Guidance for Prevention of Norovirus Outbreaks in Daycare Facilities and Schools

Guidance for Prevention of Norovirus Outbreaks in Daycare Facilities and Schools

Communicable Disease Prevention

Author: Epidemiology & Communicable Disease Staff/Thursday, November 18, 2010/Categories: Norovirus, Home Page, Educating the Public, Disease Prevention and Control

Rate this article:
No rating

Norovirus, formerly called norwalk-like virus, is a virus that causes acute gastroenteritis in humans. The most common symptoms of norovirus are diarrhea, vomiting, and stomach pain. Norovirus is very contagious, and is spread through contaminated food or water, by contact with an infected person, or by contamination in the environment. The virus has an incubation period of 24-48 hours. Infected individuals are symptomatic for 1-2 days, but may shed the virus for up to 2 weeks after recovering. Norovirus outbreaks are common in schools and daycare facilities. In 2010, Illinois has experienced a greater number of outbreaks than is normally expected. Steps daycare facilities and schools can take to reduce transmission of norovirus are outlined below.


Children and staff who are experiencing symptoms of norovirus should stay home from school or daycare until 24 hours after symptoms have stopped.

Staff involved in food preparation should be restricted from preparing food for 48 hours after symptoms stop. The staff may perform other duties not associated with food preparation 24 hours after symptoms have stopped.

Hand hygiene:

Good hand hygiene is the best way to prevent transmission of norovirus.

Hands should be washed with warm water and soap for 15-20 seconds.

Children should be taught good hand hygiene practices, and should wash their hands after using the bathroom and before eating.

 Staff, especially staff responsible for caring for diapered children, should wash their hands frequently. During outbreaks, washing hands with soap and water is preferable to using alcohol-based hand sanitizers. Hand sanitizers are only minimally effective against norovirus.

Norovirus is highly contagious. The virus can live on surfaces for up to 12 days and has a very low infective dose (<100 viral particles). Proper environmental control measures are essential to preventing infection. If a vomit or fecal spillage occurs, the area should be sanitized with an Environmental Protection Agency-approved disinfectant or a freshly prepared sodium hypochlorite solution. The hypochlorite (bleach) solution should be a 1:50 dilution; mix 1/3 cup bleach with 1 gallon water. For heavily soiled surfaces, use a dilution of 1:10, or 1 2/3 cup bleach to one gallon of water. Allow the solution to be in contact with the surface for 10-20 minutes or until it has air dried. Materials that may be put in children’s mouths (e.g. toys) should be rinsed. For porous surfaces such as upholstered furniture, carpets or clothing, clean visible debris with an absorbent, double-layermaterial. Steam clean orwash thecontaminated surface at158°Ffor5minutes or 212°Ffor1minute. Custodial staff shouldwear masks andgloves when cleaning areascontaminated by feces or vomitus. Throw away all disposable materials in sealed bags. Bathrooms and other communal spaces should be cleaned more frequently during suspected norovirus outbreaks. Frequently touched surfaces, such as door handles, telephones, and computer mice, should be disinfected with an approved product.

Norovirus is often spread through contaminated food or water. Facilities serving or sharing food should take these extra precautions:

Restrict sharing of foods brought from private homes.

Restrict students’ sharing of any communal food items in classrooms. Instead, the teacher should hand out items to be shared after washing his/her hands.

Stop using self-service food bars. Do not let children serve themselves in any manner which might promote direct hand contact with shared foods.

Outbreak detection and reporting:

Daycare facilities and schools are required to report all confirmed or suspected outbreaks of norovirus to the Will County Health department as soon as possible. It is reasonable to initiate investigation, implement prevention and control measures, and contact the Will County Health Department in the following situations: 

Two or more students in a classroom or group of students with onset of vomiting and or diarrhea on the same day.

A doubling in the number of students absent due to a vomiting and/or diarrhea over that of normal for a particular time of year is indicative of an outbreak.

Maintain a daily log of the number of students and teachers absent due to GI illness.

Although the number of cases might not meet the above definition of an outbreak, it is prudent to contact the Will County Health Department with any unusual cluster of gastrointestinal illness. Please also refer to any additional guidance from Will County Health Department regarding reporting of suspected norovirus outbreaks.
Report all confirmed or suspected outbreaks of norovirus to the Will County Health Department, Epidemiology and Communicable Disease Program at (815)740-4427.



Number of views (12976)/Comments (0)

Tags: Norovirus
Epidemiology & Communicable Disease

Epidemiology & Communicable Disease

The mission of the Epidemiology and Communicable Disease Program is to protect and promote the health of Will County residents.
Epidemiology News
Please Don't Feed The Animals

Please Don't Feed The Animals

Wild Animals Can Carry Dangerous Diseases

If you live in Will County, you have probably seen deer, coyotes, foxes, and other wildlife frolicking not far from your home. Local population growth has reduced animal living space and forced wildlife to seek shelter in, or very near residential communities.  Lee Schild D.V.M. believes animals and humans can still coexist peacefully, but he knows that humans need to make sure wild animals don't get too close.

SITUATION AWARENESS BRIEFING: Deadly MERS Virus Hits Uncomfortably Close To Home

International Travel Brings Dangerous Diseases to Our Doorstep

Middle East Respiratory Syndrome (MERS), a potentially fatal virus which has now sickened hundreds in 12 countries and carries a fatality rate of more than 30 percent. In 2012, health officials from the Arabian Peninsula reported the first cases of what is now called Middle East Respiratory Syndrome (MERS), a potentially fatal virus which has now sickened hundreds in 12 countries and carries a fatality rate of more than 30 percent.

Influenza Activity in Illinois is Now Confined to Local Outbreaks

Influenza Has Peaked According to the CDC

This article contains updates to the article posted February 20, 2013.

According to the CDC, the influenza outbreak that was so widespread during much of the winter has peaked and activity has decreased in most parts of the U.S. During the latest reporting period (the week ending March 3-9), there were no states reporting high influenza-like activity. According to the latest Overview of Influenza Surveillance in the United States, Illinois has gone from reporting high flu incidence to reporting only localized outbreaks. 

Health Department Recommending Flu Shots for the Unprotected

It's Not Too Late for a Flu Shot!

Most area students are returning to the classroom this week, and the Will County Health Department will be watching. Illinois is one of nearly 40 states currently experiencing widespread influenza activity and the Health Department will be monitoring school attendance to help gauge the severity of the local problem. If current trends continue, the 2012-2013 flu season could be memorable. 

Community-Associated  MRSA Information for the Public

Community-Associated MRSA Information for the Public

Frequently Asked Questions About MRSA

What is Staphylococcus aureus (staph)?

Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25% to 30o/o of the population is colonized (when bacteria are present , but not causing an infection) in the nose with staph bacteria.