‘Tis the season for noroviruses, and this was one of those times when we’d start writing about one school outbreak, then another would pop up. And then another, and another…until finally the better story was not so much about detailing the plethora of specific instances, but on noroviruses and schools in general.
Norovirus was first identified in a school outbreak in Norwalk, Ohio, about 50 years ago. In just a few days, about half of the students and staff had taken ill with an unknown agent generally called “winter vomiting disease.” A couple of years later, we were finally able to see this virus for the first time using an immune electron microscope. It was called Norwalk virus in recognition of where the outbreak had taken place. (A great synopsis of the story and our early research into the virus can be found here, written by Dr. Kapikian himself.)
Since norovirus only infects humans, and is spread through close contact with infected people or with contaminated food, water, or surfaces, we tend to see norovirus where people gather and/or have meals. Schools are a logical setting for norovirus outbreaks, as well as places such as hospitals, eldercare facilities, and restaurants.
We at NoroCORE have been informally and formally looking at school norovirus outbreaks for a few years now, with a goal of finding ways to help schools prevent and control these outbreaks, and one thing we have seen is variation in how schools manage these events. For example:
- How they inform parents: letter, email, Facebook post, local news media, etc.
- What information they give to parents
- Whether they educate the students of how to prevent getting or spreading the virus
- What precautions they take around the school: where they disinfect and what they use, and do they do it in-house with their custodial staff or hire an outside cleaning service
- What criteria they use to decide when to close a school
- Whether they elect to collaborate with their local or state health departments
Below is every U.S. school outbreak we heard of in December, with some of their differences or interesting notes highlighted. In each case, norovirus was at least the presumed cause, and a six of the ten schools temporarily closed to contain the virus.
Gladstone Elementary in Rhode Island closed at the beginning of December due to a norovirus outbreak that affected about 40% of their kindergarten class. This was the first time the author had seen mention of both the school and the buses being disinfected, which is a good idea. The school also elected to disinfect surfaces on three separate days because the virus is hardy.
Shepherd of the Hills Christian School in Colorado was closed one day for cleaning, and notified parents through its Facebook page.
P.S. 83 Annex School in New York City had over 100 students out sick, and the pupils were sent home with letters before the school was disinfected over a weekend.
Manor Heights Elementary in Wyoming had about 80 students out sick.
Gifford Middle School in Florida had over 100 ill students (out of a student body of 900), perhaps with 60 of those being due to norovirus and some of the others staying home out of caution. The school was cleaned and sanitized daily and underwent a deep cleaning over the weekend. They focused on disinfecting doorknobs, desks, bathrooms, cafeteria tables, and water fountains and used Facebook to notify parents.
North Scituate Elementary School in Rhode Island closed on a Friday for a deep cleaning over a weekend.
Viera Charter School in Florida closed a day before their scheduled holiday break, after 40 students were confirmed as sick, and 400 students or about half of the school was absent as a precaution. The school used a contracted cleaning service to disinfect the premises.
Three schools, Cole Middle School, Cole High School and Cole Arts and Science Academy, housed on the same campus in Denver, Colorado were closed for two days right before the holiday break so their custodial staff could disinfect the school. During the event, Denver Public Health contacted Denver Public Schools to inform them their disinfectant wasn’t strong enough to kill the virus, leading the school to close early for more cleaning.
The facilities department for Boston Public Schools cleaned Mendell School multiple times over a week after about a tenth of the student body was absent with norovirus-like symptoms.