New CDC Guidelines for Prevention and Control of Norovirus

Over the past several years, norovirus outbreaks have been increasingly reported at health care facilities across the county. Several states have implemented guidelines to help health care institutions and communities prevent norovirus transmission.

Noroviruses cause gastroenteritis, an inflammation of the stomach and the small and large intestines, in people of all ages. Noroviruses are most dangerous for young children, seniors and people with compromised immune systems.

The Centers for Disease Control and Prevention (CDC) report common ways to contract a norovirus infection include contaminated food and water and contact with an infected person or with surfaces contaminated by a person with the disease.

Recently, the CDC released Draft Guidelines for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Health Care Settings. The guidelines include recommendations on:

• Patient cohorting and isolation precautions
• Hand hygiene
• Food handlers in health care setting
• Diagnostics
• Personal protective equipment
• Environmental cleaning
• Staff leave policy
• Visitors
• Education
• Active case finding
• Communication and notification

Because noroviruses are excreted in very large numbers, it is important to thoroughly clean contaminated surfaces and then disinfect the surface with chlorine bleach, which has been proven to kill/inactivate this virus. Evidence from outbreak investigations and laboratory-based research has shown that there are a limited number of disinfectants, such as chlorine bleach, that are effective against noroviruses. Bleach destroys these viruses by breaking their outside protein cover and genetic material into inactive fragments.

So how can one prevent a norovirus infection? Make sure that you wash and disinfectant all surfaces that have been contaminated or that are likely to be contaminated by a person with the disease. Remember to wash hands with soap and warm water after using the bathroom, changing a diaper, blowing your nose, sneezing or coughing, caring for a sick person, playing with a pet, and also before preparing or eating raw or undercooked food. Cook all shellfish thoroughly and wash raw vegetables and fruits before eating. Food handlers should never contact ready-to-eat food with bare hands. Food preparation surfaces should regularly be cleaned and then disinfected using one tablespoon of bleach in one gallon of water. Solutions should be made fresh daily, and bleach solutions should never be mixed with ammonia-based cleaning products.

(Barbara M. Soule, R.N., is an Infection Preventionist and a member of the Water Quality and Health Council)