Please take the time to read through this information.

Norovirus (winter vomiting bug)  is highly infectious and is easily spread through contact with someone with the infection or with contaminated surfaces. One of the best ways to prevent the spread of norovirus is by regularly washing hands with soap and warm water especially after using the toilet or an episode of illness and before eating or preparing food. 

Most people will make a full recovery within 2 to 3 days, but it is important to drink plenty of fluids to prevent dehydration, especially for the very young, elderly or those with weakened immune systems who are more at risk.

Guidance 

• Guidance on managing norovirus outbreaks to help stop the spread of infection. 
• Infection prevention and control: resource for adult social care
• Deep-cleaning-guidance-for-Care-Homes-May-2020.pdf  
• Guidelines for the management of norovirus outbreaks in acute and community health and social care settings
• Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance
• Guidance: Preventing and controlling infections: 
• National infection prevention and control manual for England

Useful resources 

• Graphic 1
• Graphic 2

Norovirus:

Norovirus is easily transmitted through contact with people with the infection and any surfaces or objects which have been contaminated with the virus. 

Symptoms 

Symptoms include sudden onset of nausea, projectile vomiting and diarrhoea but can also include a high temperature, abdominal pain and aching limbs.

Incubation period 

The incubation period of norovirus is 12-48 hours, which is the time between catching the virus and developing symptoms. Individuals are most infectious when symptomatic, but it is possible to pass on norovirus or shed the virus, thereby contaminating surfaces, objects or even food, both before developing symptoms and after symptoms have stopped.

• For most people this is an unpleasant, short-lived illness and they make a full recovery within 2-3 days without needing any medicine. 
• However, some groups, including young children, the elderly or those with weakened immunity, are at risk of suffering more serious and prolonged illness which may require medical treatment.

Norovirus is highly contagious, It can easily spread in closed indoor settings with large populations, including nursing homes, assisted living facilities, and healthcare settings. 

You can catch norovirus from:

• close contact with someone with norovirus
• touching surfaces or objects that have the virus on them, then touching your mouth
• eating food that’s been prepared or handled by someone with norovirus

While norovirus doesn’t typically have serious consequences, older people are at higher risk for complications—mainly dehydration. 

Washing your hands frequently with soap and  warm water is the best way to stop it spreading. Alcohol hand gels do not kill norovirus.. This is most important following an episode of illness, after using the toilet, before eating or preparing food as well as cleaning up vomit or diarrhoea. Alcohol-based hand sanitisers are not effective against norovirus.

Outbreak management 

Norovirus is able to spread easily through communities and so outbreaks are common in settings where individuals have close contact such as hospitals, care homes, schools and nurseries

Suspected Norovirus outbreak is defined as: Two or more cases of diarrhoea and/or vomiting within 48 hours which occur in residents and/or staff. A confirmed outbreak is where one of more cases have a positive test for norovirus.

• Ensure you know when and how to contact your local HPT: outbreaks of D&V should be reported promptly to the local HPT for a full risk assessment and further guidance (even if care home already aware of local D&V outbreak management guidelines).
• Contact the Health Protection Team (HPT), and follow the advice provided: Email: [email protected], Phone: 0344 326 2052

Infection control precautions 

1.  Ensure infection control policies are up to date, read and followed by all staff.
2.   Conduct a hand washing audit and educate staff on the importance of hand washing and the appropriate hand washing technique. 
3.  Ensure that liquid soap and disposable paper hand towels are available in all toilets and communal bathrooms, including individuals’ room/en-suite.
4.   Ensure that Personal Protective Equipment (PPE) is available i.e. masks, gloves, aprons. 
5.  Ensure linen management systems are in place as well as clinical waste disposal systems, including foot operated bins
6.   Refer to the norovirus poster for further information which can be displayed for staff and visitors in the care home. 
7.  Remind any staff with symptoms to remain off work until 48 hours after symptoms have stopped.

 Reporting to the local Health Protection Team

•  Ensure you know how to recognise an outbreak of diarrhoea and/or vomiting (D&V) amongst staff and/or residents in care homes (2 or more cases within 48 hours). 
•  Ensure you know when and how to contact your local HPT: outbreaks of D&V should be reported promptly to the local HPT for a full risk assessment and further guidance (even if the care home is already aware of local D&V outbreak management guidelines).
• Prepare for record keeping to help with investigations of any outbreaks: it may help to have a list of your staff and residents ready to go, including names, dates of birth and room location in the care home. This list can then be used for recording symptoms, onset dates and other details during outbreak