Part two of this three-part article focuses on how to prevent Norovirus from spreading.

Hand washing is the best way to stop the spread of Norovirus. Bishop says prevention begins with education on proper hand hygiene. Students should wash their hands after using the restroom and before eating food. In daycares, caretakers need to wash hands after changing diapers. Distributors can help with posters, magnets, brochures and other memory aids that teach kids (and teachers) to wash hands for the time it takes to sing “Happy Birthday.” Bishop also recommends that distributors partner with the school nurse to help spread the message.

Research shows that children need reminders of when to wash their hands. According to a 2011 study by the American Cleaning Institute, an overwhelming majority of students — 89 percent — wash hands after using the toilet. That’s great news to prevent Norovirus in the restroom, but there’s more work to be done. Only 49 percent wash their hands before eating a snack. Plus, a quarter of the kids admit they only wash their hands when they look dirty. So, if a child touches a contaminated surface in the classroom or hall, or touches an infected student, Norovirus will be on his or her hands until he or she goes to the bathroom.

Hand sanitizer can be used in addition, but never as a replacement to hand washing, because it won’t kill Norovirus. Regular soap, not antibacterial, is preferred.

“Antibacterial products affect only bacteria,” says Darrel Hicks, R.E.H., author of “Infection Prevention for Dummies.” “They are useless against flu bugs, which are viruses.”

Hand washing is still needed even after an infected person starts feeling better. Norovirus is still found in stool for up to two weeks after symptoms disappear, says the CDC.

Clean And Disinfect

After a person vomits or has diarrhea, custodians need to immediately clean and disinfect the contaminated surfaces. Staff should wear personal protective equipment, including disposable gloves, aprons and masks.

Removing germs and viruses is a legitimate strategy of infection prevention. Custodians can use cloths, paper towels, mops or microfiber products to remove the vomit and stool. Microfiber does the best job of removing germs. The U.S. Environmental Protection Agency (EPA) reports that when microfiber cleaning tools are used, as much as 99 percent of germs are removed, including Norovirus.

Hicks goes a step further, recommending ultra-denier microfiber.

“It does a much better job of removing dirt and biofilm, and then if you’re using a disinfectant, it will be effective,” he says.

After removal, custodians should wash the area with soapy water and then rinse with clean water before disinfecting. The CDC recommends a bleach-based disinfectant.

“You need [bleach] in your arsenal if you have an outbreak,” says Glenn Rothstein, president of Spotswood, New Jersey-based Bio-Shine Inc.

The downside of bleach is that it damages a variety of surfaces. It also has a relatively short shelf life — mixed solutions need to be used within 24 hours. Vapors can be very harmful to children, and if mixed with other chemicals, bleach can create a toxic gas. Because of these problems, some schools ban bleach. However, there are alternatives.

An ethanol alcohol-based disinfectant, with 50 to 90 percent of the solution being the active ingredient, can be effective at reducing or eliminating viruses like Norovirus, says Hicks. In addition, they do not leave residue or corrode metal. However, they are flammable, evaporate quickly and can damage plastic and rubber. When choosing an alcohol disinfectant, isopropanol is not effective against non-enveloped viruses such as Norovirus.

Hydrogen-peroxide-based disinfectants are safer disinfectants to use, especially around children, and they have fast kill claims.

“We recommend peroxide-based cleaners,” says Rothstein. “They have a lower health and environmental impact, and they don’t leave residuals.”

A newer way to safely disinfect is with on-site generation, engineered water products. They are effective against Norovirus and depending on the product, recognized by the EPA as a registered disinfectant.

Harsh chemicals can provoke a host of negative physical reactions in children, so Bishop emphasizes utilizing the least toxic cleaning and disinfection products effective for Norovirus.

“Distributors can coach maintenance on when and where to use them to be targeted and smart, so they’re not carpet bombing,” says Bishop.

Quat-based disinfectants are commonly found in many janitors’ closets, but they are ineffective against Norovirus.

“When used according to directions, they kill 90 percent of germs, but don’t kill Norovirus,” says Rothstein. “Quats poison Norovirus, and then the germs go hybrid, adapt and continue to live.”

If customers are unsure about which disinfectant to use, distributors should advise them to consult the EPA’s list of registered disinfectants approved for Norovirus, known as List G.

If a child is sick in a carpeted room, custodians can use baking soda or an absorbent product to absorb the vomit. Then steam clean the carpet to disinfect.