Environmental Surface Disinfection Protocol

Noroviruses are a group of related, single-stranded RNA, non-enveloped viruses that cause acute gastroenteritis in humans. Noroviruses are increasingly the most common cause of clusters of viral gastroenteritis in the community and in healthcare facilities across the U.S.

Because of their structure, noroviruses are resistant to disinfection and can survive in the environment for prolonged periods. Noroviruses are transmitted primarily through the fecal-oral route, either by direct person-to-person spread, fecally-contaminated food or water, or contaminated environmental surfaces or objects. Noroviruses can also spread via inhalation and subsequent ingestion of aerosolized vomitus containing viral particles. Because noroviruses are environmentally resistant, the U.S. Centers for Disease Control and Prevention recommends cleaning up spills of body fluids and then disinfecting contaminated surfaces with a dilute chlorine bleach solution registered by the Environmental Protection Agency (EPA) as appropriate for use against noroviruses, such as Clorox® Regular-Bleach1, concentrated.
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To help prevent the spread of Noroviruses in your workplace, implement the following surface cleaning and disinfecting protocol everyday and even more diligently during an outbreak.

Prevent Outbreaks
Contain Outbreaks
Disinfecting Surfaces: Get Ready
Disinfecting Surfaces: Get Going
Bleach is Among the More Effective Solutions

Prevent Outbreaks
Emphasize thorough cleaning and disinfection of environmental surfaces. Pay close attention to frequently touched surfaces and use appropriate disinfectants for the intended surface.
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Contain Outbreaks
Separate or cohort those who are sick from those who are well, ideally in private rooms with attached bathrooms1. For suspected clusters of viral gastroenteritis, be sure to clean and then disinfect with an appropriate EPA-registered disinfectant, such as Clorox® Regular-Bleach1, concentrated.
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Disinfecting Surfaces: Get Ready

  • Wear disposable gloves.
  • Use disposable cleaning materials such as paper towels and discard any sponges or cleaning cloths/rags.
  • Prepare a fresh disinfecting bleach solution every day. Be sure point-of-use containers are properly labeled.
  • For commercial disinfectants, including bleach-containing disinfectants, always follow the manufacturer's instructions for use.

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Disinfecting Surfaces: Get Going

  • Clean visibly soiled surfaces with a detergent prior to disinfection. Excess soil or organic matter on surfaces can inactivate disinfectants, making them less effective.
  • Apply the disinfectant bleach to the surfaces as per label instructions.
  • Use clean gloves and cloths/rags to wipe down surfaces after the appropriate time has elapsed. After cleaning, dispose of or properly disinfect rags and cloths.
  • Note that repeatedly using the same cloth on consecutive surfaces can actually spread the virus from one surface to another and to the hands of the person doing the cleaning2.

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Bleach is Among the More Effective Solutions:
Noroviruses are very resistant to disinfection. Evidence from outbreak investigations and laboratory-based research has shown that there are a limited number of disinfectants, such as Clorox® Regular-Bleach1, concentrated which are effective against noroviruses. Bleach destroys viruses by breaking up their genetic material into inactive fragments. Other disinfectants may be effective, but only at concentrations two- to four-times higher than manufacturer recommendations for routine use. Bleach is effective at concentrations that are safe for routine use1.
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*Clorox® Regular-Bleach1, concentrated is registered to kill Norovirus (as Feline Calicivirus)

References

  1. Norovirus in Healthcare Facilities Fact Sheet, 2006 http://www.cdc.gov/ncidod/dhqp/id_norovirusFS.html
  2. Barker J, Vipond IB, Bloomfield SF. 2004. Effects of cleaning and disinfection in reducing the spread of Norovirus contamination via environmental surfaces. J Hosp Infect 58:42-49.
  3. Cheesbrough JS, Barkess-Jones L, Brown DW. Possible prolonged environmental survival of small round structured viruses. J Hosp Infect 35:325-326.

Additional Resources

  1. Clay S, et al. Survival on uncommon fomites of feline calicivirus, a surrogate of noroviruses. Am J Infect Control. 2006 Feb;34(1):41-3.
  2. Malik YS, et al. Disinfection of fabrics and carpets artificially contaminated with calicivirus: relevance in institutional and healthcare centres. J Hosp Infect. 2006 Jun;63(2):205-10.
  3. Jimenez L, et al. Virucidal activity of a quaternary ammonium compound disinfectant against feline calicivirus: a surrogate for norovirus. Am J Infect Control. 2006 Jun;34(5):269-73.
  4. Sattar SA, et al.Microbicides and the environmental control of nosocomial viral infections. J Hosp Infect. 2004 Apr;56 Suppl 2:S64-9.