Kalalau Trail reopening Oct. 1 following norovirus outbreak among hikers

The Kalalau Trail in the Nāpali Coast State Wilderness Park on Kaua‘i will re-open to visitors on Oct. 1 following its closure due to a norovirus outbreak among park visitors.

During the temporary closure and in consultation with Hawaiʻi Department of Health, the Department of Land and Natural Resources Division of State Parks initiated a disinfection and cleaning and airlifted barrels of effluent for treatment and disposal from the Hanakāpī’ai, Hanakoa and Kalalau composting comfort stations.

A crew of three flew in and conducted two maintenance passes at both Hanakāpī’ai and Kalalau, and a six-person crew flew into Hanakoa and spent a day performing maintenance activities, according to press release issued by the Hawai‘i Department of Health. Painting and vegetation removal was also performed among the comfort stations.

While it is not possible to ensure complete eradication of norovirus from the park or its facilities, substantial preventive measures have been taken during the closure. Repeated disinfection of comfort stations, weeks of closure allowing natural processes (rain, UV light, virus degradation) to diminish remaining virus, and the cessation of new infections, give the Hawai‘i Department of Health and the Department of Land and Natural Resources confidence that opening the park now is appropriate.

Visitors to the re-opened park are advised to take precautions including careful handwashing with soap and water (carry biodegradable soap with you), treating water before drinking it and avoiding visiting the park while ill. Visitors are asked to notify the Hawai‘i Department of Health if they develop symptoms of vomiting or diarrhea during or within 72 hours of a visit to the park. If symptoms are severe, seek medical attention.

The total number of norovirus cases reported to date is approximately 50 and remaining stable. The onset of new cases peaked on Sept. 2 and there have been no new cases reported with onset after Sept. 4. While the increased public health risk has subsided, the Hawai‘i Department of Health will continue to investigate case reports and conduct surveillance of norovirus-like symptoms in emergency room and urgent care visits, in addition to requesting that cases be reported by park visitors and/or by healthcare providers.

The initial source of this outbreak was most likely a park visitor who was already infected with norovirus and became acutely ill in the park. The Hawai‘i Department of Health survey of park visitors from the period July 1 to Sept. 4 helped identify many of the reported cases. In addition, initial analysis points to person-to-person spread and contact with contaminated comfort stations as highly suspected primary means of infection.

Centers for Disease Control and Prevention testing of water, sand and sediment from Kalalau Valley did not show any norovirus. However, CDC testing did reveal evidence of fecal contamination inside the cave. Due to fecal contamination, the cave will remain closed through the winter when it naturally becomes inaccessible. Visitors are reminded that it is against the law to urinate or defecate other than at the toilet facilities provided.

Norovirus causes copious vomiting, stomach pain and diarrhea, often with fever. It spreads very easily from person to person. Sick people shed billions of virus particles in their stool and vomit, and it only takes a few virus particles (<100) to make you sick.

The virus spreads in many ways, including:

• Touching an infected person while caring for them (they may have virus on their skin and clothing from vomiting and diarrhea).
• Eating food or drinking liquids contaminated with norovirus (for example, if the food or drink was prepared by someone who was sick or if it was shared with them).
• Touching a surface or object that has norovirus on it and then touching your food or putting your fingers in your mouth (especially without thoroughly washing your hands with soap and water).
• Sharing utensils or cups with people who are sick with norovirus.

There are steps you can take to prevent the spread of norovirus:

• Wash hands carefully with soap and running water after using the toilet and before eating or preparing or handling food. Hand sanitizers alone do not work well against norovirus and should not be substituted for soap and water.
• If you are sick, do not prepare food for others or care for others for at least two days after you recover. Throw out any food that may be contaminated with norovirus.
• Clean and disinfect contaminated surfaces (where anyone has vomited or had diarrhea), using a chlorine bleach solution or other disinfectant registered by the EPA as effective against norovirus.
• Thoroughly wash all contaminated clothing and bedding.

If you become ill with norovirus symptoms during or after a park visit, and symptoms do not improve, please seek medical attention and report your illness to the Department of Health reporting line at 808-586-4586.

For additional information on Norovirus go to: Norovirus | Disease Outbreak Control Division (hawaii.gov) and Preventing Norovirus When Camping, Hiking, or Outdoors | Norovirus | CDC.