|Points Of Contact
|Assistant to Director for Science
|Assistant to Director for Field Operations
|National Capitol Region
|Pacific West Region
Environmental surfaces, foods and drinks can very
easily become contaminated with norovirus since an infected person sheds
an extremely large amount of virus in feces and vomitus (> 1 million
virus particles/ml). This contamination can be a source of infection due
to the low dose needed to cause illness - it is estimated that fewer than
100 norovirus particles can make a person sick. Contamination can occur
either by direct contact with soiled hands or environmental surfaces that
are contaminated with stool or vomit, or by tiny droplets from nearby
vomit that can travel through air to land on food. Although the virus
cannot multiply outside the human body, once food, water, or fomites (environmental
surfaces which may include: furniture, railings, carpeting, doors, etc)
are contaminated they can cause illness.
People who are sick with norovirus illness can often
vomit violently or have explosive diarrhea without warning. Therefore
staff responding to an incident (housekeeping, kitchen, maintenance, emergency
medical and law enforcement) have a greater risk of exposure to norovirus
than the general population and the following precautions need to be taken:
- The area needs to be cleared of all non-essential
- Personal Protective Equipment (PPE) should
- Disposable gloves
- Face Mask
- All surfaces near the vomit should be promptly
cleaned and disinfected.
- Visible debris cleaned up with disposable
absorbent material (double bag and discard).
- Area within at least a 25 foot radius
disinfected by the following methods or with products containing
one of the following active ingredients (follow label instructions):
- Chlorine (1000-5000 ppm)
- 1000 PPM: 1/3 cup of 5.25% bleach per
gallon of water
- 5000 PPM: 1 2/3 cups of 5.25% bleach
per gallon of water
- High concentrations of chlorine may be
damaging to some materials
- Ensure solution is changed/remade on
a regular basis to maintain disinfectant properties
- Activated hydrogen peroxide
- Heat >170ºF
- Parachlorometaxylenol (PCMX)
- Accelerated Potassium Peroxymonosulphate
- Quaternary ammonia compounds MAY NOT BE EFFECTIVE
for norovirus disinfection .
- Hard to clean and/or heavily soiled areas
(ambulances, cabins, etc) may require additional disinfection -
please contact NPS Public Health.
- Linens (including clothes, towels, tablecloths,
napkins) soiled to any extent with vomit or stool should be promptly
washed and dried separately at high temperature (drier temperature >170ºF).
- Don't forget to clean and disinfect ice buckets
- people will grab the nearest container when they get sick.
- Food items that may have become contaminated
with norovirus should be thrown out.
- All equipment used in the cleanup should be disinfected.
- Hands should be washed with soap and water for
at least 20 seconds, and then can be followed by a hand sanitizer.
Norovirus Outbreak Control Strategies
Use one of the recommended sanitizers on:
- Entire premises at least daily
- Items which are frequently handled hourly (examples
- courtesy phones, service counters, kiosks, chair backs, tables, cup
holders, Stair rails, balcony rails, bar rails, ice machines, etc)
- Interview each employee at the start of each
shift regarding vomiting, diarrhea, or other "stomach flu"
- All employees with gastroinstestinal symptoms
seek medical treatment.
- Remain off duty for 72 hours after their
- Limit contact with others.
- Monitor employees for obvious signs of illness.
Ill employees should be sent home.
- Notify NPS Public Health with the number of all
employees with gastrointestinal illness daily.
- Treat all fecal and vomitus events as if they
are contaminated with norovirus.
- Assure that employees wash their hands
at least once per hour:
- upon entering
a food area
- handling food
- after using the restroom
- handling utensils
- after any physical contact with anyone
- after sneezing
- touching the face
- blowing the nose
- contacting any surface
- and after handling money
- Sanitize a large block of rooms in one session.
- Avoid cross contamination (do not use one sanitization
cloth for bathroom surfaces and ice buckets)
- Use high efficiency particulate air (HEPA) vacuum
- Sanitize ice buckets and glasses between guest
- Install reminders on need for proper hand washing
- guests and employees.
- Sanitize sinks, handles and doors hourly.
Food Preparation and Food Service
- Suspend self-service food activities.
- Vigilent handwashing efforts - including wait
staff and busers.
- Strict glove use in conjunction with utensils
policy for ALL food handlers - no barehand contact with ready-to-eat
Repiratory and Enteric Viruses Branch, National
Center for Infectious Diseases, Centers for Disease Control and Prevention.
Precedings of the Nevada Norovirus Summit, Las Vegas,
Nevada July 13, 2004
If you have any questions, please contact your nearest Regional Point of Contact,
park sanitarian or call WASO Public Health for more information.
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