State of Montana Health Alert Network

DPHHS HAN

Information Sheet Date: November 28, 2016 Subject: Increased reports of norovirus outbreaks Background: Since late September of this year, 12 confirmed or suspected norovirus outbreaks have been identified in senior care settings. More than 250 people have been sickened and five required hospitalization. Historically, norovirus outbreaks occur more frequently between November and April. This increase in activity serves as a good reminder to recognize, confirm and report any acute gastroenteritis illness outbreaks, especially when patients reside in any congregate settings, such as nursing homes, assisted living facilities, schools and child care centers. Information:

Norovirus Outbreaks reported in Montana 2011-2016 7 6

Outbreak Count

5 4 3 2 1 0 Jan

Feb

Mar 5-year ave

Apr

May

Jun

Jul

Aug

Sep

Reported to DPHHS by month Baseline max Baseline min

Oct

Nov

Dec

2016 YTD

Recommendations: Local Health Jurisdictions DPHHS encourages local health jurisdictions to increase awareness in their community, especially at schools, long term care facilities, and assisted living centers. Please remember to report outbreaks to DPHHS using the outbreak form on SharePoint for initial and final notification. Funding for specimen testing is available with prior approval from the CDEpi section (see

State of Montana Health Alert Network

DPHHS HAN

healthcare provider section for collection instructions). Please visit the DPHHS website for additional information and resources on norovirus. You are encouraged to share this information with your staff, and to forward it proactively to long term care facilities, providers and restaurants in your jurisdiction for their benefit. Healthcare Providers Providers are encouraged to consider a Norwalk-like virus in patients presenting with an acute gastrointestinal illness and to test accordingly. Samples should be collected from raw stool without transport media in a sterile container and shipped cold for PCR testing. Healthcare providers should report all outbreaks of acute gastroenteritis, including suspected outbreaks of norovirus, to their local health department. Long Term Care Facilities / Assisted Living Centers / Child Care Facilities Please visit our website for information and additional resources on norovirus outbreak management in healthcare, child care and other congregate settings. We encourage monitoring for patients presenting with acute gastrointestinal symptoms and reporting cases to your local health jurisdictions to help us detect and contain outbreaks when they occur. • •

Staff or volunteers suffering from acute gastrointestinal illness should not care for infants, children, or other adults Recommend staff members caring for infants, children, or other adults stay home until at least 48-72 hours after gastrointestinal symptoms have resolved

Food Handlers / Restaurants Professionals employed in the food industry can prevent the spread of diseases by following a few simple steps: • • •

Ensure food handlers wash hands frequently with soap and running water for at least 20 seconds and always before preparing or handling food Ensure staff use gloves when handling ready-to-eat foods and eating utensils Refer to the 2013 Food Code by FDA Chapter 2 for specific guidance on restriction and exclusion rules that may apply to food handlers (usually 24-48 hours symptom free before returning to work depending on population served)

The DPHHS website features more information, guidance documents and resources for these audiences at http://www.dphhs.mt.gov/ For questions please contact the DPHHS Epidemiology Section at 444-0273.