Norovirus sickens dozens on popular Hawaii hiking trail, forcing closure

It was a “hiker’s dream” turned nightmare, Danielle Burr said.

The 32-year-old embarked on the Kalalau Trail on an ideal August day. The 11-mile trail, which Burr had hiked once before, runs along the dramatic Na Pali Coast on the Hawaiian island of Kauai, challenging hundreds of intrepid hikers every year with its narrow footpaths and steep drop-offs. But the reward is worth it, Burr said: glittering views of the Pacific and sweeping expanses of the island’s luscious greenery. On Aug. 29, the skies were clear, the sun shined and her group of a dozen friends buzzed with excitement.

Until they started dropping like flies.

Violent gastrointestinal symptoms gripped eight members of her group, one by one, she told The Washington Post. Burr was helicoptered out to a hospital before the trip’s end.

“It’s one of the most beautiful places in the world. I feel really fortunate to be able to be there, and appreciate and respect that land,” Burr said. “My guts exploding all over that land was not what I wanted to do at all.”

Burr and dozens of fellow hikers caught the highly contagious norovirus. The Kalalau Trail is closed until Thursday at the earliest because of a norovirus outbreak, according to state officials. At least 50 people fell ill in August and early September, but the actual number of people affected may be higher, officials said. The state health agency launched a survey last week to determine how many others may have caught norovirus on the trail and where exposure was most common. In the meantime, the trail’s restrooms are being cleaned and disinfected, officials said, and the health agency has collected water, soil and environmental samples.

Norovirus is a highly contagious virus that causes vomiting, diarrhea and fever, according to the Centers for Disease Control and Prevention. Most people recover within one to three days, but they can still spread the virus for a few days after. Norovirus outbreaks along hiking trails have happened before: This year, one sickened hikers along the Appalachian Trail, according to the National Park Service. And in 2022, the virus infected at least 222 people in the backcountry of Grand Canyon National Park, the CDC reported.

For Burr, the experience was anything but run-of-the-mill, she said, laughing at the memory.

She’s been hiking regularly for a decade and first trekked Kalalau last year. She was enamored by it, she said, and was thrilled to be back.

“This was a hiker’s dream,” she said. “It’s such a special and peaceful place.”

Her group hiked all 11 miles within a day, arriving to their Kalalau beach campsite by late afternoon. The group planned to set up their camp and spend the evening relaxing, eating and chatting, before tucking away into their tents by sundown.

But one member of the group began vomiting profusely. Then his brother did, too. Another group member rolled out of his hammock, suddenly sick as well.

“We all pause and look at each other and go, ‘Uh oh, something’s happening,’” Burr said. By the next evening, Burr was sick.

It was relentless. For hours, Burr heaved outside her tent.

“I’m so sick, and it’s so dark out there, and the toilets are 10 minutes away,” she said. “I can barely stand up.”

By about 4 a.m., Burr told her boyfriend that she needed to go to the hospital and would need to be rescued.

“There was no way I could physically do that trail to get out,” she said. “And I was spreading the virus all over the place, like, I’m a public health risk.”

A helicopter arrived not too long after sunrise, and Burr was ferried to Wilcox Medical Center. She was strapped to a fluid bag and told she probably had caught leptospirosis, a disease caused by a bacteria that is sometimes present along Hawaii’s hiking trails, she said.

Five more from her group fell ill by then, she said. And the sickness seemed to keep spreading: Burr’s friends heard about more hiking groups becoming violently sick as well. Medical providers had not yet connected the dots that there was an outbreak, Burr said.

As tales of fellow sickened hikers rolled in, Burr called the Hawaii Department of Health. The agency sent her a test kit, which confirmed that she had norovirus. By Sept. 5, the state health agency confirmed that norovirus had sickened several other hikers and campers, too, and shut down the trail.

“There was a window of time that people were still hiking in and getting sick. That could have been prevented,” Burr said, adding that the outbreak’s severity could have been mitigated if there were more restrooms - and cleaner ones - at the campgrounds.

“A lot of people found themselves in a situation of urgency where they were going in the woods.”

The state parks agency detailed its efforts to sanitize the campground’s restrooms since the trail’s closure, and the health agency in a statement Monday evening emphasized that it has a system for health-care providers to report public health concerns, including outbreaks.

The state’s health-care providers are required to report cases in which two or more people become ill “where a common place of exposure has occurred,” Hawaii state epidemiologist Sarah Kemble said.

Burr said she hopes this outbreak leads to improvements of the trail and its campgrounds.

Still, Kalalau calls to Burr. She plans to hike it again next year.