Institute Of Child Nutrition
The University of Mississippi
School of Applied Sciences
Everyone Plays a P.A.R.T. –
Norovirus Control in
Child Care Facilities
Goals for Today
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What is norovirus
Why it is a concern in child care settings
What the symptoms are
How it is transmitted
 Describe norovirus control
◦ Prevention
◦ Assemble a Body Fluid Cleanup Kit
◦ Respond to an incident
◦ Total cleanup
A Case of Norovirus - Video
 What mistakes were made?
 Video viewing guide
Why is Norovirus a Concern?
 Leading cause of foodborne illnesses
• More than 50% of all food-related outbreaks
 Survives at least a week on surfaces
 Very resistant to routine cleaning and sanitizers
Norovirus Symptoms
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Nausea
Vomiting
Diarrhea
Abdominal cramps
 Onset – 1 to 2 days after exposure
 Duration - 1 to 3 days
Highly Contagious
• About 1 Trillion viral particles per gram of feces
• About 300 thousand virus particles in one projectile
vomiting incident
• About 18 viral particles to make you sick
2013 FDA Food Code
Norovirus Transmission
In stool or vomit of
infected people
Food
Contact
Transmission through
–
–
–
–
–
Person to person
Food
Water
Environmental surfaces
Air
Water
Surfaces
Other
Hall 2012 Preliminary CDC Data
Transmission by Air: 25 feet
Everyone Plays a P.A.R.T.
 Prevent through good personal hygiene
 Assemble a Body-Fluid Cleanup Kit
 Respond correctly to a vomiting incident
 Total cleanup after an incident
Prevent
Use frequent, appropriate handwashing
Handwashing
 Video viewing guide – Page 13
Prevent
Do not use bare hand contact with ready-to-eat foods
Prevent
Report symptoms:
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Vomiting
Diarrhea
Jaundice (yellowing)
Sore throat with fever
 Cuts & infected wounds on
the hands, wrists, or
exposed portions of the
arms.
 A current, recent or
exposure to a foodborne
illness
Prevent
 Exclude: to prevent a person from working as a
foodservice employee in the foodservice operation or
entering the foodservice operation as an employee.
 Restrict: to limit the activities of a foodservice
employee so that the foodservice employee does not
work with exposed food, clean equipment, utensils,
linens, or single-service or single-use articles.
FDA “Three-Legged Stool”
FDA “three legged stool” for norovirus protection:
1. Effective handwashing
2. No bare hand contact with ready-to-eat foods
3. Employee health program
A Challenge….
 Identify the components of a Body Fluid Cleanup Kit
 Which components are for Personal Protection
Equipment (PPE)?
 Which components are for cleaning?
Items
PPE
Bucket and spray bottle
Disposable gown
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Effective disinfectant*
Facemask with eye protection or goggles
Gloves
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Paper towels
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Plastic garbage bag
Sand or liquid spill absorbent material
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Flat-edged scoop, small shovel or dustpan
Shoe covers
Cleaning

Assemble
Personal Protective Equipment
 Disposable, non-latex, medical grade
gloves
 Disposable facemask with eye
protection or goggles
 Disposable shoe covers
 Disposable gown
Assemble
Cleaning Supplies
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Sand, or liquid spill absorbent material
Disposable flat-edge scoop, shovel, or dustpan
Bucket and spray bottle
Disposable paper towels
Liquid soap
Designated, disposable mop head
Plastic garbage bag & twist-ties
Assemble
Disinfectants
 EPA-registered effective against norovirus
 http://www.epa.gov/oppad001/list_g_norovirus.pdf
 Chlorine bleach (5.25% - 8.25% concentration)
 1000-5000 parts per million =
 1 1/2 cups bleach per 1 gallon of water
Respond
 Stop all operations
 Remove individuals within 25 feet
 Require handwashing
Respond
Put on Personal Protective Equipment
Respond
Cover and remove the waste; re-glove.
Respond
Reglove
Respond
Clean the affected area
Respond
Mix, then spray fresh disinfectant to saturate the waste
& adjacent 25 foot area– Include food contact surfaces
Respond
Disinfect high-tough surfaces
Respond
Rinse
Respond
Disinfect cloth surfaces
Respond
Dispose of exposed foods
within 25 feet
Respond
Disinfect non-disposable tools
Respond
Remove Personal Protective Equipment
Total Cleanup
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Wash
Rinse
Sanitize (routine)
Air dry
 Restock
Everyone Plays a P.A.R.T.
 Prevent through good personal hygiene
 Assemble a Body-Fluid Cleanup Kit
 Respond correctly to a vomiting incident
 Total cleanup after an incident
Knowledge Challenge
 Self-check
 Post-assessment
Resources from ICN
www.theicn.org/norovirus
 18 –Minute Video
 Online courses
 Tool kit
 Standard operating procedures
 Fact sheets
 Mini posters
 Employee Health & Personal Hygiene
 http://www.theicn.org/ResourceOverview.aspx?ID=430
Resources
 The Stomach Bug Book
 Available online at
http://www.fns.usda.gov/fns/safety/pdf
/stomach_bug_book.pdf
 Hardcopies available from NEA
http://www.neahin.org/HINPrograms/
order.html
Training Wrap-Up
 Questions?
 ICN Evaluation
 ICN Roster
Institute of Child Nutrition
www.theicn.org
800-321-3054
The University of Mississippi
School of Applied Sciences