Editor : Li Jun / Publisher : China News Network / http://www.chinanews.com/gn/2020/10-29/9325462.shtml / Direct translation
Image : Norovirus (Web Screenshot)
According to the website of the National Health Commission, the National Health Commission issued the "Health Tips for the Prevention and Control of Norovirus Infectious Diarrhea Season in Schools" on 29 October 2020, which clarified that collective units such as nurseries and schools must ventilate and disinfect, and isolate the sick in time. When a student/child has vomiting, the instructor should evacuate other students/children immediately, and report to the school doctor/garden doctor, cooperate with the school doctor/garden doctor and cleaning staff to deal with the vomit, and isolate the sick student/child separately and notify the parents to bring the sick child to see a doctor or go home to rest. The patient cannot resume classes until 3 days after the symptoms disappear.
Below is the translation of the full text of "Health Tips for Prevention and Control of Norovirus Infectious Diarrhea".
Norovirus infectious diarrhea occurs throughout the year. October to March of the following year is the high incidence season for norovirus infectious diarrhea. Winter is approaching. How does this disease spread? What are the clinical manifestations after infection? How is it prevented? Here to introduce you to relevant knowledge.
What is norovirus?
Norovirus, formerly known as Norwalk virus, belongs to the genus Calicivirus Norovirus. It is a single-stranded positive-stranded RNA virus with no envelope on its surface.
Norovirus has multiple genotypes. According to the characteristics of gene structure, norovirus is divided into 10 genomes (Genogroup, GI-GVI), among which GI, GII and GIV infect humans. GI and GII are the two main genomes that cause infectious diarrhea in humans, which are further divided into more than 30 genomes.
Norovirus mutates quickly and immune protection time is short. The same person can be repeatedly infected with the same strain or different types of Norovirus, and there is no cross immunity between different genotypes.
Norovirus is highly contagious, low infective dose, long detoxification time, short immune protection time and general susceptibility of the whole population. It makes norovirus appear in schools, families, hospitals, communities, kindergartens, tourist areas and other crowd gathering places. A cluster of viral infectious diarrhea is possible.
Norovirus is mainly excreted through the patient's feces and vomit, and the invisible infection can also excrete toxins. The patient can excrete norovirus during the incubation period. The peak detoxification period is 2 to 5 days after the onset of illness and lasts for about 2 to 3 weeks. The longest detoxification period has been reported to exceed 56 days. Norovirus infection dose is 18-2800 virus particles.
Norovirus has strong environmental resistance. It can survive in the temperature range of 0℃-60℃, can survive on the surface of objects for 2 weeks, and survive in water for more than 2 months. Alcohol and no-rinse hand sanitizer have no inactivation effect, but the use of a high concentration of 10mg/L chloride ions (chloride ion concentration used in sewage treatment) can inactivate norovirus.
How does norovirus spread?
Norovirus infections, cases and recessive infections are the source of infection of norovirus infection.
Norovirus spreads in various ways. Contact with patients infected with norovirus, such as handling patients’ vomit or excrement, through ingestion of feces or aerosols produced by vomit, or indirect contact with the environment contaminated by excrement. It can also be spread through eating and drinking, food and water spread.
What are the main clinical manifestations of norovirus infection?
Norovirus infection has a short incubation period, usually 24-48 hours, the shortest 12 hours, and the longest 72 hours. The main symptoms are mild. The most common symptoms are diarrhea and vomiting, followed by nausea, abdominal pain, headache, fever, chills, and muscle aches. Children are mainly vomiting, and adults are mostly diarrhea.
Norovirus infection is a self-limiting disease. Most patients do not need treatment after the onset of illness, and they can recover after a 2-3 days rest. A few patients need timely treatment due to serious complications. There are no vaccines and specific drugs for norovirus infection.
How should norovirus infectious diarrhea be treated?
When norovirus infectious diarrhea occurs, no antibiotics are needed, and the water consumed during vomiting and diarrhea should be supplemented in time. Supplementing sugar or saline or oral rehydration salt can help the patient to balance water and electrolytes. Seek medical attention if symptoms of vomiting or diarrhea are severe.
How to prevent individuals and families from norovirus infection?
--Maintain good hand hygiene
Maintaining good hand hygiene is the most important and effective measure to prevent norovirus infection and control the spread of Norovirus. Wash your hands correctly in accordance with the 6-step hand washing method before meals, after going to the toilet, and before processing food. Wash your hands with soap and running water for at least 20 seconds. Note: Disinfecting paper towels and hand-washing disinfectants are not effective for norovirus and cannot replace hand washing.
--Pay attention to personal dietary hygiene
Drink boiled water, wash vegetables and fruits thoroughly, cook food well, especially shellfish and other seafood foods.
--Isolate at home during illness
Patients need to be isolated at home or in hospital according to their condition until 3 days after the symptoms have completely disappeared, and those with latent infection who test positive for norovirus but without symptoms of infectious diarrhea also need to be isolated at home for 3 days. Patients wash their hands frequently, maintain hand hygiene, and try not to have close contact with other healthy family members, especially not to cook or take care of the elderly and young children.
--Do a good job of disinfection
The environment and objects contaminated by patient's vomit or feces need to be disinfected with chlorine-containing preparations. When cleaning objects contaminated by vomit, wear plastic gloves and masks to avoid direct contact with pollutants. The patient’s home environment should also be disinfected according to the guidance of medical staff to avoid spreading within the family.
--Don't worry too much after getting sick
Norovirus infectious diarrhea is generally mild, short duration, and good prognosis. Patients should rest and eat lightly.
How to prevent norovirus infection and control collective units such as kindergartens and schools
--Promote well
Do a good job in health education about norovirus infection, advocate good hygiene and eating habits, and encourage students to actively exercise and improve immunity; use a variety of methods to promote the prevention and control of norovirus infection.
--Strengthen management and training
Strengthen the management of drinking water and food hygiene, and conduct training on vomit and environmental disinfection methods and infectious disease knowledge in various schools such as kindergarten institutions.
--formulate infectious disease prevention and control plans and emergency plans
Schools and kindergartens should formulate infectious disease prevention and control plans and emergency plans, and effectively implement the morning and afternoon inspections of teachers and staff, and the system for registration and tracking of absence/absence due to illness, the inspection system for resumption certification, and the reporting of infectious diseases.
--Do a good job of ventilation and disinfection
Schools/kindergartens should be equipped with sufficient disinfection materials and personal protective materials, and regularly check public places (such as classrooms, dormitories, canteens, libraries, toilets, etc.), key parts (such as door handles, stair rails, faucets, Toilet buttons, elevator buttons, bed rails, etc.) for ventilation, cleaning and disinfection.
--Isolate sick people in time
When a student/child has vomiting, the instructor should immediately evacuate other students/children and report to the school doctor/garden doctor, cooperate with the school doctor/garden doctor and cleaning staff to deal with the vomit in a standardized manner, and isolate the sick student/child separately and notify the parents to bring See a doctor or go home to rest. The patient cannot resume classes until 3 days after the symptoms disappear. Food processors, nurses, nursery nurses, and other service-related patients will return to work after 3 days after their symptoms disappear.
--Report the epidemic in time
School doctors/garden doctors should report the epidemic to the district health department and the primary and middle school health centers in a timely manner after the outbreak, and carry out further data reporting and case management under the guidance of professionals.
How to disinfect patient's vomit and feces?
Alcohol is not effective against norovirus, and chlorine-containing disinfectants are most effective against norovirus. Dip 5000mg/L～10000mg/L of chlorine-containing disinfectant with disposable absorbent materials such as gauze or rag to completely cover the pollutants, and carefully remove them. The cleaned up pollutants are treated as medical wastes, or soaked in a disinfectant containing 5000mg/L of effective chlorine for 30 minutes. The toilet can be filled with a sufficient amount of 5000mg/L～10000mg/L chlorine-containing disinfectant for more than 30 minutes. Mops, wipes and other tools used in cleaning, as well as containers containing contaminants, must be immersed in a disinfectant solution containing effective chlorine 5000mg/L for 30 minutes and rinsed thoroughly before they can be used again. The mops for cleaning toilets and toilets in collective units should be dedicated.
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