Norovirus is the leading cause of illness and contaminated food outbreaks in the United States, according to the Centers for Disease Control and Prevention. Norovirus is a common virus that can spread widely and rapidly. Many people refer to this illness as the “24 hour bug,” “stomach bug,” or “flu.”

It is a common misnomer that norovirus and influenza are one and the same; influenza is a virus that affects the lungs and respiratory system. Symptoms include a sudden fever, a headache, sore throat, cough, body aches, and congestion. Vomiting and diarrhea are not a symptom of the flu, although they may occur as the body’s immune system is weakened. Similarities do include the fact that both are highly contagious, have the potential to cause outbreaks and be deadly. Influenza, or “the flu,” is not a foodborne illness, but norovirus is and can wreak havoc in the foodservice industry and your brand.

Every year, norovirus causes 19­–21 million illnesses and between 570–800 deaths, according to the CDC. Most of these outbreaks occur in food service settings—restaurants, schools, nursing homes, hospitals, day care centers, military barracks, universities and cruise ships. Individuals in the “high risk” populations are the most susceptible. This includes young children, the elderly, and those with weakened immune systems.

Typically, norovirus involves vomiting and diarrhea. However, in some situations, the ramifications are much more severe. A norovirus infection can become very serious in children, the elderly and individuals with compromised immune systems. Norovirus can cause severe dehydration, malnutrition, and even death.

Preventing norovirus is a critical issue for the entire food service industry. Any company that makes, serves, or sells food in any capacity must be vigilant about this issue. It has been determined that 64 percent of outbreaks are attributed to restaurants and 70 percent of those outbreaks are caused by infected workers.

All food businesses should implement and train team members on SOP’s (Standard Operating Procedures) for preventing and reporting illness. This includes:

Conditional Employee Reporting Agreements

This agreement’s purpose is to inform conditional employees or food employees of their responsibility to notify the person in charge (PIC) when they experience any of the conditions listed so that the PIC can take appropriate steps to preclude the transmission of foodborne illness. (These steps include proper disposal of bodily fluids/vomit, sanitation of all surfaces, washing/sanitizing all linens, towels and rags, etc.)

Employee Reporting & Exclusion Policy

• Report illness to PIC
• Avoid preparing food for others while you’re sick and for at least 48 hours after symptoms stop.  Don’t allow employees to work if they’re exhibiting symptoms of norovirus (vomiting, diarrhea). They must be symptom-free for a minimum of 48 hours before returning to work.
• Report the symptoms to their manager or employee health department immediately and seek medical attention. The employee should not return to work until after receiving clearance from a health practitioner.
• Ensure all employees wash their hands carefully and often with soap and hot water, dry with paper towel or air dryer, and wash again when returning to their work station.

Policy Acknowledgement

• Develop and implement written procedures for employees to follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the food establishment, as recommended in the 2017 FDA Food Code.
• Body Fluid (Vomit and Diarrhea) Cleanup/Disinfection Procedures. Use proper equipment to clean up bodily fluids that could spread norovirus. For instance, PURELL Body Fluid Spill kits are instrumental in containing and disposing of body fluids (vomit, diarrhea) that could spread norovirus. 

A study at MIT showed projectile vomiting can contaminate close to 84 square feet, and virus particles can also be suspended in air! This report exposes that these germs are spread quickly, easily and can be projected to surfaces and people all the way across a room. Also, these germs often linger in places that appear to be clean … How gross is that?

Even thought your kitchen utensils, counters, and surfaces may appear to be clean, viruses and germs may be lingering on surfaces and in hidden spaces, such as spaces between counters and walls, in tile grout, etc. In fact, norovirus can live outside the body for several days, so it’s imperative to clean and sanitize facilities thoroughly and often—especially during/after a norovirus incident or outbreak. Food safety facilities should:

• Clean and sanitize kitchen utensils, counters, and surfaces routinely.
• Wash table linens, napkins, dish rags, and other laundry thoroughly.
• Train your staff about food safety protocols and ensure they follow the strictest procedures whenever they’re preparing, storing and serving food. 

It only takes 18 cells to contract norovirus … 18 cells that are small enough to fit on the eraser of a pencil.  When and if you contract norovirus, you will be spewing projectile vomit and explosive diarrhea for days, and can easily spread this hideous illness to others. Do yourself (and the rest of us!) a favor and educate your staff on the how’s and why’s of preventing this dreadful illness. You’ll be thankful you did.