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Tighter rules for managing norovirus

As new guidelines are published for dealing with cases of the winter vomiting bug, it has emerged that norovirus is present in three quarters of British oysters
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
man holding stomach

30th November 2011 - Patients with norovirus should be treated in single rooms or bays to prevent whole hospitals from being closed, new guidelines say.

Outbreaks of the winter vomiting bug have frequently led to ward closures and the virus is estimated to cost the NHS more than £100 million each year. On Tuesday, seven wards at Monklands Hospital in North Lanarkshire were shut because of the virus. Hillingdon Hospital in Middlesex has shut one ward because of an outbreak.


Norovirus is highly contagious and can be transmitted by contact with an infected person, by consuming contaminated food or water or by contact with contaminated surfaces or objects. It can spread quickly through hospitals, schools, cruise ships, nursing and residential homes and hotels.

Symptoms include a sudden onset of vomiting and/or diarrhoea. It can also be accompanied by a high temperature, headache and stomach cramps.

Patients usually make a full recovery within two days.

Managing an outbreak

A working group set up by several public health bodies, including the Health Protection Agency (HPA) has set out new guidance for how the bug should be managed in hospitals and community health and social care facilities.

It calls for cases of norovirus to be managed initially in single rooms and bays wherever possible and not in 'Nightingale' style wards where all the beds are in the same room. It says this would allow for cleaning to take place allowing smaller wards to be able to re-open more quickly.

In cases where the outbreak cannot be contained in a single room or bay, the ward would need to be shut, the guidance says.

Other strategies for containing an outbreak include closing affected bays to patient admissions and transfers, keeping doors shut and putting up signs to inform visitors that the ward is closed and keeping visits to affected patients to a minimum.

In a statement, Dr Bharat Patel, the HPA’s Lead Consultant Medical Microbiologist and one of the authors on the report said: "Managing norovirus outbreaks is very hard owing to the nature of the virus and how quickly it spreads. Any outbreak causes widespread disruption and it is very important that appropriate control measures are implemented quickly.

"This guidance gives very clear recommendations on how to manage outbreaks within the hospital and community setting. It will be greatly beneficial to staff to know that there is now the option of trying to manage the outbreak at the single room and bay level which will reduce the pressure that closing wards has on both staff and patients."

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