and Suicide Prevention Workgroup, said at a national meeting.
Yet the available assistance is “not designed for us.”
According to the National Autism Indicators Report, more than half of parents of autistic youth who were surveyed had trouble getting the mental health services their autistic kids needed, with 22% saying it was “very difficult” or “impossible.” A report commissioned by L.A. County found autistic youth were especially likely to languish in ERs amid few options for ongoing psychiatric treatment.
Karissa interacts with her brother, Noah, as he watches a video after school.
(Allen J. Schaben / Los Angeles Times)
In decades past, many psychiatrists were unwilling to diagnose mental health disorders in autistic people, believing “it was either part of the autism or for other reasons it was undiagnosable,” said Jessica Rast, an assistant research professor affiliated with the A.J. Drexel Autism Institute. Much more is now known about both autism and mental health treatment, but experts say the two fields aren’t consistently linked in practice.
Mental health providers may focus on an autism diagnosis for a prospective patient and say, “‘Well, that’s not in our wheelhouse. We’re treating things like depression or anxiety,’” said Brenna Maddox, assistant professor of psychiatry at the University of North Carolina School of Medicine.
Yet patients or their families “weren’t asking for autism treatment. They were asking for depression or anxiety or other mental health treatment,” Maddox said.
In the meantime, the system that serves children with developmental disabilities has faltered.
“Never have I seen that we can’t staff the needed things on so many cases,” Larry Landauer, executive director of the Regional Center of Orange County, said last year. Statewide, “there’s thousands and thousands of cases that are struggling.”
“If I’m a respite worker and I get called on to provide help to families … who am I going to select?” Landauer asked. “The [person] that watches TV and plays on his iPad and I just sit and monitor him? Or do I take someone that is significantly behaviorally challenged — that pulls my hair, that scares me all the time, that tries to run out the door? … Those are the ones getting left out.”
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The fall and winter of 2022 were so trying that LyBurtus eventually took matters into her own hands. Noah bit his mother and smashed a bathroom window and tried to climb out before the Fullerton Fire Department arrived. Weeks later, LyBurtus had to dial 911 again after he bit his sister’s finger badly enough to draw blood.
Caregiver Terrence Morris, left, keeps a watchful eye on Noah.
(Mel Melcon / Los Angeles Times)
He ended up in a hold at Children’s Hospital of Orange County, which searched for another facility that might help him, but “all placement options declined patient placement,” according to his medical records.
Noah was again sent home with his mother, but the next day, he was back at Children’s Hospital of Orange County after slamming his head against a tile floor.
LyBurtus, frantic and bruised, made call after call and finally used her credit card to pay for an ambulance to take him to UCLA Resnick Neuropsychiatric Hospital, where he was admitted.
Week by week, psychiatrists there said Noah seemed to be making some strides as they adjusted his alphabet soup of medications. But hospital staff struggled to understand what would set him off.
Once, while playing cards, Noah suddenly started knocking the cards off the table and struck another patient in the face. Another day, he appeared suddenly to be frightened after using the bathroom, and then charged at a computer plugged in nearby.
But there were also days when he danced to a Michael Jackson song, or played Giant Jenga outside on the deck. One day, a doctor wrote, “He made eye contact for a few seconds. I waved to him, and he looked at his hand, as though he was wondering what to do with it in return.”
Christine LyBurtus washes her son’s face. When Noah was 3, a doctor noted he was a “very cute little boy” who played alone, rocked back and forth, and sometimes bit himself.
(Mel Melcon / Los Angeles Times)
LyBurtus was straining to find more help at home so UCLA held off on discharging him, but at the end of January 2023 Noah was sent home. With no changes in medication planned, “and the strong possibility that Noah grew tired of the inpatient setting, the ward no longer was deemed therapeutic or necessary,” a doctor wrote.
Less than a month later, he was back in the emergency room at Children’s Hospital of Orange County after biting and attacking his mother.
A psychiatrist at the pediatric hospital wrote that because he had limited ability to communicate, another round of psychiatric hospitalization would do little unless it was specialized for “individuals with neurodevelopmental needs.” When the 72-hour hold at children’s hospital ran out, LyBurtus asked for an ambulance to take Noah home, fearful of driving him herself.
In May, the month Noah turned 14, LyBurtus heard the regional center had found a place for Noah: a four-bed facility in Rio Linda, a tiny town near Sacramento that she’d never heard of. He could live there for more than a year, she was told, and then hopefully return home with the right support.
Christine LyBurtus shows photographs to Noah.
(Mel Melcon / Los Angeles Times)
But LyBurtus fretted about what she would do if something happened to him so far away. She felt, she said, like she had failed her child. Months passed as they waited for a spot there; LyBurtus said she was told they were trying to hire the needed staff.
“I don’t want him to go,” she said, “but I don’t want to continue going on the way that we’re going on.”
Then in August, LyBurtus was told the regional center had found a spot at a facility much closer to home: the state-run South STAR facility in Costa Mesa, about 20 miles from their apartment. Noah would occupy one of only 15 STAR beds across the state for developmentally disabled adolescents in “acute crisis.”
On a bright September morning, LyBurtus pulled up at an unassuming gray house with a “Home Sweet Home” sign by the door. The three teens living there were gone for the morning while an administrator and South STAR program director Kim Hamilton-Royse showed LyBurtus around the house.
Minutes into the tour, LyBurtus found herself crying. Hamilton-Royse stopped her explanation of the daily schedule. “I know this is super hard for you,” she said gently.
But LyBurtus brightened at the sight of the sensory room outfitted with crash pads and a mesmerizing, colorful cylinder of bubbling water. Hamilton-Royse pointed out a vibrating chair and added that they had a projector that would fill the room with illuminated stars.
LyBurtus took photos on her smartphone to show Noah. “You’re not going to be able to get him out of here,” she said.
As they rounded the rest of the house — bedrooms with dressers secured to the wall, a living room with paintings of sailboats, a fish tank — Hamilton-Royse asked if LyBurtus felt any better.
Christine LyBurtus reacts while boxing up items for Noah’s move.
(Mel Melcon / Los Angeles Times)
“I do,” she said. “I just hope that he can behave.”
Hamilton-Royse reassured her that South STAR had never kicked anyone out. “And we’ve had some really challenging folks,” she said.
“I promise you we’ll take very good care of him.”
As she returned to her car, LyBurtus took a deep breath. “It’s hard not to feel like I’m betraying him,” she said, her voice shaking. “But I can’t keep living like this, you know?”
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1. Christine Lyburtus tours a residential care facility in Costa Mesa, about 20 minutes from her home. (Irfan Khan / Los Angeles Times) 2. At the South STAR facility, LyBurtus was told, Noah would occupy one of only 15 STAR beds across the state for developmentally disabled adolescents in “acute crisis.” (Irfan Khan / Los Angeles Times) 3. “I just hope that he can behave,” LyBurtus said of son Noah. (Irfan Khan / Los Angeles Times)
Three days later, Noah went back to the Children’s Hospital of Orange County on another psychiatric hold. He came home, then was back in the emergency department a week and a half later.
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The October night before Noah left home, LyBurtus had brought home sushi for him, one of his favorite foods. He fell asleep around 6:30 p.m, and woke up again at 1 a.m. LyBurtus gave him his medication and as he drifted back to sleep, his mother held him, enjoying the peace.
When he woke up in the morning, she could tell he knew something was up. His clothes had been packed. She’d already shown him photos of the Costa Mesa home and told him, “This is where you’re going. I’m still your mom. I’m still going to go and see you.”
Noah embraces his mother shortly before he was picked up and driven to a residential care facility in Costa Mesa.
(Mel Melcon / Los Angeles Times)
When the black SUV arrived, LyBurtus offered Oreos to coax him into the unfamiliar car. She followed the SUV in her car, staying far enough behind to avoid having Noah see her when he arrived. LyBurtus had been told it would ease the transition.
Back at home, she sank into the bathtub, utterly spent. “I’m going to have to just go with trusting this process as much as I can,” she said, “because I don’t have another choice right now.”
The next day, she met with the South STAR staff to tell them more about Noah. What he likes to eat. What triggers him. His favorite things to do. The Costa Mesa home called whenever staff had physically restrained Noah, but when a weekend passed without a call, she felt some relief.
Lyburtus smiled at the photos and videos sent home: putting together an elaborate stacking toy, washing dishes. It felt like things were going well, LyBurtus said. The staff had scaled back the amount of psychiatric medication he was taking.
But more than a month later, when she first went to visit Noah, he excitedly took her to the front door, as if to say, “Let’s go,” she recalled. She gently told him she was just visiting.
Christine LyBurtus is comforted by caregivers Schahara Zad, left, and Terrence Morris after Noah moved into his residential care facility.
(Mel Melcon / Los Angeles Times)
He led her to the side door instead. She steered him away again. They stepped into the courtyard, and Noah immediately went to the gate to exit.
LyBurtus fell into a funk. As she worried about Noah, she was also figuring out how to make ends meet. With Noah in the Costa Mesa home, Lyburtus was no longer being paid more than $4,000 a month as his caregiver, her sole source of income for years. She tried a number of jobs but ultimately found the work that suited her: caregiving for an elderly woman and children with disabilities.
Her second and third visits with Noah were easier. She snapped photos — Mother and son nestled together on the couch. Noah touching her forehead.
The STAR program runs up to 13 months. As time passed, the regional center had started talking to her about where Noah would go next. LyBurtus was startled.
Wasn’t the plan for him to come home, she asked?
Christine LyBurtus, left, is briefed by Kim Hamilton-Royse while touring a residential care facility for her son.
(Irfan Khan/Los Angeles Times)
That was still on the table, LyBurtus said she was told. But if he wasn’t ready, they didn’t want to wait until the last minute to find somewhere else for Noah, who turned 15 in May.
LyBurtus wanted to block out the idea of him going to another facility.
“I never want to live the way we were living again,” she said.
“But is that worse than him being hours away? I don’t know.”
Science
Early adopters of ‘zone zero’ fared better in L.A. County fires, insurance-backed investigation finds
As the Eaton and Palisades fires rapidly jumped between tightly packed houses, the proactive steps some residents took to retrofit their homes with fire-resistant building materials and to clear flammable brush became a significant indicator of a home’s fate.
Early adopters who cleared vegetation and flammable materials within the first five feet of their houses’ walls — in line with draft rules for the state’s hotly debated “zone zero” regulations — fared better than those who didn’t, an on-the-ground investigation from the Insurance Institute for Business and Home Safety published Wednesday found.
Over a week in January, while the fires were still burning, the insurance team inspected more than 250 damaged, destroyed and unscathed homes in Altadena and Pacific Palisades.
On properties where the majority of zone zero land was covered in vegetation and flammable materials, the fires destroyed 27% of homes; On properties with less than a quarter of zone zero covered, only 9% were destroyed.
The Insurance Institute for Business and Home Safety, an independent research nonprofit funded by the insurance industry, performed similar investigations for Colorado’s 2012 Waldo Canyon fire, Hawaii’s 2023 Lahaina fire and California’s Tubbs, Camp and Woolsey fires of 2017 and 2018.
While a handful of recent studies have found homes with sparse vegetation in zone zero were more likely to survive fires, skeptics say it does not yet amount to a scientific consensus.
Travis Longcore, senior associate director and an adjunct professor at the UCLA Institute of the Environment and Sustainability, cautioned that the insurance nonprofit’s results are only exploratory: The team did not analyze whether other factors, such as the age of the homes, were influencing their zone zero analysis, and how the nonprofit characterizes zone zero for its report, he noted, does not exactly mirror California’s draft regulations.
Meanwhile, Michael Gollner, an associate professor of mechanical engineering at UC Berkeley who studies how wildfires destroy and damage homes, noted that the nonprofit’s sample does not perfectly represent the entire burn areas, since the group focused specifically on damaged properties and were constrained by the active firefight.
Nonetheless, the nonprofit’s findings help tie together growing evidence of zone zero’s effectiveness from tests in the lab — aimed at identifying the pathways fire can use to enter a home — with the real-world analyses of which measures protected homes in wildfires, Gollner said.
A recent study from Gollner looking at more than 47,000 structures in five major California fires (which did not include the Eaton and Palisades fires) found that of the properties that removed vegetation from zone zero, 37% survived, compared with 20% that did not.
Once a fire spills from the wildlands into an urban area, homes become the primary fuel. When a home catches fire, it increases the chance nearby homes burn, too. That is especially true when homes are tightly packed.
When looking at California Department of Forestry and Fire Protection data for the entirety of the two fires, the insurance team found that “hardened” homes in Altadena and the Palisades that had noncombustable roofs, fire-resistant siding, double-pane windows and closed eaves survived undamaged at least 66% of the time, if they were at least 20 feet away from other structures.
But when the distance was less than 10 feet, only 45% of the hardened homes escaped with no damage.
“The spacing between structures, it’s the most definitive way to differentiate what survives and what doesn’t,” said Roy Wright, president and chief executive of the Insurance Institute for Business and Home Safety. At the same time, said Wright, “it’s not feasible to change that.”
Looking at steps that residents are more likely to be able to take, the insurance nonprofit found that the best approach is for homeowners to apply however many home hardening and defensible space measures that they can. Each one can shave a few percentage points off the risk of a home burning, and combined, the effect can be significant.
As for zone zero, the insurance team found a number of examples of how vegetation and flammable materials near a home could aid the destruction of a property.
At one home, embers appeared to have ignited some hedges a few feet away from the structure. That heat was enough to shatter a single pane window, creating the perfect opportunity for embers to enter and burn the house from the inside out. It miraculously survived.
At others, embers from the blazes landed on trash and recycling bins close to the houses, sometimes burning holes through the plastic lids and igniting the material inside. In one instance, the fire in the bin spread to a nearby garage door, but the house was spared.
Wooden decks and fences were also common accomplices that helped embers ignite a structure.
California’s current zone zero draft regulations take some of those risks into account. They prohibit wooden fences within the first five feet of a home; the state’s zone zero committee is also considering whether to prohibit virtually all vegetation in the zone or to just limit it (regardless, well-maintained trees are allowed).
On the other hand, the draft regulations do not prohibit keeping trash bins in the zone, which the committee determined would be difficult to enforce. They also do not mandate homeowners replace wooden decks.
The controversy around the draft regulations center around the proposal to remove virtually all healthy vegetation, including shrubs and grasses, from the zone.
Critics argue that, given the financial burden zone zero would place on homeowners, the state should instead focus on measures with lower costs and a significant proven benefit.
“A focus on vegetation is misguided,” said David Lefkowith, president of the Mandeville Canyon Assn.
At its most recent zone zero meeting, the Board of Forestry and Fire Protection directed staff to further research the draft regulations’ affordability.
“As the Board and subcommittee consider which set of options best balance safety, urgency, and public feasibility, we are also shifting our focus to implementation and looking to state leaders to identify resources for delivering on this first-in-the-nation regulation,” Tony Andersen, executive officer of the board, said in a statement. “The need is urgent, but we also want to invest the time necessary to get this right.”
Home hardening and defensible space are just two of many strategies used to protect lives and property. The insurance team suspects that many of the close calls they studied in the field — homes that almost burned but didn’t — ultimately survived thanks to firefighters who stepped in. Wildfire experts also recommend programs to prevent ignitions in the first place and to manage wildlands to prevent intense spread of a fire that does ignite.
For Wright, the report is a reminder of the importance of community. The fate of any individual home is tied to that of those nearby — it takes a whole neighborhood hardening their homes and maintaining their lawns to reach herd immunity protection against fire’s contagious spread.
“When there is collective action, it changes the outcomes,” Wright said. “Wildfire is insidious. It doesn’t stop at the fence line.”
Science
Notorious ‘winter vomiting bug’ rising in California. A new norovirus strain could make it worse
The dreaded norovirus — the “vomiting bug” that often causes stomach flu symptoms — is climbing again in California, and doctors warn that a new subvariant could make even more people sick this season.
In L.A. County, concentrations of norovirus are already on the rise in wastewater, indicating increased circulation of the disease, the local Department of Public Health told the Los Angeles Times.
Norovirus levels are increasing across California, and the rise is especially notable in the San Francisco Bay Area and L.A., according to the California Department of Public Health.
And the rate at which norovirus tests are confirming infection is rising nationally and in the Western U.S. For the week that ended Nov. 22, the test positivity rate nationally was 11.69%, up from 8.66% two months earlier. In the West, it was even worse: 14.08%, up from 9.59%, according to the U.S. Centers for Disease Control and Prevention.
Norovirus is extraordinarily contagious, and is America’s leading cause of vomiting and diarrhea, according to the CDC. Outbreaks typically happen in the cooler months between November and April.
Clouding the picture is the recent emergence of a new norovirus strain — GII.17. Such a development can result in 50% more norovirus illness than typical, the CDC says.
“If your immune system isn’t used to something that comes around, a lot of people get infected,” said Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco.
During the 2024-25 winter season, GII.17 overthrew the previous dominant norovirus strain, GII.4, that had been responsible for more than half of national norovirus outbreaks over the preceding decade. The ancestor of the GII.17 strain probably came from a subvariant that triggered an outbreak in Romania in 2021, according to CDC scientists.
GII.17 vaulted in prominence during last winter’s norovirus surge and was ultimately responsible for about 75% of outbreaks of the disease nationally.
The strain’s emergence coincided with a particularly bad year for norovirus, one that started unusually early in October 2024, peaked earlier than normal the following January and stretched into the summer, according to CDC scientists writing in the journal Emerging Infectious Diseases.
During the three prior seasons, when GII.4 was dominant, norovirus activity had been relatively stable, Chin-Hong said.
Norovirus can cause substantial disruptions — as many parents know all too well. An elementary school in Massachusetts was forced to cancel all classes on Thursday and Friday because of the “high volume of stomach illness cases,” which was suspected to be driven by norovirus.
More than 130 students at Roberts Elementary School in Medford, Mass., were absent Wednesday, and administrators said there probably wouldn’t be a “reasonable number of students and staff” to resume classes Friday. A company was hired to perform a deep clean of the school’s classrooms, doorknobs and kitchen equipment.
Some places in California, however, aren’t seeing major norovirus activity so far this season. Statewide, while norovirus levels in wastewater are increasing, they still remain low, the California Department of Public Health said.
There have been 32 lab-confirmed norovirus outbreaks reported to the California Department of Public Health so far this year. Last year, there were 69.
Officials caution the numbers don’t necessarily reflect how bad norovirus is in a particular year, as many outbreaks are not lab-confirmed, and an outbreak can affect either a small or large number of people.
Between Aug. 1 and Nov. 13, there were 153 norovirus outbreaks publicly reported nationally, according to the CDC. During the same period last year, there were 235.
UCLA hasn’t reported an increase in the number of norovirus tests ordered, nor has it seen a significant increase in test positivity rates. Chin-Hong said he likewise hasn’t seen a big increase at UC San Francisco.
“Things are relatively still stable clinically in California, but I think it’s just some amount of time before it comes here,” Chin-Hong said.
In a typical year, norovirus causes 2.27 million outpatient clinic visits, mostly young children; 465,000 emergency department visits, 109,000 hospitalizations, and 900 deaths, mostly among seniors age 65 and older.
People with severe ongoing vomiting, profound diarrhea and dehydration may need to seek medical attention to get hydration intravenously.
“Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy,” the CDC says. Sports drinks can help with mild dehydration, but what may be more helpful are oral rehydration fluids that can be bought over the counter.
Children under the age of 5 and adults 85 and older are most likely to need to visit an emergency room or clinic because of norovirus, and should not hesitate to seek care, experts say.
“Everyone’s at risk, but the people who you worry about, the ones that we see in the hospital, are the very young and very old,” Chin-Hong said.
Those at highest risk are babies, because it doesn’t take much to cause potentially serious problems. Newborns are at risk for necrotizing enterocolitis, a life-threatening inflammation of the intestine that virtually only affects new babies, according to the National Library of Medicine.
Whereas healthy people generally clear the virus in one to three days, immune-compromised individuals can continue to have diarrhea for a long time “because their body’s immune system can’t neutralize the virus as effectively,” Chin-Hong said.
The main way people get norovirus is by accidentally drinking water or eating food contaminated with fecal matter, or touching a contaminated surface and then placing their fingers in their mouths.
People usually develop symptoms 12 to 48 hours after they’re exposed to the virus.
Hand sanitizer does not work well against norovirus — meaning that proper handwashing is vital, experts say.
People should lather their hands with soap and scrub for at least 20 seconds, including the back of their hands, between their fingers and under their nails, before rinsing and drying, the CDC says.
One helpful way to keep track of time is to hum the “Happy Birthday” song from beginning to end twice, the CDC says. Chin-Hong says his favorite is the chorus of Kelly Clarkson’s “Since U Been Gone.”
If you’re living with someone with norovirus, “you really have to clean surfaces and stuff if they’re touching it,” Chin-Hong said. Contamination is shockingly easy. Even just breathing out little saliva droplets on food that is later consumed by someone else can spread infection.
Throw out food that might be contaminated with norovirus, the CDC says. Noroviruses are relatively resistant to heat and can survive temperatures as high as 145 degrees.
Norovirus is so contagious that even just 10 viral particles are enough to cause infection. By contrast, it takes ingesting thousands of salmonella particles to get sick from that bacterium.
People are most contagious when they are sick with norovirus — but they can still be infectious even after they feel better, the CDC says.
The CDC advises staying home for 48 hours after infection. Some studies have even shown that “you can still spread norovirus for two weeks or more after you feel better,” according to the CDC.
The CDC also recommends washing laundry in hot water.
Besides schools, other places where norovirus can spread quickly are cruise ships, day-care centers and prisons, Chin-Hong said.
The most recent norovirus outbreak on a cruise ship reported by the CDC is on the ship AIDAdiva, which set sail on Nov. 10 from Germany. Out of 2,007 passengers on board, 4.8% have reported being ill. The outbreak was first reported on Nov. 30 following stops that month at the Isle of Portland, England; Halifax, Canada; Boston; New York City; Charleston, S.C.; and Miami.
According to CruiseMapper, the ship was set to make stops in Puerto Vallarta on Saturday, San Diego on Tuesday, Los Angeles on Wednesday, Santa Barbara on Thursday and San Francisco between Dec. 19-21.
Science
Southern California mountain lions recommended for threatened status
The California Department of Fish and Wildlife has recommended granting threatened species status to roughly 1,400 mountain lions roaming the Central Coast and Southern California, pointing to grave threats posed by freeways, rat poison and fierce wildfires.
The determination, released Wednesday, is not the final say but signals a possibility that several clans of the iconic cougars will be listed under the California Endangered Species Act.
It’s a move that supporters say would give the vulnerable animals a chance at recovery, but detractors have argued would make it harder to get rid of lions that pose a safety risk to people and livestock.
The recommendation was “overdue,” Charlton Bonham, director of the state wildlife department, said during a California Fish and Game Commission meeting.
It arrives about six years after the Center for Biological Diversity and Mountain Lion Foundation petitioned the commission to consider listing a half-dozen isolated lion populations that have suffered from being hit by cars, poisoned by rodenticides and trapped by development.
The following year, in 2020 the Commission found the request might be warranted, giving the lions temporary endangered species protections as “candidates” for listing. It also prompted the state wildlife department to put together a report to inform the commission’s final decision.
The next step is for state wildlife commissioners to to vote on the protections, possibly in February.
Brendan Cummings, conservation director for Center for Biological Diversity, hailed the moment as “a good day, not just for mountain lions, but for Californians.”
If the commissioners adopt the recommendation, as he believes they will, then the “final listing of the species removes any uncertainty about the state’s commitment to conserving and recovering these ecologically important, charismatic and well-loved species that are so much a part of California.”
The report recommends listing lions “in an area largely coinciding” with what the petitioners requested, which includes the Santa Ana, San Gabriel, San Bernardino, Santa Monica, Santa Cruz and Tehachapi mountains.
It trims off portions along the northern and eastern borders of what was proposed, including agricultural lands in the Bay Area and a southeastern portion of desert — areas where state experts had no records of lions, according to Cummings.
Officials in the report note that most of the lion groups proposed for listing are contending with a lack of gene flow because urban barriers keep them from reaching one another.
In Southern California, lions have shown deformities from inbreeding, including kinked tails and malformed sperm. There’s an almost 1 in 4 chance, according to research, that mountain lions could become extinct in the Santa Monica and Santa Ana mountains within 50 years.
The late P-22 — a celebrity mountain lion that inhabited Griffith Park – personified the tribulations facing his kind. Rat poison and car collisions battered him from the inside out. He was captured and euthanized in late 2022, deemed too sick to return to the wild because of injuries and infection.
For some species, protections come in the form of stopping chainsaws or bulldozers. But imperiled lions, Cummings said, need their habitats stitched together in the form of wildlife crossings — such as the gargantuan one being built over the 101 Freeway in Agoura Hills. He added that developments that could restrict their movement should get more scrutiny under the proposed protections.
Critics of the effort to list lion populations have said that it will stymie residential and commercial projects.
California is home to roughly 4,170 mountain lions, according to the recent report, but not all are equal in their struggle.
Many lion populations, particularly in northwest coastal forests, are hearty and healthy.
Protections are not being sought for those cats. Some, in fact, would like to see their numbers reduced amid some high-profile conflicts.
Bonham, the director of the state Department of Fish and Wildlife, spoke to concerns about public safety at the recent meeting, alluding to the tragic death of young man who was mauled by a cougar last year in Northern California.
“These are really delicate issues and the conversation I know in the coming years is going to have to grapple with all that,” said Bonham, who will be stepping down this month after nearly 15 years in his role.
California’s lions already enjoy certain protections. In 1990, voters approved a measure that designated them a “specially protected species” and banned hunting them for sport.
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