Our Latest Perspectives Posts

Norovirus Takes to the Great Outdoors
Written by Water Quality & Health Council

Norovirus Takes to the Great OutdoorsNorovirus, the highly contagious “Winter Vomiting Bug1” or “Stomach Flu2” has taken to the great outdoors, hitch-hiking with travelers on the Appalachian Trail (AT) and accompanying tourists to Yellowstone and Grand Teton National Parks. This virus, the bane of cruise ship vacationers, can also ruin a land-based vacation.

Norovirus on the “AT”

According to a recent report, “the worst viral outbreak to strike hikers in Appalachian Trail history is traveling north from Georgia into Pennsylvania.” Norovirus is spread via the fecal-to-oral route, so appropriate hand-washing is a must for controlling transmission. But hot water and soap are not mainstays along AT facilities, so hikers may be inadvertently spreading the virus by hand contact. Hand sanitizer, so often carried and used by hikers and tourists on the move, may not be as effective against norovirus as a good old “lather up” with soap and warm water. Additionally, according to a National Park Service Hiking Alert, “Outbreaks occur more often where people share untreated water sources and facilities for sleeping, dining, showering, and toileting. The virus can spread rapidly in crowded shelters and hostels.”

Norovirus “Does Yellowstone”

On June 7, two tourist buses arrived at Yellowstone National Park’s Mammoth Hot Springs area. Some of the tourists “complained of stomach flu symptoms,” according to one article, and evidently passed the infection on to park employees, who exhibited symptoms within 48 hours. The report quoted a healthcare professional as characterizing the outbreak as “one of the most significant ones he’s seen.” A June 24 report noted at least 100 visitors have been infected and that “the problem continues to grow.” The outbreak has spread to Grand Teton National Park as well.

Staying One Step Ahead of Norovirus on Your Outdoor Vacation3

  1. Treat all water by boiling, filtering, and/or treating with chemicals. To learn how best to treat your water, visit: http://www.cdc.gov/healthywater/drinking/travel/backcountry_water_treatment.html
  2. Do not eat out of the same food bag, share utensils, or drink from other hikers’ /tourists’ water bottles.
  3. Wash your hands with warm (or cold water if warm is unavailable), soapy water whenever possible after using the bathroom and before and after handling food. “Paper soap” is lightweight and convenient. Hand sanitizer is better than nothing, but it may not be effective against norovirus.
  4. Follow “Leave No Trace” guidelines for disposing of human waste: Use only sanitary facilities or bury four to six inches deep in an area not frequented by the public, not visible from trails, campsites or developed areas, and at least 100 feet from any water source. For best practices visit www.appalachiantrail.org/hiking/hiking-basics/regulations-permits.
  5. Consider carrying chlorine bleach-based disinfectant wipes to apply to frequently touched hard surfaces such as a toilet handle or cabin food preparation or eating surfaces.
  6. If you have a diarrhea or vomiting incident clean up as well as possible using the steps listed on this poster.
  7. Stay home if you are sick and wait at least three days beyond the time of symptoms to prevent spreading norovirus—it’s the right thing to do.

Here’s wishing you a happy, healthy, norovirus-free outdoor vacation!

1Norovirus is more common in late Fall through early Spring, but outbreaks in warm weather are also common.
2Although it is commonly called the “Stomach Flu,” norovirus is not a flu.
3Tips are based on a National Park Service Hiking Alert at: http://www.nps.gov/shen/planyourvisit/hiking-alerts.htm


Six Sneaky Hiding Spots for Kitchen Germs
Written by Ralph Morris, MD

Six Sneaky Hiding Sports for Kitchen Germs
Watch full video here.

What are the sneakiest hiding spots for kitchen germs?  Microbiologist Lisa Yakas, of NSF-International recently set out to answer that question.  Her findings confirm that germs are especially partial to environments that feature moisture and food residue. 

Twenty volunteer families enlisted in Yakas’ NSF-International project in which participants swabbed 14 common kitchen surfaces.  Next the surfaces were tested for yeast, mold and the bacteria E. coli, Salmonella and Listeria.  The presence of these germs signal a potential elevated health risk, especially for susceptible people, such as pregnant women, older adults, children and people with a compromised immune system. 

 Most volunteers thought the most contaminated kitchen surface would turn out to be the microwave control pad. That was not the case.  Hard-to -access surfaces that are not regularly cleaned or disinfected but that regularly contact food were the germiest.  Yakas recounts several of these examples in the video.  The table below lists these surfaces, the particular germs found inhabiting them, and tips for reducing your risk of illness from these germs. 

 Kitchen Surface Germs Identified Tips for Avoiding these Germs
Rubber spatula Salmonella, E. coli, yeast and mold For 2-piece spatula, separate pieces of the spatula and if dishwasher-safe, place in dishwasher; if hand-washing, wash in hot, soapy water, rinse, dry and reassemble.
For 1-piece spatula, if dishwasher-safe, place in dishwasher; if hand-washing, wash in hot, soapy water; rinse and dry.
Can opener Salmonella, E. coli, yeast and mold Wash thoroughly in hot, soapy water, especially grooved areas, removing all food debris, and dry; if dishwasher safe, scrub lightly and place in dishwasher.
Blender gasket Salmonella, E. coli, yeast and mold Unplug blender and follow manufacturer’s directions for disassembly and cleaning.  Suggestion: If dishwasher-safe, place in dishwasher; if hand-washing, wash each component in hot, soapy water, especially the area between rubber gasket and metal blade assembly; rinse and dry before reassembling.
Refrigerator produce bin/drawer Salmonella, Listeria, yeast and mold Wash bin with a mild detergent mixed with warm water; rinse and wipe dry. The US Food and Drug Administration recommends monthly sanitizing as an added precaution against Listeria.  Combine 1 teaspoon of unscented bleach to 1 quart of water; flood the surface with this solution and leave wet for 10 minutes, followed by rinsing with clean water. Air or pat dry.
Separate pre-washed and unwashed vegetables to avoid cross-contamination.
Refrigerator meat compartment Salmonella, E.coli, yeast and mold Wash bin with a mild detergent mixed with warm water; rinse and wipe dry.
Ideally, store meat and seafood below produce to avoid raw juices dripping onto produce.
Rubber-sealed food storage container Salmonella, yeast and mold If dishwasher-safe, place container and lid in dishwasher; if hand-washing, use hot soapy water, paying attention to the seal and groove areas; rinse and air dry.

Each year, 48 million people in the United States–one in six of us–become sick from germs taken in with our food.  Most of these illnesses cause only mild symptoms, but 128,000 people are hospitalized and 3,000 die of foodborne diseases annually, according to estimates by the US Centers for Disease Control and Prevention (CDC).  CDC reports that from 2009-2010, among foodborne outbreaks with a known single setting where food was consumed, approximately one in five originated in a private home.  That’s why one of the most important lines of defense against foodborne illness is the education of home-based food handlers according to researcher Dr. Elizabeth Scott (2003 study).1  We agree, and we hope this new information is helpful to you in your efforts to keep a clean, safe kitchen.  And by the way, the handiest food safety tip we know is about hands themselves:  Be sure to wash your hands thoroughly before and after touching food!

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

1The other two lines of defense against foodborne illness are: (1) improving the hygienic quality of raw foodstuffs and (2) using food processing technologies, e.g. pasteurization and irradiation, and employing hazard analysis and critical control point concepts.


Cleaning vs. Disinfecting: What’s the Difference?

bucketWe all want to live in a clean indoor environment, but of course there are degrees of “clean” and different requirements for “clean,” depending on the living space targeted. The “clean your room” chore given to children generally refers to straightening up and organizing stray objects into drawers, closets and onto shelves. It might involve dusting and vacuuming, but it is decidedly different from cleaning a bathroom or kitchen where germs present a more obvious risk

Definitions, definitions…

Cleaning, accomplished with soap–or detergent–and water, refers to the physical removal of dirt and grime, and in the process, some portion of the germs on a given surface. Sometimes cleaning tools, including sponges and cloths, simply move germs from one surface to another. Disinfecting, on the other hand, refers to killing a high percentage of the germs on a surface or rendering them incapable of reproducing. Sanitizing is another relevant term in this discussion. According to www.flu.gov, sanitizing lowers the number of germs on surfaces to a safe level, as judged by public health standards or requirements. The process works by either cleaning or disinfection to reduce the risk of spreading infection. Finally, sterilizing destroys all forms of microbial life and is used mainly in healthcare and laboratory settings.

The Order of Operations

If disinfecting a surface is the task at hand—for example, you might be tackling a food preparation counter that has just contacted raw meat or fish—the order of operations is important. Just remember “C” (cleaning) comes before “D” (disinfection). First, clean the surface with detergent or general household cleaner to remove any visible food or waste particles. Second, rinse the surface with water, dry and then apply disinfectant.

A quick home-made disinfectant can be prepared by adding one-half tablespoon of ordinary household bleach to one-half gallon of plain water. Apply the solution to the (cleaned, dry) surface and let air dry. That’s it! No rinsing is required at that bleach solution concentration.

Why Chlorine Bleach?

Chlorine bleach is an inexpensive, effective surface disinfectant at very low dilutions. A 2011 Water Quality & Health Council survey of 1,000 American adults found that nearly half of all respondents (47 percent) overestimated the amount of bleach needed in a gallon of water to kill common foodborne germs. In a 2009 study by Yang et al.1, five common household products were tested for their ability to destroy three of the most common kitchen germs (E. coli O157:H7, Salmonella and Listeria). Of chlorine bleach, hydrogen peroxide, white vinegar, lemon/lime juice and baking soda, only chlorine bleach solution successfully destroyed all three of these types of foodborne bacteria. Chlorine bleach is also effective against viruses, and it is widely recommended for disinfecting surfaces against the extremely contagious norovirus (norovirus posters).

Safety Always

Always keep chlorine bleach out of the reach of children. Make chlorine bleach solutions fresh daily, as they break down over time. Use the chart below to help you make up only the quantity you expect to need for the day. Never combine chlorine bleach with ammonia-containing products.

Household Task Add This Much Bleach… …to This Much Water
Routine Kitchen Disinfection ½ tablespoon ½ gallon
Small Quantity ¼ tablespoon 1 quart
Routine Bathroom Disinfection ½ tablespoon ½ gallon
Small Quantity ¼ tablespoon 1 quart
Disinfecting Surfaces against Flu virusesi 2 tablespoons ½ gallon
Small Quantity 1 tablespoon 1 quart
Disinfecting Surfaces against Norovirusii 3 tablespoons ½ gallon
Small Quantity 1 1/2 tablespoons 1 quart

Joan B. Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.

iWhen disinfecting against flu virus, leave disinfecting solution on surface for 10 minutes, then rinse.

1Yang, H., Kendall, P.A., Medeiros, L. and Sofos, J.N. (2009). Inactivation of Listeria monocytogenes, Escherichia coli O157:H7, and Salmonella Typhimurium with Compounds Available in Households. Journal of Food Protection, v. 72, No. 6, pp. 1201-120ne8.

iiWhen disinfecting against norovirus, air dry after applying disinfecting solution. If object is intended for food or mouth contact, rinse with plain water before using.


Easter Egg Safety
Written by Water Quality & Health Council

Easter EggsDying Easter eggs and organizing Easter egg hunts are treasured traditions in many families. Enjoying these traditions safely—without foodborne illness—is a matter of following a few commonsense guidelines. We provide the following Easter egg safety tips based on US Department of Agriculture Fact Sheets with our wishes for a healthy, enjoyable holiday.

Buying Eggs

Buy eggs from a refrigerated case. Open the carton and inspect for clean, uncracked shells. The egg carton should be imprinted with a USDA grade shield and indicate a future “sell by” date (see photos below).

Refrigerating Eggs

Eggs in a carton
Grade A eggs

Any bacteria present in an egg can multiply quickly at room temperature, so refrigerate eggs as soon as possible after purchasing them. The USDA recommends storing eggs in their carton in the coldest part of the refrigerator (40 degrees F or below). Do not store eggs on the refrigerator door shelf, which is warmer than interior areas.

Refrigerated eggs should not be left out for more than two hours. Hard-cooked eggs should be refrigerated within two hours of cooking and used within one week. It may seem counter-intuitive, but hard-cooked eggs spoil faster than fresh eggs because in cooking eggs, a protective coating on the egg shell is washed away.

Dying Eggs

Always wash hands thoroughly before and after handling eggs. Dye hard-cooked eggs using food-safe coloring and return eggs to the refrigerator within two hours.

Blowing out Eggshells

In some traditions, egg contents are blown out of shells before decorating. Use only eggs that have been kept refrigerated and are uncracked. To destroy bacteria that may be present on the shell surface, before blowing out contents, wash the egg in hot water followed by a rinse in a solution of one teaspoon liquid chlorine bleach in ½ cup of water.

Hunting Eggs

If eggs are to be consumed, they should be hidden in places that are free of dirt, moisture, pets and other sources of bacteria. Eggs in contact with soil can pick up bacteria, especially if the shells are cracked. The total “hide + hunt time” should not exceed two hours. “Found” eggs should be washed, re-refrigerated and eaten within seven days of cooking.


Five Tips for Avoiding Norovirus
Written by Joan Rose, PhD

Five Tips for Avoiding Norovirus“GII.4 Sydney” is the technical name of a rapidly spreading strain of norovirus, first identified in Australia and currently causing outbreaks of gastrointestinal illness in North America and elsewhere around the globe. Some know it as the “stomach bug” or “winter vomiting disease.” Whatever you call it, this highly contagious virus can take you out of commission for several days. The Centers for Disease Control and Prevention reports that annually norovirus causes 21 million cases of illness, 70,000 hospitalizations and 800 deaths.

The following tips can help you avoid norovirus:

  1. Wash Your Hands Frequently: Because person-to-person contact is one of the main routes by which norovirus spreads, frequent hand-washing is a must, especially after using the bathroom or changing diapers, and before cooking or eating. Washing virus particles from your hands and down the drain helps prevent you from inadvertently delivering them to your mouth and eyes, entry points for infection. It also helps halt the chain of transmission of the virus to those around you. Do you wash and dry your hands properly?
  2. Don’t Rely on Hand Sanitizer: Hand sanitizer may not be completely effective in reducing the millions of norovirus that can end up on contaminated hands.
  3. Disinfect Hard Surfaces: Norovirus can remain on surfaces for days. Cleaning frequently touched surfaces is a step in the right direction but should be followed up with disinfecting. After cleaning, wipe hard surfaces with a solution made by adding 1/3 cup of bleach to 1 gallon of water; air dry the surface. If you are disinfecting a surface that may have food or mouth contact (e.g., toys or utensils), rinse well with plain water after air drying. You can download a free set of norovirus posters with disinfection directions (in English or Spanish) here.
  4. Wash Affected Laundry with Hot Water and Bleach: There are billions of norovirus particles in the stool and vomit of infected people. Laundry that has contacted these materials should be washed with very hot water and bleach (fabric permitting). Choose the longest wash cycle and, if possible, machine dry them.
  5. Place the Toilet Seat Cover Down before You Flush: Studies show norovirus can become airborne and travel up to three meters, infecting surrounding surfaces. Following a vomiting or diarrhea incident be sure to place the toilet seat cover down before flushing. Thoroughly clean and disinfect the bathroom.
  6. Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.


“Vomiting Larry” Helps Researchers Understand Norovirus Spread

Vomiting? Assume Norovirus

Even though flu can cause nausea and vomiting, particularly in children, any vomit or diarrhea may contain norovirus and should be treated as though it does.

It’s January, and norovirus, known as “winter vomiting virus,” the “stomach bug” or the “stomach flu,” is on the move in the Northern Hemisphere. Norovirus is not the same as the seasonal flu, but both are off to an early start this year. The seasonal flu is a respiratory illness caused by the influenza virus, whereas norovirus inflames the gastrointestinal tract and causes vomiting and diarrhea. In a creative use of robotics, scientists in Great Britain are learning how the virus spreads when sick people vomit.

Meet Vomiting Larry (but keep your distance)

Vomiting Larry is a “humanoid simulated vomiting system” designed to help scientists analyze contagion, according to a Science Daily article. Vomiting Larry was developed by Catherine Makison-Booth at the Health and Safety Laboratory in Derbyshire, northern England. Larry consists of a mannequin head with simulated tongue, teeth, esophagus and stomach. A calibrated piston pushes fluid up and out of Larry’s mouth to simulate vomiting.

Larry has been helping scientists understand the spread of norovirus. Professor Ian Goodfellow of the University of Cambridge describes norovirus as “the Ferrari of the virus world” for its ability to infect hosts with fewer than 20 virus particles. Dr. Goodfellow notes “…each droplet of vomit…from an infected person can contain enough virus to infect more than 100,000 people.”

Larry is infused with a “vomitus substitute” that includes a fluorescent marker to help track even very small splashes. In experimental trials, researchers identified vomitus droplets as far as three meters away from Larry, helping them understand the need to disinfect surfaces farther from a vomiting incident than one might expect. The plot thickens, however: Because tiny norovirus particles can float through the air, people in the vicinity of a vomiting person can become infected simply by having the virus enter the mouth or contact the eyes.

Destroying Norovirus on Surfaces

In 2012, representatives of the Water Quality and Health Council, the New Jersey Somerset County Health Department, the National Environmental Health Association , the US Centers for Disease Control and Prevention and the American Chemistry Council collaborated to develop a series of posters with explicit directions on disinfecting surfaces against norovirus using chlorine bleach and water solutions.

One of these posters instructs on disinfecting surfaces following a diarrhea or vomiting “event” and the other is meant for stepped-up routine surface disinfection when norovirus is known to be present in the community. Both posters may be freely downloaded in either English or Spanish. Additionally, for a limited time, color, laminated posters are available by contacting the Water Quality & Health Council at 202-249-6705.

We hope you get through norovirus season “without incident,” but if you don’t, keep in mind what researchers have learned:

  • Airborne norovirus particles can infect people in the vicinity of a vomiting individual by entering the mouth or making contact with the eyes.
  • To be most effective, norovirus cleanup after a vomiting incident should extend well beyond the immediate location of vomiting, up to a distance of 3 meters away.

Barbara M. Soule, R.N. MPA, CIC, FSHEA is an Infection Preventionist and a member of the Water Quality & Health Council.


Reducing the Risk of Mycobacteria in Home Water Systems

Shower A group of bacteria known to occur in treated water may present a health risk to certain susceptible individuals.  An article in the December, 2012 issue of Opflow, a journal of the American Water Works Association, describes these microorganisms and how they propagate and provides practical tips for reducing exposure to mycobacteria.

The mycobacterium avium complex (MAC) and related bacteria are known as nontuberculous mycobacteria (NTM).  As the name implies, NTM do not cause tuberculosis.  NTM may however cause pulmonary disease or blood or lymph node infections.  According to National Jewish Health, every year approximately two people in 100,000 in the US develop NTM infections.  These incidents may be rising in some parts of the country.

NTM may cause no symptoms at all or they can cause symptoms similar to tuberculosis, such as coughing, weight loss, coughing up blood or mucous, weakness, fatigue, night sweats and/or lack of appetite.  If you have these symptoms and do not know why, talk to your health professional.  You may be infected with NTM.

Who is at risk?

According to the Opflow article, those at risk for NTM disease include people with the inherited lung disease cystic fibrosis and the four percent of the US population who carry a single cystic fibrosis mutation.  Older people are also at increased risk of infection.

Tracking NTM

NTM are found in natural waters and soils. The bacteria attach themselves to soil particles and interior surfaces of water distribution pipes in slimy coatings known as biofilms.  In a recent study, an estimated 40 percent of NTM-infected patients across the US had bacteria in their household plumbing that matched their particular infection, implicating home plumbing.

How do people become infected?

People may become infected with NTM by inhaling fine mists of infected water, such as during showering or when using humidifiers.  It is also possible to inhale NTM while working with potting soils. NTM are resistant to common forms of water treatment, such as chlorine, chloramine, chlorine dioxide and ozone.  This resistance is due to a biological design in which NTM cells are surrounded by a thick fatty membrane that repels water and prevents contact with disinfectant.  

NTM Infection: Reducing Your Risk

If you are at risk for NTM infection, here are some tips to help reduce your risk of infection:

  • Avoid showering and exposure to the mist that develops in a shower. Substitute bathing for showering and ensure bathroom ventilation to avoid inhaling water mist.
  • Set your hot water heater temperature to at least 130 degrees F (55 degrees C); research shows at least two species of mycobacteria are killed or inactivated by high hot water heater temperatures. This will also reduce risk of MRSA and Legionella.
  • Avoid hot tubs.
  • Avoid using humidifiers.
  • Keep potting soil moist when working with it to avoid breathing soil dust; wear a dust mask to prevent inhalation.

As the US population ages, NTM infection rates are likely to increase.  According to the Opflow article, the prevalence of NTM-related diseases is increasing at a rate of five to eight percent annually.  Understanding how NTM are transmitted helps us develop strategic measures to prevent infection.  Communicating these measures will be a growing public health priority.

Fred Reiff, P.E., is retired official of both the U.S. Public Health Service and the Pan American Health Organization, and currently lives in the Reno, Nevada area.


That White Film on Baby Carrots: Myth and Fact
Written by Linda Golodner


There is no truth to the myth that the whitish film on baby cut carrots is a chlorine residue from carrot processing.

Myth: The white film noticed occasionally on baby carrots is a chlorine residue from carrot processing that presents a cancer health risk to consumers.

Fact: The white film in question, sometimes referred to as “white blush” or “carrot blush,” is not chlorine, but a thin layer of dehydrated carrot. The film develops when baby carrots are exposed to the atmosphere and the outer layer of carrot becomes dry. Baby carrots, unlike their full-sized counterparts, do not have a protective skin that helps prevent drying. That’s because most baby carrots are made by cutting and shaping large deformed carrots. These are correctly called “baby-cut” carrots.

According to Joe Schwarcz, director of McGill University’s Office for Science and Society (article), moisture loss from the carrot surface roughens up the carrot surface and causes light to be scattered, resulting in a whitish appearance. The white blush may also appear when abrasion damages cells on the carrot surface, releasing an enzyme that catalyzes the formation of lignin, a natural substance in plants that scatters light to produce a whitish tinge.

Eat Your Carrots!

Because of their beta carotene content, one-half cup of baby carrots supplies more than a day’s worth of Vitamin A, according to the US Department of Agriculture’s fact sheet on fresh baby carrots. The nutritional value of baby carrots is approximately the same as that of ordinary carrots. Vitamin A helps maintain the health of specialized tissues such as the retina; aids in the growth and health of skin and mucous membranes; and promotes normal development of the teeth, soft and skeletal tissue. Eating carrots can even enhance night vision.

FDA Recommends Antimicrobial Use in Produce Processing Water

The US Food and Drug Administration (FDA) recommends baby carrots and many types of fresh produce be washed in an antimicrobial water solution during fresh produce processing. The purpose of this requirement is to reduce pathogens on fruits and vegetables that could cause an outbreak of foodborne illness. These germs may originate with soil contact or contamination during handling and processing. According to FDA’s Guidance for Industry: Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables, “Chlorine…is commonly added to water at 50-200 parts per million total chlorine, at a pH (a measure of acidity of the water) of 6.0-7.5, for post-harvest treatments of fresh produce, with a contact time of 1-2 minutes.” For reference, chlorinated drinking water contains up to 4 parts per million chlorine. As a final step, processing water is rinsed off produce with plain tap water.

The baby carrot myth has been making the rounds for years. Instead of representing a cancer health hazard, carrot processing with chlorinated water is a health-protective step that helps prevent foodborne outbreaks. According to the Centers for Disease Control and Prevention, each year 48 million people, or one in six Americans, contract foodborne illnesses; 128,000 Americans are hospitalized and 3,000 die as a result of unsafe foods. We need to eat fruits and vegetables to stay healthy and antimicrobials like chlorine-based disinfectants help us do that safely. So, eat your carrots and enjoy!

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.


New Tools to Help Reduce the Spread of Norovirus
Written by Linda Golodner

Help Prevent the Spread of Norovirus
Clean-up and Disinfection for Norovirus

These posters may be viewed at higher resolution at: http://www.disinfect-for-health.org/resources

Each year an estimated 20 million Americans are sickened by a highly contagious virus that usually turns up in force in late fall and hangs around until early spring. Norovirus, aka the “stomach bug,” “winter vomiting disease,” or “stomach flui” is an uninvited guest at nursing homes, schools, holiday parties, and wherever people congregate. It is the leading cause of outbreaks of diarrhea and vomiting in the US, and it spreads like wildfire because (brace yourself) the vomit and diarrhea of infected people contain billions of norovirus particles. Viruses are extremely small—smaller than bacteria—and norovirus particles can float through the air, settling on environmental surfaces where they can remain alive or infectious for weeks while they await their next host.

Recognizing the need for effective resources to help battle norovirus, a team of public health partners (New Jersey Somerset County Health Department, the Centers for Disease Control and Prevention (CDC), the Water Quality & Health Council, the National Environmental Health Association and the American Chemistry Council) collaborated to produce two new posters: One features plain-language directions for responding to a vomiting or diarrhea incident; the other gives clear directions for routine disinfection when norovirus is known to be affecting the community.

All about Norovirus

Just How Contagious is Norovirus?

A 2010 norovirus outbreak among a girls’ soccer team demonstrates how easily the virus can spread. One player became sick during a tournament in Seattle. The girl spent the night in a chaperone’s room and used the bathroom several times. Stored in the bathroom was a reusable grocery bag filled with cookies and chips. After eating snacks from the bag, six other team members became sick with the same strain of norovirus. Although the girl had not touched the bag, she was the likely source of the infectious norovirus particles that had settled through the air of the bathroom onto the bag and its contents.

Norovirus is characterized by diarrhea, vomiting, nausea and stomach cramping, according to the CDC. Less common symptoms include low-grade fever, chills, headache, muscle aches and a general sense of fatigue. Most people get better in one to two days (though they may remain contagious for at least three days after being sick), but in the elderly, young children and people with health conditions, norovirus can lead to severe dehydration, hospitalization and even death.

Norovirus can be spread by direct contact with an infected person or by an individual touching a contaminated surface and then touching their mouth or nose. Norovirus is the leading cause of foodborne illness in the US, and can be transmitted through foods prepared by sick food handlers.

Older people are most susceptible to norovirus, according the CDC, followed by children under the age of five. Approximately 800 deaths are attributed to norovirus annually, but this toll can climb to about 1200 when new strains emerge.

Spread the Word

Poster directions for mixing bleach solutions are based on CDC protocols and those promoted by many state health departments. These posters are freely available for download in English or Spanish, color or black-and-white and large (11”x17”) or small (8.5”x11”), on the website of the Water Quality & Health Council. The public health partners who created these resources truly hope that their efforts will make a difference by curtailing the spread of norovirus.

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

i“Stomach flu” is a misnomer because norovirus is unrelated to influenza viruses.


Activating Your Holiday Kitchen
Written by Water Quality & Health Council

carrotsIt’s the holiday season and your kitchen may be one of the millions in America that is about to be activated. Get ready to turn out your favorite dishes in the warmest, friendliest room in the house. But keep in mind that according to the Centers for Disease Control and Prevention, each year one in six Americans (48 million) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne illness. Here are some tips to help prevent the spread of foodborne illness during the holiday cooking season:

Handle Food Safely

  • Clean – Wash all food contact surfaces with hot, soapy water followed by disinfecting with 1/2 tablespoon chlorine bleach in 1/2 gallon of water. Do this before and after working with raw foods, especially meat and poultry.
  • Wash Hands – Thoroughly wash hands with warm, soapy water before and after all food preparation and after handling turkey.
  • Compartmentalize – Keep fresh fruits and vegetables separate from raw meat, poultry and seafood.
  • Cook – to kill any bacteria that might be present, thoroughly cook meat, poultry and eggs to the appropriate temperature.
  • Chill – Refrigerate leftover perishables at 40 degrees within two hours after cooking or serving.

Zap that Sponge to Stop Spreading Germs

From a microbiological point of view, the kitchen sponge may be the most contaminated item in your home.  Researchers recommend “zapping” wet kitchen sponges every other day or so (more frequently during heavy use) for 2 minutes on high power to destroy germs that thrive in damp sponges.  This is a simple and effective method when carried out properly (with the emphasis on “properly” because improper microwaving of sponges can cause severe skin burns and has the potential to start a fire). 

Zap It Safely:

  • Guard against the risk of fire: Ensure sponge is completely wet before placing in the microwave oven.
  • Guard against burns: Be careful when removing sponge from the microwave oven as it will be hot and there may be steam when the microwave is opened.
  • Guard against electrical shorting: Sponges should have no metallic content.

Wash Reusable Shopping Bags

Reusable bags are only as clean as the items with which we fill them and research shows they may contain large numbers of bacteria. You can take steps to help prevent cross-contamination with “bag bacteria.”

  • Ask to separate raw foods from ready-to-eat foods at the check-out.
  • Clean bags regularly. Canvas and cloth bags can be washed in washing machines; plastic reusable bags can be washed by hand with hot, soapy water.
  • Store bags in a dry environment with good air circulation, not in the trunk of your car.

The Water Quality & Health Council wishes you a happy, healthy Holiday Season!


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