Sacramento Has Seen an Increase in Norovirus Outbreaks
Commensurate with other areas of California and the nation, the County of Sacramento is registering an increase in the number of facilities reporting norovirus outbreaks. The year 2006 closed with a total of 24 (some overlap in facilities) outbreaks, as compared with 11 reported in 2005.
As required by law, licensed facilities reported gastrointestinal illness outbreaks to Sacramento County's Division of Public Health. In each outbreak, the facility implemented measures to control the outbreak, consistent with state standards.
Analysis of the data does not indicate that Norovirus is spreading between facilities, but rather that the increased number of outbreaks is a reflection of a marked worldwide increase in norovirus outbreaks, which may be due to new strain evolution.
The Sacramento County Communicable Disease Controller, Dr. Vivian Belmusto, with the assistance of the California Department of Health Services, has developed supplemental recommendations for the control of Norovirus outbreaks in facilities. These guidelines were sent to long-term care facilities in Sacramento County on January 2nd, 2007. It is expected that this additional information will assist in decreasing the spread of the disease.
Norovirus may be transmitted through food and water contamination and person-to-person spread. Some factors contribute to the easy spread of this virus. Very small amounts of the virus can produce disease, people without symptoms can shed the virus, and humans do not develop permanent immunity to the virus.
In addition, the virus can remain viable in the environment for some time. In long-term care facilities control measures include having residents who are sick remain in their rooms until at least 48 hours after symptoms cease, excluding non-essential staff, volunteers and visitors from the affected areas of the facilities, and postponing new admissions to affected areas until there have been no new cases for at least 48 hours. In addition, strict hand hygiene is a must. Washing hands frequently with soap and water is the most effective way of eliminating the virus from hands. In addition, since the virus can be aerosolized and spread when someone vomits, clean-ups should be done quickly and linens and rags used for cleaning should be bagged with minimal handling. Environmental surfaces should be disinfected with chlorine-containing solutions whenever possible, as these are shown to be effective in destroying Norovirus.