PHE’s ‘Guidance on preventing person-to-person gastrointestinal infections’ issued originally in 2004 is still current.3

The guidance advises that all cases of diarrhoea and/or vomiting should be regarded as potentially infectious. People with symptoms “should normally be excluded, from work, school or other institutional settings, at least until 48 hours after the person is free from diarrhoea and/or vomiting.”

Good personal hygiene can help reduce the risk of transmission. The most important factor in preventing the spread of gastrointestinal infections is for people to use soap (preferably liquid) in warm running water and to wash their hands frequently. However, the NHS advises that “alcohol hand gels don't kill norovirus,” although they “may have a role in certain circumstances, particularly during outbreaks in institutional settings.”3,23

Hand washing is needed after contact with the sick person, handling their clothes and bedding, and any other potential fomites. It should also be done before preparing food or eating meals, after using the toilet or changing a nappy. Towels should not be shared. Soiled clothing and bed linen should be laundered separately to other items at the highest temperature the material can withstand.

Norovirus can survive for long periods on surfaces and will not be affected by freezing and or relatively high temperatures, up to 60°C. A Canadian study in 2010 found that sodium hypochlorite 3% solution was potentially 100 times more effective at reducing the level of norovirus contamination on a steel surface compared to quaternary ammonium compounds and ethoxylated alcohols.28,29