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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.
Download & Save Important Public Health Data Before It Disappears
If your work depends on federal public health data, now is the time to act. In the two weeks since President Trump took office, multiple federal websites have already removed key reports, datasets, and surveillance tools that public health practitioners and nonprofit organizations rely on. More and more data are being deleted from servers in several agencies daily – even hourly.
If you use these resources, don’t assume they’ll still be there next week or that some archive website will have captured and preserved them — download and save them now before it’s too late.
Examples of some of the most at-risk resources include:
- Reproductive Health and Family Planning – Data and guidelines related to contraception, abortion access, and maternal health (e.g., Title X program information, reproductive health statistics from HHS).
- Gun Violence Research – Studies and surveillance data on firearm-related injuries and deaths, including CDC and NIH-funded research.
- Health Disparities and Equity Data – Reports on racial, ethnic, and socioeconomic health disparities, including those from the Office of Minority Health and CDC’s Health Equity initiatives.
- Vaccine Information and Data (e.g. child school vaccination rate data)
- Workplace and Occupational Health – Data on worker safety, chemical exposures, and OSHA regulations that protect laborers from hazardous conditions.
- Climate and Environmental Health Data – Information on air and water quality, climate change impacts on health, and environmental justice (e.g., EPA climate reports, CDC’s Climate and Health Program)
- Infectious Disease Surveillance and Prevention – Information on vaccine recommendations, pandemic preparedness, and global disease tracking.
- Substance Use and Harm Reduction – Research on opioid overdose prevention, needle exchange programs, and medication-assisted treatment (e.g., SAMHSA and CDC opioid crisis resources).
- The Behavioral Risk Factor Surveillance System – The gold standard for tracking chronic disease, health behaviors, and access to care at the state level.
- Youth Risk Behavior Surveillance System – Essential for understanding adolescent health trends, including substance use, mental health, and sexual behavior.
- U.S. Preventive Services Task Force Guidelines – Evidence-based recommendations that guide screenings and preventive care.
- Environmental and Occupational Health Data – Information on air quality, toxic exposures, and workplace safety that could be targeted for removal.
- LGBTQ+ Health Resources – Research on health disparities, HIV prevention programs, and transgender healthcare guidelines (e.g., NIH and CDC LGBTQ+ health pages).
These aren’t just abstract concerns. If (when) these resources disappear, Arizona’s public health professionals and nonprofits will lose the ability to track trends, advocate for funding, and implement evidence-based programs.
Set aside time today to download the reports and datasets you use. Save them in multiple locations and share copies with colleagues. If you wait, you may find yourself scrambling to recover information that’s already gone.
Public health depends on data, and right now, that data is at risk. Don’t procrastinate—act now to protect the resources we need to keep Arizona healthy.
Dismantling Discrimination Safeguards: Trump Revokes President Johnson’s Anti-Discrimination Executive Order
Last week Mr. Trump signed the “Ending Illegal Discrimination and Restoring Merit-Based Opportunity” executive order, repealing Executive Order 11246 from 1965, which mandated equal employment opportunities and prohibited discrimination based on race, color, religion, sex, or national origin for federal contractors.
Executive Order 11246, As Amended | U.S. Department of Labor
The revocation of EO 11246 will be damaging to fairness & workplace equality. For the last 60 years this order has improved diversity and prevented some discriminatory practices in the federal government and federal contractors.
Its repeal green lights discrimination in hiring practices, allowing biases to influence employment decisions and potentially marginalizing qualified individuals from underrepresented groups (damaging the social determinants of health and health equity).
The Order even tells the Office of Federal Contract Compliance Programs to stop promoting diversity and holding contractors accountable for affirmative action – a move to extinguish initiative-taking measures that have addressed systemic inequalities in the workplace.
Freezing Carbon Reduction Progress: How a New Executive Order Hurts U.S. Carbon Reduction Goals
This week, the new U.S. president signed an executive order titled “Unleashing American Energy,” which freezes already approved investments in electrification infrastructure. While the order claims to prioritize energy independence and economic growth, Section 7, which pauses federal investments in electrification projects, could severely undermine U.S. efforts to reduce carbon emissions.
Unleashing American Energy – The White House
Electrification is a cornerstone of transitioning to a lower-carbon economy. Investments in electric vehicle charging stations, grid modernization, and clean energy infrastructure are essential to cutting emissions from transportation and energy production—the two largest sources of greenhouse gases in the U.S. Freezing these projects halts progress on these fronts, leaving the country reliant on outdated, fossil-fuel-intensive systems.
Expanding charging networks is critical to encouraging widespread adoption. Without federal support, many rural and underserved areas will remain charging deserts, discouraging potential EV buyers and prolonging reliance on gas-powered vehicles.
The same applies to modernizing the electrical grid, which is essential for integrating renewable energy sources like wind and solar. A pause on grid upgrades delays the transition to cleaner energy and increases the risk of power outages as demand continues to rise.
By hitting pause on electrification, this executive order will leave the U.S. stuck in neutral while the rest of the world speeds ahead on the road to clean energy.
Rural Arizona at Risk: The Dramatic Impact of Project 2025 Medicaid Cuts
A proposed federal budget (and the Trump Administration’s policy template – Project 2025) is proposing to reduce the federal government’s contribution for covering childless adults and other notch populations covered by AHCCCS in Arizona, which would leave over 550,000 Arizonans without coverage—primarily childless adults.
Rural Arizonans to feel outsized burden of proposed Medicaid cuts
The proposed cuts would slash over $1 billion from Arizona’s Medicaid budget by changing the federal contribution for childless adults and the expansion population (people from 100 to 138% of federal poverty) from 90% to 64%.
Such a move would cancel the state statute that authorizes AHCCCS to collect a hospital assessment to pay for the state portion for these 550,000 people.
Rural Arizona, which overwhelmingly voted for Trump, stands to lose the most. For rural communities, this would mean shuttered clinics, overwhelmed emergency rooms, and longer drives to access care.
Medicaid is a critical source of funding for rural hospitals, accounting for up to 60% of their revenue in some cases. Without it, these facilities may close their doors, forcing residents to travel for hours for even basic medical needs.
The High Stakes of Medicaid Cuts: What Arizona Stands to Lose
Childless adults, who make up the majority of those at risk of losing coverage, are important to rural economies. They include farmers, ranchers, service workers, and small business employees. Without access to healthcare, their health—and their ability to work—will suffer, creating ripple effects across entire communities.
Medicaid’s Role in Small Towns and Rural Areas – Georgetown Center For Children and Families
Medicaid doesn’t just help people – it supports jobs and keeps healthcare facilities afloat. When Medicaid funding is cut, everyone feels the impact, from healthcare workers to local businesses that rely on healthy customers.
Rural Arizona deserves better. Cutting Medicaid would disproportionately harm the very communities that rely on it the most.
It’s time for rural policymakers (e.g. Rep Ciscomani) to recognize the real-life consequences of these decisions and prevent congress from reducing the federal contribution for covering childless adults.
Action Alert: Urge Senators Kelly & Gallego to Vote NO on RFK Jr’s Nomination as HHS Secretary
RFK Jr Confirmation Hearing this Wednesday in the Senate Finance Committee
The nomination of Robert F. Kennedy, Jr. as Secretary of the U.S. Department of Health and Human Services is extremely concerning given his history of basing his opinions and policy priorities on hunches rather than evidence. As the department that oversees CMS (Medicare & Medicaid), CDC, HRSA, NIH, FDA HHS requires leadership with relevant experience and the proven ability to trust and follow evidence & science. Mr. Kennedy does not.
Mr. Kennedy will be in front of the Senate Finance Committee this Wednesday and on the floor of the Senate later in the week. I’ve already contacted Senator Kelly and Gallego’s offices urging them to vote No on Kennedy’s confirmation this week – and you can do so too by using the APHA’s Action Center to let the Senators know how you feel.
Late January Legislative Session Update
The 2025 legislative session has gotten off to a slow start this year. In previous years the committees have been pretty active. No bills of public health consequence were heard last week.
This week there are a few, but not many. Here are the bills up this coming week:
House Regulatory Oversight (Tuesday 2pm)
HB2055 immunizations; requirements; exemption (AZPHA position is NO)
Declares that school/employer immunization requirements must include exemptions unless strict criteria are met that go way beyond current vaccine licensing requirements for every school required vaccine like co administration testing with combinations of vaccines, long term evaluation for cancer/infertility, 2 year post clinical trials against placebo/similar vaccine, ADHS post injuries/disease caused by vaccine, etc. It also would remove all conditions when claiming a personal exemption.
House Health (Monday 2pm)
HB2001behavioral health; temporary licensure; graduates (AZPHA Position YES)
Requires the Arizona Board of Behavioral Health Examiners to issue temporary licenses to behavioral health graduates who are applying for an associate level license. Temporary licensees would still need to work under the direction of a fully licensed professional. Includes counseling, marriage and family therapy, social work and addiction counseling.
Public Health Related Bills So Far:
House
HB2001 behavioral health; temporary licensure; graduates YES
HB2012 emergency use products; employers; prohibition
HB2022 school safety; employee certification; policies NO
HB2055 immunizations; requirements; exemption NO
HB2057 parental rights; medical records
HB2058 school immunizations; exemption; adult students
HB2062 sex-based terms; laws; rules; regulations
HB2063 parental notification; school immunization exemptions
HB2125 insurance coverage; hearing aids; children YES
HB2130 claims; prior authorization; denials; contact YES
HB2145 registered sanitarians; qualifications YES
HB2159 prohibited weapon; bump-fire device; accessory YES
HB2165 SNAP; prohibited purchases; waiver YES
HB2175 claims; prior authorization; conduct YES
HB2211 severe threat order of protection YES
HB2214 failure to secure weapon; minor YES
HB2250 AHCCCS; preventative dental care YES
HB2276 legislative ratification; rulemaking; regulatory costs NO
HB2293 tobacco products; vaping; minimum age YES
HB2309 vacation rentals; short-term rentals; restrictions
HB2518 employment; prohibitions; corporation commission YES
HB2619 assault weapons; magazines; prohibition; registration YES
HB2620 firearm sales; permit verification; requirements YES
HB2621 firearm sales; transfers; background checks YES
HB2683 working conditions; heat illness; prevention YES
Senate
SB1019 photo enforcement systems; prohibition NO
SB1020 disruption; educational institution; concealed weapon NO
SB1043 homeless shelter services fund; appropriation YES
SB1044 secure behavioral health facilities YES
SB1045 secure behavioral health facilities; appropriations YES
SB1046 mental illness; prisoners; diagnosis; treatment YES
SB1125 psychologists; prescribing authority YES