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Preventing the Spread of Norovirus

Lisa Mack
February 06, 2018


Causing your stomach or small intestines to become inflamed, which leads to  nausea, vomiting, stomach pain, fever, and diarrhea - Norovirus will hit you like a ton of bricks. There is no specific cure, but keeping hydrated is the most important factor in your recovery. While most otherwise healthy people recover on their own, the very young and elderly may often experience much more serious effects of dehydration. These at-risk groups have a much harder time holding onto fluids. Norovirus is very contagious and spreads easily through college dorms, military barracks, cruises, and other facilities, such as assisted nursing homes where people live close together. You can get infected by another person, contaminated food or water, or contaminated surfaces. There are many different types of noroviruses so it’s possible to become infected many times.


Norovirus affects people worldwide. It’s responsible for 685 M cases/year of gastroenteritis in children under 5, and leads to 50,000 deaths; mainly in developing countries. It has become a serious factor that the World Health Organization ranks as #1 cause of foodborne illness, and the #4 cause of foodborne deaths. While the deaths occur mainly in developing countries, Norovirus is responsible for lost days of work and productivity.


Transmission of this virus


Transmission of Norovirus

“The mode of transmission is via the fecal-oral route. Aerosolised vomitus has also been implicated as a mode of transmission as well” (1).  As you see, once you’ve come in contact with Norovirus, the spread is primarily through contaminated hands. Shaking hands, touching surfaces that aren’t clean, touching food, and taking care of people with norovirus can all be means of transmission.


There are notable features of this type of infection which make it so hard to contain and stop are:


  1. There needs only to be as few as 18 viral particles to make you sick. The number of viral particles that fit on the head of a pin can sicken over 1,000 people.
  2. Infected people are infectious before they have symptoms.
  3. The virus does not decrease in pathogenicity or contagiousness during outbreaks.

Norovirus and Food Safety


Norovirus is the leading cause of illness and outbreaks from contaminated food in the United States. Most of these outbreaks occur in the food service settings like restaurants. Infected food workers are frequently the source of the outbreaks, often by touching ready-to-eat foods, such as raw fruits and vegetables, ice, silverware, with their bare hands before serving them. However, any food served raw or handled after being cooked can get contaminated with norovirus. Norovirus outbreaks can also occur from contaminated foods, such as oysters, fruits, and vegetables, that are contaminated at their source.


Food workers can follow some simple tips to prevent norovirus from spreading:


  • Avoid preparing food for others while you are sick and for at least 48 hours after symptoms stop
  • Wash your hands carefully and often with soap and water
  • Rinse fruits and vegetables and cook shellfish thoroughly
  • Clean and sanitize kitchen utensils, counters, and surfaces routinely
  • Wash table linens, napkins, and other laundry thoroughly(3)


Norovirus in Healthcare Facilities


Each year outbreaks of gastrointestinal illness occur in settings such as long term care facilities (LTCFs). The communal living in these settings makes transmission easier and, due to their underlying health status, these residents are at a higher risk for developing serious complications or dying when they become acutely ill. Norovirus is the most common cause of outbreaks of gastrointestinal illness in a LTCF. Norovirus outbreaks most commonly occur in the health-care facility setting. This includes LTCFs and hospitals. Virus can be introduced from the community into health care facilities by staff, visitors and patients who might either be incubating or infected with norovirus upon admission, or by contaminated food products.


Outbreaks in these settings can be prolonged, sometimes lasting months. Illness can be more severe in frail patients, and associated deaths have been reported. Strict control measures (including isolation of symptomatic patients, exclusion of affected staff, and restricting new admissions into affected units) are disruptive and costly, but are often required to stop an outbreak.


What public health recommends in these situations and for the public, is always make hand hygiene your number one priority. Your hands are the most efficient means of transmission of this virus. Washing with soap and water frequently or using a high efficacy alcohol sanitizer when water and a sink is not available, and keeping hands in good condition, will be your best defense. 


  Learn About the Proper Hand Washing Technique  





  1. How to prevent the spread of norovirus.
  2. Key Infection Control Recommendation for the control of Norovirus Outbreaks in Healthcare Settings.
  3. Norovirus and Working with Food.,
  5. Norovirus Worldwide.
  6. Norovirus in Healthcare Facilities Fact Sheet.

infection prevention and control


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