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Role of Environmental Contamination in Norovirus Gastroenteritis pp. 89-128 $100.00
Authors:  (Charmaine Gauci, Anthony Gatt, Disease Surveillance Unit, Malta, Franco Maria Ruggier, Ilaria di Bartoli, Istituto Superiore di Sanita, Italy)
Norovirus disease, a highly infectious gastroenteritis, traditionally known as winter
vomiting disease, is spreading rapidly across many countries and continents. Schools,
hospitals, hotels, cruise ships and facilities for the elderly are particularly prone to
outbreaks of infection. Although few persons die from the infection, the burden of illness
is high since many people can be afflicted in outbreaks. Norovirus is known to occur
after eating contaminated food however the majority of cases have resulted from person
to person transmission and via environmental contamination. This can occur when
persons or health care workers have poor personal hygiene or where there is failure to
clean common areas properly.
A protracted outbreak of Norovirus occurred in a hotel in Malta between March and
October 2006 with four identified outbreaks affecting a total of 337 persons. The
recurrent waves of infection in successive cohorts of tourists indicated a source of
environmental contamination. Traditional cleaning agents were not sufficient to eliminate
the source of infection. The outbreaks were only successfully curtailed with isolation of
ill patients; environmental cleaning with appropriate agents; specific prevention
strategies including the early identification of patients; contact precautions with patients;
enhanced patient and staff hygiene and training and discipline during food preparation
and serving.
Environmental contamination has been shown to be implicated in Norovirus
outbreaks. Hygiene measures are not a luxury but a necessity to help reduce the burden
of this highly contagious infectious disease. 

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Role of Environmental Contamination in Norovirus Gastroenteritis pp. 89-128