Avoiding norovirus like the plague
Norovirus is the scourge of nursing homes, not to mention frequent travelers. The release of Center for Disease Control and Prevention data this week confirms what many of us see firsthand, which is “the public health burden exacted by noroviruses is substantial.”
This report is near and dear to my heart: If you didn't see me much at LeadingAge PEAK in March in Washington, D.C., or if I looked like I was about to pass out, it's because a strain of a norovirus found me. During my bout of severe sickness, I became mildly obsessed with figuring out the cause of who contaminated me, and where.
Since I hadn't recently been in a nursing facility — still the No. 1 site of norovirus — my best guess is it was food-related. It was like CSI: O'Hare in my mind, and I am pretty confident I nailed the culprit as being from an airport restaurant where I grabbed breakfast en route to D.C. This is based partially on the time of onset of illness, as the CDC noted, “Restaurants were the most common setting (64%) of food preparation reported in outbreaks.” It also said, “[A]n observational study of food workers in restaurants found proper hand washing in only 27% of activities for which it is recommended and even less frequently (16%) when gloves were used.” Gross. Let's not even spend too much time on how norovirus is primarily spread. Gross, gross, gross.
Obviously, I survived being sick, and lathered on hand sanitizer when meeting people during that conference like I was addicted to ethyl alcohol. The upside was it gave me a new appreciation for both caregivers and sick long-term care residents. This type of illness causes physical detriment, and it's no surprise that it leads to 400,000 emergency room visits a year, and contributes to 71,000 hospitalizations annually.
Long-term care professionals know the importance of hand-washing and good housekeeping practices, even if they aren't making sure those practices are always followed. What is more insidious, however, is what is all-too-common in restaurant work and healthcare: Not sending sick people home, or punishing them for calling out sick. In the CDC report, 1 in 5 food workers in restaurants reported having worked while ill with vomiting and diarrhea for at least one shift in the previous year.
“Fear of job loss and concerns about leaving coworkers short-staffed were identified as significant factors in their decision to work while ill and thus are important barriers to be addressed,” the report said. It's talking about food workers, but it could just as easily apply to clinical staff, especially those who feel easily replaceable.
Beyond hand hygiene, it's clear good sick-leave policies reduce infections. Dining and food services in long-term care also should follow what the CDC recommends for kitchen managers: Training and certification with food safety practices, supervision by kitchen managers and absence of bare-hand contact with ready-to-eat food.
There is no way to minimize all infection, or all risk. But good policies — and avoiding egg and cheese bagels at O'Hare International Airport — can be a place to start.
Elizabeth Newman is Senior Editor at McKnight's Long-Term Care News. Follow her @TigerELN.