Norovirus - think restaurants

20th of September 2017
Norovirus - think restaurants

Norovirus outbreaks are most commonly associated with cruise ships, however latest US statistics suggest we are more likely to contract the virus in a local restaurant. Cleaning professionals must be trained to deal with incidences in order to prevent its quick spread, and must use appropriate tools. Robert Kravitz writes for ECJ.

In November 2016, several branches of a favourite Mexican restaurant chain in London were forced to close because restaurant staff and guests became sick with norovirus. Altogether more than 350 people became ill with the disease.

It’s not surprising that this happened in November. Norovirus is often referred to as the “winter vomiting bug” because it seems the most cases are reported between October and April of each year. And last winter the disease apparently made its way through many parts of Europe.

By December 2016 Public Health England reported there had already been 2,435 cases of the disease, 12 per cent more than average for the same period in the past five years. Further, and somewhat startling, “this figure was 71 per cent higher than the same period last year”, according to a report in The Guardian newspaper. However the newspaper did add that last winter the number of norovirus cases was below average.

As of April 2016 Denmark reported a high number of cases of norovirus, mostly as a result of lettuce imported from France and served in restaurants as well as marketed to consumers. And in October 2016 a news story in a Luxembourg publication reported that “norovirus has hit Lorraine (France) and the east of France hard in the middle of October”.

As to the health impacts of norovirus, while it is a very contagious disease and can be a serious health problem for the very young and the very old, the nausea, vomiting, and diarrhoea it causes are rarely life-threatening. Usually, after two to three days it’s gone.

At this point, many readers may be asking “isn’t norovirus a disease you get on a ship at sea?” Well we most commonly hear about it when it spreads on a cruise ship. But according to the US Centers for Disease Control and Prevention (CDC), we are more likely to get sick from norovirus in a local restaurant - such as the chain mentioned in London - than on a cruise ship sailing in some exotic locale.

It tends to happen more frequently in restaurants because kitchen workers do not always adhere to proper hand hygiene rules. Sometimes it is the result of imported food contaminated with the disease, as in Denmark.

But there are other reasons it can spread in restaurants and that’s where cleaning professionals - both contractors and in-house cleaning teams - come in. Here’s what we need to know:

• When someone gets sick in a restaurant, and we are referring to vomit, it must always be assumed that the cause is not the cooking but norovirus
• Norovirus, as we said earlier, is known as the vomiting disease. When someone vomits with the disease, they often vomit forcefully with pathogens becoming airborne and spreading as much as 7.62 metres (25 feet)
• This means that high-touch areas such as chairs, counters, tables, near-by high-touch areas, exposed glass and silverware, all within this 7.62-metre area can be coated with the pathogens of the virus without anyone being aware of it
• Only a small amount of norovirus particles, fewer than 100, can cause someone to get sick
• And here’s the big clincher. Whereas most germs, bacteria, and viruses that land on surfaces only survive a few hours or a day, norovirus pathogens can last a few days, even a week or more.

This explains why it is so highly contagious and why we in the cleaning industry need to know more about how to clean up after someone gets sick and what tools and products are necessary to do it properly. This is true whether the incident is in a restaurant, a school, a hotel, convention centre, or any public building.

Tools needed

As with any challenge - in this case, a fast spreading disease - there is an opportunity, and this one is for distributors. Many distributors in the professional cleaning industry do not market the right tools and products needed to ensure a vomiting incident is cleaned up properly. If the goal of the cleaning industry is to clean for health, then not having these products available for cleaning workers is a serious mistake.

The easiest way for distributors to start marketing these products is to work with manufacturers that make what are called ‘spill clean-up kits’.  The benefit of selling a kit is that all the tools and equipment needed to clean up a vomiting incident are included. The user can store the kit in one place so it’s handy and re-order supplies as needed.

The essential items needed in the kit to remove and neutralise the effects of a vomiting incident or bodily fluid spill include the following:

• An absorbent spill pad roughly 0.3048 x 0.3048 metres is the most common
• One disposable apron, gown, shoe cover, mask or face shield
• Three pairs of vinyl gloves, waste bags (preferably yellow, universally recognised as the colour of caution), twist ties and disposable towels
• Instructions

The clean-up crew should always be instructed how to clean up a vomiting or bodily fluid spill incident. But having the instructions handy for quick and easy reference is always a good idea.
Additionally, a larger spill pad is recommended, especially when it comes to norovirus concerns. So the spill is cleaned up faster and more efficiently.

Steps in the process

Based on all we have discussed so far, it should be clear that norovirus is highly transmissible and this applies to cleaning workers. If the clean-up is not done properly not only can the disease spread to other building users, but to the cleaning workers themselves.

The first thing cleaning workers should do when purchasing a spill clean-up kit is read the instructions included with the kit if they are included. Even better, work with a distributor familiar with the norovirus clean-up process. Typically, the instructions and the distributor will suggest
the following:

• Using warning signs, block off the entire area around the spill in a radius of about 7.62 metres from the incident
• Workers in charge of the clean-up operation should put on all protective gear
• Remove any chairs or furniture in the immediate area
• Place the spill pad over the incident
• Spray disinfectant over the pad and the surrounding area and allow for proper dwell time
Complete the process
• Wipe as much of the spill as possible with the spill pad
• Further wipe the area with the disposable towels
• Place the spill pad and the towels in the disposable rubbish bag and secure; waste bags should be disposed of in a receptacle outside of the facility.

What we have accomplished so far is to clean up the actual spill. Now the floor area should be cleaned and disinfected. It is best to use a cleaning solution, appropriately diluted, and a microfibre mop head because they tend to be more absorbent. Mop the entire area and then mop again using a disinfectant, a two-step process.

Finish up by cleaning and disinfecting all surfaces, objects, ledges, tables, chairs, walls - anything in the area of the incident.  Keep in mind how far the airborne pathogens can spread.

Finally remove all protective gear, thoroughly wash hands, and then inspect the area just cleaned. It’s this final step that is so important. Don’t be in a rush to open the area to traffic. The final inspection helps make certain the area is thoroughly cleaned so no one gets sick.

 

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