Norovirus - Information for Employers

Gastroenteritis due to norovirus can be very disruptive to organisations and businesses. The following information is intended to provide guidance on the management of noroviral infection for employers.

What is Norovirus
Norovirus (NoV) is a virus that causes one of the commonest forms of gastroenteritis. Every year as many as 5% of the population will develop it. Although it is known commonly as ”winter vomiting disease” it occurs throughout the year, however in winter, people tend to be in closer contact indoors making spread more likely. Outbreaks occur in hospitals, nursing and residential homes, nurseries, schools, hotels, cruise ships and places of employment – anywhere in fact, large numbers of people gather. As norovirus is so very infectious, when outbreaks occur, it can affect large numbers of people. Not uncommonly, outbreaks can be so extensive that they lead to closure of affected facilities (hospital wards/hotels/reception and residential centres/businesses etc). Therefore, a very rapid, effective response to episodes of vomiting is needed to avoid closure.

The main symptoms are vomiting and diarrhoea but patients can develop headaches, muscle aches, fever, and abdominal pain. The vomit from someone with NoV is highly infectious and any surfaces, food or water contaminated by vomit or faeces can lead to spread of the disease. Not all episodes of vomiting will be due to norovirus, but all vomit should be treated as infectious and cleaned up as outlined below.

The onset is sudden and the illness is generally mild (although it can be more severe in older people). The duration of the illness is normally short, rarely more than a couple of days and most people make a full and rapid recovery. Symptoms usually appear within 24-48 hours of being exposed to the virus. Even after a patient’s vomiting or diarrhoea has stopped, they go on shedding virus from their body for at least 48 hours. Ensuring that staff do not return to work is extremely important in limiting the onward spread of infection. For more information about NoV see HPSC Norovirus - Frequently Asked Questions.

Are there any types of employees who present a particularly high risk of spread?
Certain groups of staff have a very high potential for spreading NoV and this can lead to illness being passed on to vulnerable groups. These include:

• Food handlers whose work involves unwrapped or ready to eat food,
• Health care staff who have contact with food or patients,
• Those who may find it difficult to practise good personal hygiene

In addition, children aged below 5 years attending nurseries, playgroups, etc are at greater risk of contracting and spreading norovirus.

What can I as an employer do to protect my staff?
Anyone who has gastroenteritis due to NoV is very likely to infect other staff members (and also clients or customers). The following simple steps are important in protecting your staff and limiting any possible spread of NoV.

1. NoV is very common; it is important to be prepared for the possibility of sickness in the workplace by having any necessary cleaning equipment and staff designated to clean and decontaminate soiled areas.

2. If staff report in sick with symptoms of NoV they should remain off work until their vomiting and diarrhoea has stopped and for 48 hours afterwards. Staff returning to work while still infectious are very likely to reintroduce infection make even more staff members ill.

3. If a staff member vomits in work:

• The vomit should be cleared up immediately (see How can spread of NoV be prevented? below) and
• The staff member should remain out of work until they have been free from vomiting and/or diarrhoea for 48 hours.

How can spread of NoV be prevented?

• Following any episode of vomiting, the vomit should be treated as potentially infectious.
  As far as possible a staff member should be designated to clean and decontaminate soiled areas. This person should never be employed in food preparation.
• Cleaning up after a vomiting (or faecal) accident, using hot water and detergent is important. If a staff member vomits, follow these steps:

I. Cover the area of vomit or diarrhoea (with paper towels – this soaks up excess liquid)
II. Clear other staff away
III. Cordon off the immediate area
IV. Call the staff member responsible for cleaning who will
V. Clean and decontaminate the area.

• When cleaning up vomit or diarrhoea, staff should protect themselves by wearing disposable rubber gloves and if available wear a plastic disposable apron.
• Carefully remove the material for safe disposal – a plastic dustpan is a useful scoop.
  The material should be then flushed down the toilet.
• When as much of the material as possible has been removed, thoroughly wash the area and any equipment used with detergent and hot water and then disinfected with 0.1% hypochlorite (bleach) solution. (The concentration of supermarket domestic bleach solutions is variable and the dilution recommended by the manufacturer for disinfection of surfaces should be used.) Cloths should be disposed of as waste.
• Wash down food contact surfaces with detergent and hot water, using a disposable cloth, then disinfect with 0.1% bleach solution. Thoroughly clean soiled carpets and soft furnishings with hot water and detergent or carpet shampoo. Steam cleaning can be used if available.

Hand washing is important in preventing the spread of Norovirus.
Thoroughly wash your hands with soap under warm running water:

• After using or cleaning the toilet
• After attending to anyone with diarrhoea or vomiting
• After touching anything contaminated by diarrhoea or vomiting
• After handling contaminated clothing or bedding (including nappies)
• Before handling, preparing, serving, or consuming food or drink

Cleaning toilet areas
If the toilet has been used by someone who is ill:

• When cleaning the toilet, always wear household rubber gloves and a plastic apron if available
• Disinfect the toilet seat with hot water followed by bleach solution, using a disposable cloth.
• Wash and disinfect with bleach solution the toilet door handle, wash hand basin taps and flush handle after use
• Clean the toilet bowl using a toilet brush and bleach. Rinse the brush by flushing the toilet.
• Do not use the rubber gloves for any other purpose
• Always flush the toilet with the seat and lid down.

For more information about NoV see HPSC Norovirus - Frequently Asked Questions

Further detailed information about tackling norovirus can be found in HPSC Norovirus - Publications.

Updated 25th April 2022