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It’s noro season, and while cases can happen year-round, they’re highest from late fall to early spring. Norovirus is spreading globally right now, with a particularly high rate in the UK, about 66% higher than it usually is at this time of year in a non-pandemic year. In the US, the overall rate isn’t actually any worse than it was this time of year pre-pandemic, but rates have been very low over the past three years because COVID precautions were also preventing the spread of noro. So here, we’re seeing a return to normal levels of norovirus, though cases aren’t consistent across the US, but spread through outbreaks and hotspots. Right now, cases are highest (and still rising) in the midwest.
Norovirus generally causes repeated diarrhea and vomiting - sometimes at the same time. It can also include fever and stomach pain, but its hallmarks are GI distress. It happens 12-24 hours after exposure and generally lasts one to three days. It can be hard to know just based on symptoms whether you have noro or some other “stomach bug” or foodborne illness without lab testing, which is generally only done if someone is sick enough to go to the emergency room (which with norovirus is rare, and usually for dehydration). If it lasts more than 3 days or has symptoms other than vomiting, diarrhea, fever, headache, and body aches, it may be some other illness.
Norovirus is responsible for a full 50% of foodborne illness outbreaks, and restaurants are the most common setting for noro outbreaks. According to a Johns Hopkins study, a single norovirus outbreak can cost a casual restaurant $2.2 million, so the stakes are high. First and foremost, make sure employees do NOT work while sick, especially if they have vomiting or diarrhea. Share the symptoms of noro and make sure employees know it’s a big deal if they work sick with GI symptoms. If someone gets sick at work, send them home ASAP and make sure to clean up properly with a body fluid clean-up kit. Do a full cleaning with a noro-approved sanitizer (see the list here and remember that QUAT doesn’t kill noro!). Pay extra attention to bathrooms and their highest touch areas, and step up handwashing and glove use to the next level for a few days. Employees who are sick can return when they’re 48 hours symptom-free for noro.
If a guest or employee becomes sick, first, make sure they’re safe and then send them home as soon as possible. If they vomited anywhere but the toilet, use a body fluid cleanup kit. Put one person in charge of clean up to reduce the number of people exposed and ensure they wear proper PPE. If you think it could be norovirus, you’ll need to do a full cleaning and sanitizing of the space. Norovirus in particular is incredibly transmissible - a sick person sheds billions of virus particles, but it only takes eighteen to get someone else sick! If someone is sick with noro, they’re likely to be quite ill - this isn’t one isolated vomit or case of diarrhea, but ongoing. Be sure to do a full noro sanitizing protocol if someone got sick with noro-like symptoms in the restaurant, even if it was in the bathroom.