Purpose: The objective of this study was to investigate and examine policies and practices of schools during norovirus outbreaks, including outbreak control and communication methods, through school decision makers and sanitation staff.
Methods: Norovirus procedures were collected via a convenience sample of 92 North Carolina school principals. Participants were asked a combination of open-ended, Likert scale, and importance-ranking tasks regarding school policies during a norovirus outbreak, including cleaning measures, exclusion policies and communication with parents and students. Additionally, twenty school janitors were interviewed about their knowledge of norovirus control measures and specific school practices for dealing with norovirus.
Results: Only 13% of principals knew detailed school norovirus control policies and 42% indicated that janitorial staff would be a better source of that information (n = 60). Additionally, 30% of principals stated their school had no written policy on staff exclusion during an outbreak and 18% had no student policy (n = 72). Sixty-six percent of principals said written policies for janitorial staff would be helpful, and 60% indicated a need for better resources on GI illnesses (n = 70). Interviews with janitors revealed that the effectiveness of quaternary ammonium compounds on norovirus is not well understood.
Significance: This is one of the first studies to analyze school practices during a norovirus outbreak and results suggest that there are important gaps that need to be addressed in school procedures. There is a need for written exclusion and control guidelines within schools and norovirus specific cleaning protocols that identify appropriate sanitizers, concentration and contact time.