preparing for & dealing with norwalk virus dave phillips eho health protection
TRANSCRIPT
The States of Jersey Department for
Health & Social ServicesHealth Protection
Public Health Department
Guidelines for dealing with Norwalk&
Norwalk-like viruses in Hotels and GuestHouses
January 2006
WHAT IS NORWALK?
A VIRUS-can’t be treated by antibiotics FROM GROUP CALLED SMALL ROUND
STRUCTURED VIRUSES RENAMED NOROVIRUS VIABLE IN THE ENVIRONMENT FOR 2-3
WEEKS
SYMPTOMS
INCUBATION PERIOD OF 12-48 HOURS
USUALLY LASTS 12-60 HOURS
SYMPTOMS (SUDDEN ONSET) NAUSEA
PROJECTILE VOMITINGABDOMINAL CRAMPSDIARRHOEA
CHARACTERISTICS
VERY CONTAGIOUS 30 MILLION VIRAL PARTICLES
RELEASED DURING 1 VOMITING INCIDENT
100 PARTICLES CAN CAUSE ILLNESS AFFECTED PERSON CAN REMAIN
CONTAGEOUS FOR AT LEAST 48 HOURS AFTER SYMPTOMS STOP
SPREAD
CONTAINED IN VOMIT AND STOOLS OF AFFECTED PERSON
VIRUS BECOMES AIRBORNE SETTLES ON SURFACES
AND FOOD PERSON TO PERSON
SPREAD EATING CONTAMINATED
FOOD
MANAGING A NORWALK OUTBREAK
BE PREPARED – NOW!
DECIDE IN ADVANCE
- WHAT YOU ARE GOING TO DO
- HOW YOU ARE GOING TO DO IT
- WHO NEEDS TO BE INVOVED
MANAGING A NORWALK OUTBREAK
EASILY SPREAD THROUGH STAFF & GUESTS IF NOT CONTROLLED FROM OUTSET
NEW GUESTS ARRIVING WEEKLY MEANS THE OUTBREAK CAN CONTINUE OVER SEVERAL WEEKS OR LONGER
TREAT SUDDEN CASES OF VOMITING OR DIARRHOEA AS POSSIBLE CASES OF NORWALK
CONTROL OF INFECTION TEAM
ESTABLISH A “CIT” BEFORE OUTBREAKS e.g. MANAGER,DEPUTY MANAGER,
HOUSEKEEPER, HEAD CHEF ETC. DON’T FORGET NIGHT SHIFT ! CO-ORDINATE CONTROL MEASURES-GATHER INFORMATION-ARRANGE FOR FAECAL SAMPLE-NOTIFY EHO’s-ARRANGE AND MONITOR CLEANING
COMMUNICATE !
KEEP PEOPLE INFORMED –
STAFF HEALTH PROTECTION G.P.’S NEW GUESTS / EXISTING GUESTS TOUR OPERATORS
Control of Infection in Hotels
Have procedures in place now and train staff
Advise guests if you have a problem- need to stay in room while ill- observe good personal hygiene after symptoms stop
Increase cleaning of public toilets, ‘touch points’, etc, using bleach solution.
Exclusion policy for staff
Control of infection in Hotels
Implement cleaning procedures in full
- correct cleaning materials
- use boiler suits and correct protective equipment
- steam clean or launder soft furnishings
Laundry
Commercial laundries must be notified if you are sending contaminated bedding
ALL soft furnishings in contaminated rooms must be laundered or steam cleaned
If contaminated bedding etc must be securely bagged and taken straight to laundry. Commercial laundries will supply red soluble laundry bags.
Laundry
If using an in-house laundry, all contaminated items must be done after ‘usual’ items.
Clean linen should be removed from the room to prevent cross contamination.
Laundry
A hot wash followed by tumble drying is recommended.
The laundry room must be thoroughly cleaned and disinfected after washing soiled items.
Laundry staff must observe good personal hygiene at all times.
Summary
The virus is very contagious and easily spread
Prompt action is needed to control the spread
The Guidelines should be read and followed closely
Inform HP if you have cases so that help and advice can be provided
FORM AN OUTBREAK CONTROL TEAM Including key individuals e.g. General Manager, Heads of
Departments, Cleaning Supervisor
FORM AN OUTBREAK CONTROL TEAM Including key individuals e.g. General Manager, Heads of
Departments, Cleaning Supervisor
DEVELOP AN ACTION PLANPut key points in writing
DEVELOP AN ACTION PLANPut key points in writing
PROVIDE INFORMATION AND INSTRUCTION TO ALL STAFF RE: ACTION PLAN AND REPOIRTING OF SICKNESS
INCIDENTSE.g. including housekeeping staff, food handlers, coach drivers,
night staff, reception, porters
PROVIDE INFORMATION AND INSTRUCTION TO ALL STAFF RE: ACTION PLAN AND REPOIRTING OF SICKNESS
INCIDENTSE.g. including housekeeping staff, food handlers, coach drivers,
night staff, reception, porters
TRAIN RELEVANT STAFF IN CLEANING METHODSE.g. dilutions, correct use of equipment
TRAIN RELEVANT STAFF IN CLEANING METHODSE.g. dilutions, correct use of equipment
PURCHASE A SUPPLY OF NECESSARY CLEANING EQUIPMENT,
CLEANING CHEMICALS & PROTECTIVE CLOTHING
PURCHASE A SUPPLY OF NECESSARY CLEANING EQUIPMENT,
CLEANING CHEMICALS & PROTECTIVE CLOTHING
PERIODICALLY CHECK SUPPLIES OF CLEANING CHEMICALS TO ENSURE THEY
ARE PROPERLY STORED AND WITHIN DATE
PERIODICALLY CHECK SUPPLIES OF CLEANING CHEMICALS TO ENSURE THEY
ARE PROPERLY STORED AND WITHIN DATE
CONTACT SUPPORT ORGANISATIONS
GP, Health Protection Department, Visitors Clinic,
Contract Cleaners
CONTACT SUPPORT ORGANISATIONS
GP, Health Protection Department, Visitors Clinic,
Contract Cleaners
FORM A CLEANING ‘HIT SQUAD’FORM A CLEANING ‘HIT SQUAD’
FLOW CHART SHOWING ACTION PLAN BEFORE ANOUTBREAK OF VIRAL GASTROENTERITIS OCCURS
FLOW CHART SHOWING ACTION PLAN WHERE ANOUTBREAK OF VIRAL GASTROENTERITIS OCCURS
Q. Are two or more cases with symptoms of viral Gastro-enteritis linked or unaccountably exceed the expected number?
Q. Are two or more cases with symptoms of viral Gastro-enteritis linked or unaccountably exceed the expected number? Monitor situation for new cases of illness
Monitor situation for new cases of illness
CONTACT HEALTH PROTECTION DEPARTMENTCONTACT HEALTH PROTECTION DEPARTMENT
CALL TOGETHER THE OUTBREAK CONTROL TEAM
CALL TOGETHER THE OUTBREAK CONTROL TEAM
Interview Sick Persons Complete Illness Report FormInterview Sick Persons Complete Illness Report Form
Call GP for medical advice where necessary. Request samples to be taken. For subsequent
cases contact the Health Protection Department.
Call GP for medical advice where necessary. Request samples to be taken. For subsequent
cases contact the Health Protection Department.
Activate the cleaning ‘Hit Squad’Activate the cleaning ‘Hit Squad’
Inform staffInform staff
Give information re: good personal hygiene
Give information re: good personal hygiene
Keep sick staff off workKeep sick staff off work
“Persuade” sick persons to remain isolated from other guests
“Persuade” sick persons to remain isolated from other guests
Ensure necessary cleaning equipment is available and used
Ensure necessary cleaning equipment is available and used
Implement Outbreak Control Cleaning Procedures
Implement Outbreak Control Cleaning Procedures
Undertake regular checks of Public Areas and upgrade
cleaning arrangements
Undertake regular checks of Public Areas and upgrade
cleaning arrangements
IS THE OUTBREAK ONGOING?IS THE OUTBREAK ONGOING?
Keep ill staff off work until they have been symptom free for a minimum of 48 hours
Keep ill staff off work until they have been symptom free for a minimum of 48 hours
Interview staff prior to returning to work to ensure they have been symptom free for a minimum of
48 hours
Interview staff prior to returning to work to ensure they have been symptom free for a minimum of
48 hours
1.REVIEW CLEANING PROCEDURES2.PROVIDE GENERAL INFORMATION TO ALL GUESTS (EXISTING AND NEW)3.IT IS RECOMMENDED THAT YOU SPEAK TO YOUR OPERATORS AND ADVANCED BOOKINGS4.CONSIDER COMPLETE/PART CLOSURE OF PREMISES FOR FULL ENVIRONMENTAL DECONTAMINATION e.g. fogging
1.REVIEW CLEANING PROCEDURES2.PROVIDE GENERAL INFORMATION TO ALL GUESTS (EXISTING AND NEW)3.IT IS RECOMMENDED THAT YOU SPEAK TO YOUR OPERATORS AND ADVANCED BOOKINGS4.CONSIDER COMPLETE/PART CLOSURE OF PREMISES FOR FULL ENVIRONMENTAL DECONTAMINATION e.g. fogging
Remain vigilant and monitor situation
Remain vigilant and monitor situation
IF NO FURTHER CASES revert to normal operating
procedures
IF NO FURTHER CASES revert to normal operating
procedures
NO
YESNO
YES
OTHER GUIDANCE
•Dealing with Norwalk - Advice for Coach Operators•Dealing with Norwalk – advice for suppliers and industrial cleaners