COMBATING INFECTION: Recognizing and preventing norovirus infection
Steven J. Schweon MPH, MSN, RN, CIC, HEM

June 2012 
Volume 42  Number 6
Pages 68 - 69
  PDF Version Available!

FIRST DESCRIBED IN 1929 as "winter vomiting disease," norovirus infection is caused by a group of viruses that are the most common cause of gastroenteritis: They're responsible for over 23 million cases annually.1,2 Because they were first identified in a gastroenteritis outbreak in Norwalk, Ohio, they were previously called Norwalk-like viruses.3 One in 14 Americans become ill from norovirus infections each year, resulting in 91,000 ED visits and 71,000 hospitalizations.4 All age groups are susceptible, but older adults may have more severe outcomes and longer illness.4Hospitalized patients who are immunocompromised or who have significant medical problems can have a longer length of stay and additional medical complications. They're also at greater risk for relapse. Some patients with norovirus infection die, although this is rare.Noroviruses are classified into six subgroups, with multiple variants emerging and becoming the predominant causes of disease.5 Reasons include increased pathogenicity and transmissibility, and decreased population immunity.2Introduced into healthcare facilities by patients, visitors, or staff, noroviruses may be responsible for more than 50% of hospital and long-term-care gastroenteritis outbreaks.2 Outbreaks have also been reported in schools, day-care centers, hotels, prisons, restaurants, and cruise ships. Norovirus can contaminate curtains, carpets, cushions, bedside commodes, toilets, handrails, faucets, telephones, door handles, kitchen surfaces, and elevator buttons. Norovirus is very stable in the environment and can persist for up to 28 days.2Noroviruses are highly contagious. They're easily transmitted from contaminated foods such as bakery products, shellfish, sauces, sandwiches, fruits, vegetables, and salads; the hands of ill food handlers who prepare meals (fecal-oral transmission); and water (from wells, ice, lakes, swimming pools).1 Aerosol exposure from vomiting persons can lead to norovirus being swallowed.In healthcare

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