To: School Nurses, Long-term Care Facilities, Licensed Childcare Providers, and Correctional Facilities
From: Patsy Kelso, State Epidemiologist for Infectious Disease
Date: February 3, 2012
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In 2012 so far, the Vermont Department of Health has received seven reports of outbreaks of acute gastrointestinal illness in institutional settings. Outbreaks have been reported in several settings, including long-term care facilities, a correctional facility and a college. Three outbreaks have been confirmed to be caused by norovirus. In addition, the Health Department has seen an increase in visits to Vermont emergency rooms due to gastrointestinal illnesses.
Many of these acute gastrointestinal illnesses are likely due to noroviruses. Typical symptoms of norovirus infection are vomiting, diarrhea, abdominal cramps and low-grade fever. Symptoms typically begin 12 to 48 hours after exposure, and last 24 to 72 hours. Most people recover completely without treatment, but some require hospitalization for rehydration.
Noroviruses are highly contagious. They are usually spread from person to person, but can also spread through food, water, and even aerosolized vomitus.
Tips to prevent the spread of norovirus–
- Practice proper hand hygiene: Hand washing is very important for controlling the spread of gastrointestinal viruses. Wash hands thoroughly with soap and water, especially after using the toilet, changing diapers and before eating or preparing food.
- Ill people should not prepare food for others: People who are infected with norovirus should not prepare food for others while they have symptoms, and for three days after they recover from their illness.
- Clean and disinfect contaminated surfaces: After an episode of illness, such as vomiting or diarrhea, contaminated surfaces should be cleaned and disinfected by using a bleach-based household cleaner as directed on the product label or a solution made by adding five to 25 tablespoons of household bleach to 1 gallon of water.
- Wash laundry thoroughly: Immediately remove and wash clothing or linens that are contaminated with vomit or fecal matter. Launder with detergent at the maximum available cycle length and then machine dry.
- Cohort ill people/exclude ill people: People should stay home when they are ill and limit their contact with others. In institutional settings, cohort ill people if possible.
- Report outbreaks: Single suspected cases of acute gastroenteritis are not reportable to the Vermont Department of Health. Report clusters of acute gastrointestinal illness by calling 1-800-640-4374 or 863-7240.
In cases of clusters or outbreaks, the Health Department Laboratory can test stool or vomitus samples for norovirus to confirm the cause. In these situations, unpreserved stool from three to five ill people is usually sufficient to detect the virus and confirm the cause of the outbreak.
The decision to submit samples for norovirus testing should be made in
consultation with an epidemiologist from the health department.