Understanding Norovirus: Prevention and Control in High-Risk Settings

Norovirus is a highly contagious virus that leads to inflammation of the stomach and intestines, resulting in symptoms such as vomiting, diarrhea, nausea, and stomach pain.

Tracking norovirus is difficult because diagnosing it requires a very specific stool test (not the easiest thing to collect from a norovirus patient) and the illness isn’t required to be reported – meaning the state and county health departments don’t have good data to track its spread.

There’s plenty of anecdotal evidence from emergency departments around Arizona that norovirus is definitely going around.

Norovirus in Arizona: What to know about the stomach bug

Norovirus spreads rapidly through several routes:

  • Direct Contact: Touching an infected person.
  • Contaminated Food or Water: Consuming food or beverages handled by someone infected.
  • Surface Contact: Touching surfaces or objects contaminated with the virus and then touching the mouth.

The virus can survive on surfaces for a long time and only a few viral particles are needed to cause infection.

Norovirus can wreak havoc in places like senior independent living, assisted living and skilled nursing, so it’s super important for leadership at these kinds of facilities to take quick action when there’s a sign that the virus has gotten a toe hold in the facility.

  • Hand Hygiene: Urge residents, staff, guests and contractors to regularly wash hands with soap and water, particularly after using the restroom, changing diapers, and before eating or preparing food.
  • Surface Disinfection: Clean and disinfect surfaces using a bleach-based household cleaner, especially areas contaminated by vomit or feces.
  • Isolation: Individuals exhibiting symptoms should avoid preparing food or caring for others until at least two days after symptoms cease.
  • Food Handling: Thoroughly wash fruits and vegetables. Ensure shellfish are cooked properly before consumption.

Note: ADHS regulations require licensed healthcare facilities and assisted living to implement stringent infection and disease control measures to prevent the spread of norovirus.

Norovirus presents a significant health risk, particularly in communal living environments, which also have people who have a high risk of complications and who can easily get dehydrated.

Note from the Field: The Pima County Health Department is team is actively investigating unknown gastrointestinal outbreaks in congregate care settings and schools, ensuring that samples are sent for testing to confirm etiology.

They work closely with the Consumer Health and Food Safety team whenever permitted food establishments may be involved. Additionally, they are providing ongoing education to our community partners and constituents and have responded to multiple media inquiries to raise awareness.

While individual case investigations are not required for non-outbreak cases, they frequently reach out to assess whether individuals work in sensitive occupations or belong to sensitive populations. This helps them implement appropriate public health measures when necessary. 

Legislative Update

The House and Senate Health and Human Services Committees are finally starting to have robust agenda. Multiple bills in each of those committees this week. Nothing earthshatteringly good or bad though – although we have signed up in support or opposition to some of them. Probably won’t ask to testify in committee though.

Here’s a link to our latest tracking worksheet – when you click on the bill number it should take you to the actual bill.