Purpose of the GuidelinesThe purpose of the Guidelines for the public health management of gastroenteritis outbreaks due to norovirus or suspected viral agents in Australia (the Guidelines) is to provide national best practice guidelines for staff of public health units.
They are written to help in identifying, preventing, defining and managing outbreaks of suspected viral illness, particularly those due to norovirus. They will assist in the investigation and management of outbreaks and are designed to guide investigations from the time a report is received, through the initial investigation to the control and clean-up phases. The Guidelines also identify educational opportunities.
Target audienceStaff of public health units, health departments and infection control practitioners will use these Guidelines. Extracts of Guidelines may also be useful for managers of aged-care facilities and other institutions and facilities affected by outbreaks.
Institutions are particularly affected by outbreaks of viral illness. For the purpose of the Guidelines, ‘institutions’ are taken to mean an organisation, society or community setting where people come together for long or short periods of time, on a one-off or ongoing basis – for example, a school, a cruise ship or an aged-care facility. The Guidelines are not specific to one particular setting or institution; the principles are applicable to any setting, although outbreaks may be more difficult to manage in certain institutional settings.
Preparation of GuidelinesThe Guidelines have been prepared under the auspices of the Communicable Diseases Network Australia (CDNA). CDNA is a subcommittee of the Australian Health Protection Committee (AHPC), which is a subcommittee of the Australian Health Ministers’ Advisory Council. CDNA consists of directors of communicable disease surveillance from State, Territory and Federal health departments, along with other expert members. The Norovirus Guidelines Working Group was formed by CDNA to develop these Guidelines. This group consisted of public health and laboratory representatives with support from the Australian Government Department of Health and Ageing (DoHA).
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Topics coveredRecommendations in these Guidelines were derived from evidence-based literature and research and also from local and international documents specifically developed for norovirus and viral gastroenteritis.
The Guidelines make recommendations for:
- defining cases and outbreaks (Chapter 6)
- criteria for starting an investigation (Chapter 7, Section 7.2)
- outbreak investigation (Chapter 7)
- outbreak management (Chapter 8).
- links to further web-based sources of information about norovirus (Appendix 1)
- a public fact sheet (Appendix 2)
- information about collecting clinical specimens in an outbreak (Appendix 3)
- a summary of cleaning and disinfection procedures to use or forward to institutions and general practitioners to assist in outbreak control (Appendix 4)
- details of the management of norovirus outbreaks in aged-care facilities (Appendix 5).
Help for aged-care facilitiesAppendix 5 has been specifically written to address the Management of norovirus outbreaks in aged-care facilities. The section includes detailed information on infection control measures, specimen collection and an illness register. This appendix has been designed to enable aged-care facilities to identify and self-manage outbreaks using the resources available as well as referring to any internal policies that they may already have in place.
Gastrointestinal illness in institutions is notifiable in some states and territories, as is suspected foodborne or waterborne illness. In this instance, aged-care facilities will need to report the outbreak to their local public health unit. Managers of agedcare facilities may at any time contact their local public health unit if needed, even if the outbreak is not notifiable in their jurisdiction. Aged-care facilities should also be encouraged to inform the state office of DoHA (aged care section) within their jurisdiction about the outbreak.
Using the GuidelinesThe Guidelines should be used as a:
- reference for Public Health Unit (PHU) staff
- basis for education / training
- resource during outbreaks.