Outbreaks of a form of viral gastro-enteritis – Norovirus – (frequently called Winter Vomiting Disease in the press) have become increasingly common in hotels, cruise ships, hospitals and nursing homes and in the wider community. The disease is also known by a number of other names including SRSV (small round structured virus), noro virus, Norwalk virus, Norwalk-like virus and gastric flu. It is important to realise, however, that this disease is not unique to Scotland, to tourism, to hotels, coach tours or cruises.

Norovirus

Left unchecked, the virus will rapidly infect a large group of people including guests and members of staff.  However, by implementing certain procedures at the earliest sign of infection and ensuring that disinfection is carried out meticulously, it is possible to bring an outbreak under control. This short paper is intended to draw the attention of tourism operators to the disease and provide advice on sources of further information.

The recognisable symptoms of an outbreak are violent sickness and/or diarrhoea. The duration of the illness is short. Symptoms normally last for between twelve and forty-eight hours. Twenty-four hours is the most usual. Projectile vomiting is the most common symptom, and the most infectious.

The disease is likely to be brought into an establishment by a single person who was either ill upon arrival or picked up the virus while, for example, on a tour, at a visitor attraction or in service areas. Viruses are generally airborne and this one has an incubation period of between 24-48 hours. It is highly contagious and is primarily passed on by people breathing air that has become contaminated by those who are ill and have vomited.  It can also be spread by poor personal hygiene (ie, not washing hands after using the toilet, causing door handles to become contaminated), or from environmental contamination, such as poorly cleaned public toilets.

Information on procedures for dealing with an outbreak can be found on  website www.lurgywatch.com which has been assembled using hard-won experience of businesses which have frequently been subject to outbreaks of the virus.  It is permissible for businesses to copy and paste information from the website into training and information material for their own use.

The website contains information on:

• equipment and supplies related to dealing with an outbreak, and
• procedures which can be adopted by accommodation providers, transport operators and businesses such as attractions, roadside services and restaurants to deal with an outbreak.

There is useful guidance available, including tips on effective hand hygiene, from the HPS (Health Protection Scotland) website: www.hps.scot.nhs.uk/haiic/ic/index.aspx

VisitScotland is pleased to draw this information to the attention of the wider tourism industry. However, VisitScotland has no particular medical expertise and would recommend that individual businesses seek further advice by:

• reading the information on the www.lurgywatch.com website
• visiting the HPS website described above
• contacting the relevant local authority environmental health department
• taking professional advice from environmental or occupational health consultants

January 2008