Aaron Baunee

Who: Nearly everyone is susceptible to norovirus, and the symptoms can be serious, especially for young children and older adults with compromised immune systems. What: Each year, norovirus causes about 21 million illnesses and contributes to about 70,000 hospitalizations, including some 800 deaths from symptoms similar to those seen with influenza. Where: Common on cruise ships, in daycare centers, amongst retirement communities and other locations where individuals are in close quarters, norovirus can spread quickly if not eradicated immediately through disinfection or sterilization. When: In the U.S., norovirus outbreaks are virulent from November to April — leading to the common classification of norovirus as “the winter vomiting bug” — and the virus can remain live in fecal matter for two weeks or more after an individual stops exhibiting symptoms. Why: Norovirus, which has numerous strains, is transmittable from an infected person, tainted food and water or by touching contaminated surfaces; being infected with one type of norovirus will not cause immunity in other strains, and one can fall ill with norovirus numerous times throughout their life. Norovirus is a highly contagious strain of microorganisms that cause inflammation of the stomach and large intestine, otherwise known as acute gastroenteritis. The leading cause of gastroenteritis in the U.S., norovirus was originally called the Norwalk virus after the town of Norwalk, Ohio, the location of the first confirmed outbreak in 1972. According to Jeff Anderson, Ph.D., public health and sanitation science manager for Procter & Gamble Professional, institutional settings are the most common types of facilities associated with outbreaks because they are generally occupied my large numbers of people. “Given their nature, institutional settings simply have more opportunities for the virus to enter the facility on infected individuals, food and water, which can then be transmitted to high numbers of individuals via food, contaminated surfaces, contaminated water and through person-to-person interaction.” Symptoms, which include stomach pain, nausea, diarrhea and vomiting, are best avoided by proper and frequent handwashing and by adhering to general cleanliness and hygiene guidelines, as there are no specific medicinal treatments to cure norovirus. Nick Pangaro, operations manager for KBM Facility Solutions, asserts, “You don’t have to stand in a restroom for long to see how many people don’t wash their hands; proper handwashing is one of the most effective lines of defense against norovirus and, unfortunately, many people don’t do it.” But, it is wholly impractical for one to wash and/or sanitize his or her hands after every surface they touch — we would be a population of perpetual handwashers with no time to do anything else. According to Kim LaFreniere, Ph.D., associate research fellow for Clorox Professional Products Company, norovirus outbreaks are difficult to contain and eliminate because of the highly contagious nature of the virus. “It takes as few as 18 virus particles to cause an infection and, once infected, a person is capable of quickly infecting many others,” notes LaFreniere. Therefore, the only solution is regimentation through proper, frequent cleaning and disinfection, with particular attention paid to high-touch surfaces. “Not just any disinfectant will deactivate novovirus,” stresses Anderson. “Because they can be a challenging organism to deactivate, only disinfectants approved by the U.S. Environmental Protection Agency (EPA) that are registered for norovirus should be used to disinfect surfaces and help prevent and eradicate outbreaks.” Stick To A Plan If your department or company already adheres to established infection control guidelines — you use a disinfectant with a noted kill claim for norovirus and allow for the allotted dwell time, sufficient personal protective equipment (PPE) is utilized by applicable personnel, staffs are continuously trained and educated on emerging pathogens and best practices, etc. — then managing a norovirus outbreak in your indoor environment may require little to no changes in protocol. “Facilities managers need to make sure their buildings are cleaned for health and not just for appearance,” offers Pangaro. “More businesses are opting for appearance-based cleaning, which basically just ensures the building looks good and cleaning occurs where the dirt is visible instead of where the germs and bacteria are present.” However, if you are waiting and addressing germs, bacteria and viruses after they breach your guard and negatively affect the wellbeing of building occupants and staffs, it would be wise to create some guiding principles. As Steven Powers, product specialist for Genesan LLC, points out, simple measures beyond proper hand hygiene that can be taken to conquer a norovirus outbreak include cleaning and disinfecting contaminated surfaces with either a bleach-based cleaner or a hospital-grade disinfectant that has a norovirus efficacy claim. Powers adds, “Once infected, people should minimize contact with others for three days after recovering.” Although the practice of quarantining infected populations is often employed as a way to reduce the spread of norovirus and allow custodial professionals to thoroughly disinfect surfaces without hindrance, some would argue that isolation is not necessary. “A common misconception about norovirus and the procedures necessary to eradicate an outbreak is that sick people need to be isolated from the general population,” says Darrel Hicks, director of environmental services for St. Luke’s Hospital and the author of Infection Prevention for Dummies. Hicks cautions that norovirus can strike any building, facility or institution where cleaning staffs are not properly equipped or trained on proper cleaning and disinfection procedures — regardless if sick individuals are present or not. Norovirus and other pathogenic outbreaks have become an unintended consequence of surviving the economic downturn; to remain profitable, many companies and organizations are trimming their workforces and asking more of those who remain employed. “The cleanable square footage of hospitals, nursing homes and other healthcare facilities doesn’t get smaller when staffs are reduced,” proclaims Meaghan Brown, healthcare industry account executive for S. Freedman & Sons Inc. “Now, there just aren’t enough workers to cover an increase in cleaning frequency during high-risk periods.” According to Pangaro, bacteria counts double every 15 minutes, so when you start making cuts to save a few dollars, it can come at a risk to building occupants. An Evolving

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Aaron Baunee

Managing Editor of Cleaning & Maintenance Management Magazine

Articles by Aaron Baunee

Combating A Norovirus Outbreak

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