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This message is being sent to the following lists: Local public health officers, Tribal health directors, enteric diseases program, local health department nurses, local public health department staff, infection prevention, Division of Quality Assurance Notifications, and Bureau of Assisted Living Forum.
Acute Gastrointestinal Outbreaks and Norovirus Guidance and Resources
Norovirus season is upon us. We are seeing a greater than usual number of outbreaks for the norovirus season. Norovirus is the number one cause of vomiting and diarrhea and the cause of most acute gastroenteritis (AGE) outbreaks. It is very contagious and spreads easily. Most people will recover within 1 to 3 days but some groups particularly young children, older adults, and people with other illnesses are more at risk of becoming severely dehydrated. Learn more about norovirus on the DHS Norovirus Webpage.
AGE outbreaks
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Long-term care facilities should notify their local or Tribal health department of any suspected or confirmed outbreak.
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Suspected and confirmed AGE outbreaks should be reported by local and Tribal health departments to DPH within 24 hours.
The definition of a suspected outbreak is different depending on the setting of the outbreak.
Long term care facilities: Three or more residents and/or staff experiencing norovirus symptoms within a 72-hour period and have a geographic communality (i.e., same wing, unit, floor).
Other settings: Two or more people with similar gastrointestinal symptoms and a suspected common exposure, such as shared food, animal contact, or venue.
Guidance for local and Tribal health departments
Wisconsin Electronic Diseases Surveillance System (WEDSS) outbreak module
The outbreak module in WEDSS facilitates reporting of acute gastroenteritis (AGE) and norovirus outbreaks occurring in LTCFs via WEDSS. Local health departments should enter all AGE outbreaks occurring in LTCFs into WEDSS using the outbreak module and may also use this module as their reporting tool.
When either acute gastroenteritis (AGE) outbreak or Norovirus Outbreak is selected as the disease name in a WEDSS outbreak, an AGE Intake tab and an OB-Supplemental tab will appear. The information requested in the AGE Intake tab should be filled out completely when reporting a new outbreak. This process is similar to the process used for reporting respiratory outbreaks in LTCFs.
A phone call is not required for reporting suspect AGE/Norovirus in LTCFs unless additional consultation with an epidemiologist is needed. This WEDSS reporting process ONLY applies to LTCF outbreaks. All other outbreaks should still be promptly reported by phone.
Guidance documents are available on how to report AGE outbreaks in WEDSS for long-term care facilities and other settings. We encourage all local health staff responsible for managing and reporting outbreaks to review this information. If you have any questions about reporting an AGE outbreak, email the Enterics Team at DHSDPHEnterics@dhs.wisconsin.gov.
Guidance for long-term care facilities
Long-term care facilities should prepare for possible AGE outbreaks by following the recommendations below.
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Develop and implement routine surveillance for gastrointestinal infection in residents and staff to more rapidly identify illness and outbreaks. Routine monitoring provides a baseline and helps to identify increases in disease that may signal an outbreak.
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Make contact information for the local health department and key health care partners readily available. Post contact information in a visible location.
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Provide information to residents and staff (in-services, notices, posters) to reinforce proper hand hygiene.
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Ensure a clear, fair, safe policy on workers with illness is in place. Develop a contingency staffing plan that identifies minimum staffing needs and prioritizes critical and nonessential services
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Review facility cleaning guidelines and identify potential gaps. Identify cross-contamination issues and high-risk surfaces. Develop an outbreak specific cleaning plan.
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Plan for promptly acquiring additional resources. There will be an increased need for support such as waste management and increased consumption of materials like paper towels and toilet paper.
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Identify specific individuals to form a multidisciplinary planning committee to provide guidance and response to potential cases or outbreaks. Designate specific individuals to manage communications, inter-facility coordination, training, and education of staff, and staffing needs during an outbreak.
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Signs for posting in facilities
Guidance for infection preventionists
Being prepared to care for patients or residents with norovirus can help reduce the risk of transmission to other patients, residents, and health care personnel.
Infection control recommendation include:
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Implement proper precautions. Patients or residents with symptoms of norovirus or who are being tested for norovirus should be placed in contact precautions until 48 hours after symptoms resolve.
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Practice proper hand hygiene. Health care personnel should wash their hands with soap and water after providing care or having contact with patients or residents with confirmed or suspected norovirus. Patients and residents should also be encouraged to wash their hands frequently. Alcohol-based hand rub is not effective against norovirus.
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Wear proper personal protective equipment (PPE). Health care personnel caring for patients or residents with norovirus or other GI illness should wear gloves and gown. If vomitus is present, eye protection and a surgical mask should also be worn.
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Follow proper cleaning and disinfection procedures. Chlorine bleach at a concentration of a minimum of 3500 ppm (¾ cup per gallon of water) is the most effective disinfectant bleach is the most effective disinfectant to kill norovirus.
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Increase the frequency of routine environmental cleaning and disinfection, this includes patient and resident care areas, bathrooms, and high-touched surfaces.
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Clean and disinfect medical equipment between each patient or resident use. Follow the manufacturers’ instructions for use for cleaning and disinfection of medical equipment.
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Exclude ill health care personnel. Those who are ill with norovirus or other GI illness should remain off work until 48 hours after vomiting and diarrhea resolves.
- Evaluate the need to cancel communal meals and group activities during a norovirus outbreak.
Other norovirus resources
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