INCLINE VILLAGE, Nev. - The number of children and adults stricken by the recent norovirus outbreak in Washoe County has risen to more than 1,400, health officials said late last week. And, concern that more cases may appear has the Washoe County Health District stressing the importance of hand washing, exclusion, and environmental cleaning to halt the gastro-intestinal illness that has sickened hundreds of residents.
Norovirus is highly contagious and causes nausea, stomach aches, vomiting, and diarrhea. While norovirus has been responsible for similar outbreaks in Washoe County before, this is the longest running outbreak and has contributed to the largest number of illnesses - seen mostly in elementary schools and day care facilities.
"Every school and daycare has complied with our exclusion and cleaning requirements," said Washoe County District Health Officer Dr. Joseph Iser. "We have even closed our investigations in some of the first schools that reported the outbreak. But, more schools and day cares have seen an increase in cases, and because norovirus is so contagious, we are asking that all Washoe County residents increase their vigilance when it comes to personal, family and home sanitation.
"And, please, if you are sick, stay home."
Iser points out the three most important measures people can take to help stop norovirus from spreading:
• Wash your hands frequently: Washing your hands is the most effective thing you can do to avoid catching many diseases and prevent passing them along to others. To wash properly you should wet hands with warm, running water; apply soap; rub hands together vigorously for 20 seconds (sing "Happy Birthday" twice); rinse hands well under running water; and, dry hands using a paper towel or air dryer. Everyone should wash whenever they come into contact with body fluids (including vomit and saliva) or whenever they are visibly soiled. Wash before preparing and eating foods. Hands should be washed after using toilet facilities; changing diapers or helping a child at the toilet; blowing your nose, sneezing, or coughing; touching raw meat, poultry, fish, or eggs; handling an animal or animal waste; and, handling garbage. Finally people should wash before and after treating a cut or wound and tending to the sick.
• Exclusion: Sick individuals should be excluded from school, work, and all public or social activities. In schools, the Health District is requiring that ill students, staff, and faculty remain at home for at least 24 hours if they experience nausea and/or stomach aches. If no other symptoms occur within that time frame they can return to school. However, if the additional symptoms of vomiting, diarrhea, or fever occur, then those people must be excluded from school for 72 hours (three days) after symptoms have subsided. Norovirus exclusion criteria are similarly rigorous for food facilities and food handlers, and due to the severity of this outbreak the Health District recommends this exclusion policy for everyone with the symptoms described.
• Environmental Cleaning: Sanitation requirements for schools and recommendations for households where vomiting or diarrhea has occurred is to clean the immediate and surrounding area with detergent and hot water prior to disinfecting the area with a mixture of ? cup of bleach to a gallon of water. When vomiting occurs the virus is aerosolized and can spread up to a 25-foot radius. Therefore, disinfecting with the bleach solution needs to occur within a 25-foot radius, including any walls, furniture, or any other objects within that area to a height of 6 feet from of where the vomiting occurred. There are other approved cleaning products available, but they must list effectiveness against norovirus.
For more information, visit the Washoe County Health District website at www.washoecounty.us/health. Additional norovirus information can also be found at www.cdc.gov/Features/Norovirus, and www.cdc.gov/norovirus/multimedia.html.