Message
Type: Health Advisory
Status: Actual
Severity:
Minor
Sensitive:
No
Jurisdiction: State
DATE:
12/19/2006
TO:
School Nurses and DHHS Outbreak Team
FROM:
Jose Montero, MD, MPH, State Epidemiologist
SUBJECT: Outbreaks of Viral Gastroenteritis
in Schools
NH Department of Health and Human Services (NH DHHS) recommends:
Background:
NH DHHS has received multiple reports of
gastrointestinal illness in communities, schools, and childcare facilities.
Many of these illnesses are caused by Norovirus and are transmitted
person-to-person or through contact with contaminated surfaces. Noroviruses are
one of the most common causes of acute viral gastroenteritis in the
Infection Control Recommendations During an Outbreak:
1. Promptly clean areas contaminated with vomit
and feces and follow up disinfections with freshly prepared 0.1% (1000 ppm)
hypochlorite solutions.
2. Review kitchen hygiene practices and health
status of all food workers, exclude any symptomatic food handlers from work
until full recovery.
3. Assess health status of students and staff
and exclude all symptomatic individuals from school/work until full recovery.
4. Practice frequent hand washing and gloving by
all food workers in the facility.
5. Practice frequent hand washing by all
students and staff.
6. Use gloves and aprons whenever contact with
an affected individual or contaminated environment is anticipated.
7. Wash hands after contact with affected
individuals, on leaving affected areas or before handling food or drinks.
8. Clean soiled carpets and soft furnishings
with hot water and detergent or steam clean; avoid vacuum cleaning.
9. Clean frequently handled objects such as door
handles.
10. Conduct terminal cleaning 72 hours after
resolution of the last case.
Attachment:
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CATEGORIES OF HEALTH ALERT NETWORK (HAN)
MESSAGES:
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Health
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an incident or situation
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communications alert has been canceled
Error: Prior
alert or communication has been retracted
Status:
Actual Communication or alert refers to a live event
Exercise Designated recipients must respond to the communication or
alert
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alert is related to a technical, system test and should be disregarded
Severity:
Extreme:
Extraordinary threat to life or property
Severe:
Significant threat to life or property
Moderate:
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Norovirus
What is Norovirus?
Noroviruses are a
group of viruses that cause the stomach flu, or gastrointestinal (stomache and
digestive) illness. Norovirus infection occurs occasionally in only one or a
few people or it can be responsible for large outbreaks, such as in long-term
care facilities.
Who gets Norovirus?
Norovirus infects
people of all ages worldwide. It may, however, be more common in adults and
older children.
How does someone get Norovirus?
Norovirus is spread
from person to person via feces, but some evidence suggests that the virus is
spread through the air during vomiting. Good hand washing is the most important
way to prevent the transmission of Norovirus. Outbreaks have been linked to
sick food handlers, ill health care workers, cases in facilities such as
nursing homes spreading to other residents, contaminated shellfish, and water
contaminated with sewage.
What are the symptoms of Norovirus?
Serious illness rarely
occurs. The most common symptoms include nausea, vomiting, and stomach cramps.
Diarrhea may occasionally accompany vomiting. Fever is usually low grade or
absent. Infected people generally recover in 1-2 days.
How soon after exposure do symptoms appear?
The incubation period
for Norovirus is 1-2 days.
How is Norovirus infection diagnosed?
Laboratory diagnosis
is difficult but there are tests that can be performed in the New Hampshire Public
Health Lab in situations where there are multiple cases. Diagnosis is often
based on the combination of symptoms and the short time of the illness.
What is the treatment for Norovirus infection?
No specific treatment
is available. People who become dehydrated might need to be rehydrated by
taking liquids by mouth. Occasionally patients may need to be hospitalized to
receive intravenous fluids.
How can Norovirus be prevented?
While there is no vaccine for Norovirus, there are
precautions people should take:
Wash
hands with soap and warm water after using the bathroom and after changing
diapers
Wash
hands with soap and warm water before preparing or eating any food
Cook
all shellfish thoroughly before eating
Wash raw vegetables before eating
Dispose of sewage in a sanitary matter
Food
handlers with symptoms of Norovirus should not prepare or touch food
Health
care workers should stay home if they have symptoms of Norovirus
For
specific concerns about Norovirus, call the New Hampshire Department of Health
and Human Services, Communicable Disease Control Section at 603-271-4496 or
800-852-3345 x4496. For further information, refer to the Centers for Disease
Control and Prevention website at www.cdc.gov or the NH Dept. of Health and
Human Services website at www.dhhs.state.nh.us.