As always excellent post. Norovirus is often mistaken as food poisoning ... Even though it may not come directly from tainted food. I was at a wedding in Los Cabos, where half the wedding party got it. The unfortunate part is that the Mexican doctors thought it was food poisoning or Montezumas revenge ... It was not until we got back to the us that we all realized it was the dreaded norovirus. Not sure if you've had it, but it is horrible! I'd like to see some more posts on the similarities between the virus and other foodborne illnesses and the difference in diagnosing and treating.

Norovirus because of its ease in transmission is unique amongst the foodborne agents. In no other type of illness related to food is there such a wide pathway of infection. The two aspects that give NoV this trait are its very low infectious dose, as few as 10 particles and its ability to survive in the environment for long periods of time, up to 30 days. These attributes, along with resistance to common sanitizers makes stopping the spread of NoV a challenge.

The key to NoV control is surveillance. In facilities prone to outbreaks, especially, any instance of vomiting or acute gastroenteritis should be identified and investigated. If incidence starts to climb above previously established baseline incidence further steps need to be taken such as more intensive case finding, notification of at risk populations, and monitoring of hand washing. Environmental mitigation of vomitus and fecal mater becomes critical and special techniques are needed to assure that clean up and disinfection are working.

In a food service environment surveillance of the employees is critical. There is often a breakdown in communication in reporting in the foodservice industry and demands for labor can override the exclusion and restriction of cases. Ill employees are not the only problem, in foodservice there is evidence that asymptomatic workers cause outbreaks as well. So NoV outbreaks must be prevented by very careful and thorough hand washing and use of barriers between hands and foods.

The challenges faced by the hospitality industry are many in NoV control. The cultural of the hospitality industry is not conducive to strict control over health and safety, and surveillance is foreign. Without these basic controls and an understanding of decontamination, outbreaks will unfortunately happen. In addition, when they do, immediate and scientific response is needed to limit cases.