Update: We expect the 2023 norovirus season to be severe, and many of those infected will likely be foodservice workers and customers entering restaurants. Read "GOJO Norovirus Expert Forecasts a Bad Norovirus Season" for more information.
The COVID-19 pandemic has had a tremendous impact on global public health as well as the food industry. In the United States, restaurant and foodservice loss of sales surpassed $185 billion between March and August 2020.1 During the pandemic, the adoption of enhanced sanitation protocols, such as increased frequency for high-touch surface disinfection, thought at the time to reduce the spread of the SARS-CoV-2 virus, was widespread.2 This helped reduce outbreaks of norovirus, the most common cause of foodborne illness in the United States, by over 80%.3 A recent study observed norovirus outbreaks during this time period to be 61% smaller than in prior years.4 Although underreporting of norovirus outbreaks was initially suspected to be the cause of this decline, investigators determined that the more likely scenario was that pandemic-related control measures, including enhanced hygiene practices such as a focus on disinfection of high-touch surfaces associated with the spread of norovirus, assisted in controlling norovirus outbreaks.
Now, let’s fast forward to 2022. Norovirus outbreaks, according to the CDC, have returned to pre-pandemic levels.3 This has coincided with a noticeable drop in enhanced hygiene practices, such as a focus on disinfection of high-touch surfaces, at the restaurant level. While maintaining elevated levels of sanitation practices can be challenging due to current labor and supply chain struggles, it is important to remember just how critical these practices are to help control foodborne illnesses. While the adoption of these control measures during the pandemic is often considered a temporary guidance, establishments should consider keeping and/or implementing many of these sanitation processes as long-term best practices to enhance their overall food safety plan.
Here are several specific key sanitation and hygiene enhancements that an establishment can adopt to enhance their food safety plan and reduce their risk of causing a foodborne illness outbreak:
- Keeping sick individuals out of an establishment – Control measures such as social distancing, capacity restrictions, and preventing sick individuals from entering an establishment through wellness checks all seek to reduce the chances of person-to-person spread of an illness. Adoption of sick leave policies and employee wellness screens to ensure employees are not reporting to work while sick with foodborne illness (such as norovirus) will reduce the risk of a facility causing a foodborne illness outbreak. In fact, in 2017, a risk assessment study by the United States FDA found that excluding employees from reporting to work when they are ill with norovirus was one of the most effective ways of reducing a restaurant’s risk of causing a norovirus outbreak.5
- Emphasizing frequent and proper hand hygiene – Some have remarked that COVID-19 has caused society to enter a “Golden Age” of handwashing. While this may have been said in jest, it is important to remind ourselves of the clear public health benefits of hand hygiene practices. More frequent handwashing, providing handwash stations, and providing alcohol-based hand sanitizers for when soap and water are not available, are all examples of best practices related to hand hygiene. Establishments should emphasize frequent and proper hand hygiene as a major aspect of their food safety plan.
- Elevating sanitation practices, including high-touch surface disinfection – There are many COVID-19-related temporary guidance policies where enhanced high-touch surface disinfection practices are adopted. Examples include frequent disinfection of restroom door handles, handwash sink faucet handles, and restroom stall latches, or increasing frequency of disinfection during high use (e.g., every 2-4 hours). Establishments should continue to adhere to these elevated practices since they have a direct carryover to controlling foodborne illnesses, especially norovirus. Norovirus can persist on surfaces for weeks if not properly cleaned and disinfected. In fact, there are many examples of norovirus outbreaks where the cause was ultimately determined to be a high-touch surface that was not cleaned and disinfected properly. Product choice also matters – when possible, choose products with short kill claims for the organisms of interest for your establishment. By keeping contact times short, compliance with enhanced disinfection protocols can increase, which helps reduce the risk of an outbreak within a facility. (For more information on product performance against norovirus, read this Q&A from North Carolina State University about new research showing how important formulation is.)
Viruses like norovirus are often first transmitted in retail food and foodservice establishments via transmission from employees’ hands to environmental surfaces like restroom door handles or handwash sink faucet handles.5 The viruses are then transmitted to other employees unknowingly when they touch these common surfaces, which then leads to cross-contamination of food, even in situations where the food handler is wearing gloves.6 Therefore, the establishment must have protocols to train and screen employees for illness in an attempt to prevent this first transmission event. Since norovirus can be transmitted from surfaces to persons and then to hands, it is critical that establishments maintain elevated levels of disinfection and hygiene practices to reduce the risk of foodborne illness outbreaks.
Knowing an enemy is the first step toward defeating it – which is why building an understanding of how to prevent the transmission of pathogens is paramount to any prevention strategy. Learn more about norovirus, as well as prevention solutions, with the latest research and insights, by downloading this new bulletin. If you are interested in participating in a norovirus prevention and control pilot program with PURELL® Foodservice Surface Sanitizing Products, contact Hal King, Ph.D., Managing Partner at Active Food Safety, by visiting www.activefoodsafety.com/contact-us.
For related information, read these GOJO blogs: