Important information for all restaurants, hoteliers, caterers. Please pass on.

10 tell-tale signs of a possible norovirus out-break 

1. Having “food poisoning” cases that increase in number day by day without any clear reason

2. Guests getting “food poisoning” from different outlets, different foods, different staff, with no apparent pattern?

3. Symptoms of diarrhoea and / or vomiting that last 2-3 days and look like food poisoning 

4. The 'food poisoning' starts with one person in the room or group, then spreads to others (just like a flu), even if they don't eat or drink
    
5. A child or other person vomits in a public area – the following day many people fall sick, even if not in direct contact
    
6. Once guests report being sick from food poisoning, staff start getting sick also even with a different food source
    
7. A pattern emerges of people getting sick in guest rooms occupied by previous guests who were sick
    
8. The sick room pattern spreads to other rooms in the order they are cleaned or serviced (carried by housekeeping staff from room to room)
    
9. Starts with one or two cases, then a few days later there's talk about “everyone getting food poisoning” – the disease spreads in a linear fashion at first, then exponentially as more and more surfaces harbour the infection.

10. Other businesses, hotels and restaurants in the local area also start getting cases of 'food poisoning', with no common food, supplier or client base

This “new” virus has been doing the rounds for a while now, but not many people know enough about the warning signs to recognise what's going on.

Norovirus is the 'mystery food poisoning' that shut down Heston Blumenthal's 3 michelin star The Fat Duck restaurant in Bray, UK, and it's something that can spread like wildfire and badly affect reputations and profitability.
In fact the Fat Duck had done nothing wrong. Hygiene, systems, food handling were all top  and notch, but the Chef and the restaurant were hammered by critics blaming the food and the food handling.
Nothing could have been further from the truth.

If it happens to you or your establishment, it's important to recognise what is happening and act quickly. 
At the very least you'll be looking at lost revenue and guest perceptions of dirty kitchens and unclean food which will spread by word of mouth.

Recognising a Norovirus outbreak, and acting quickly to contain it is vital to retaining the confidence and respect of your guests, and the integrity of your brand.

This should be included in all Food safety and hygiene training, so please share this important info with everyone you know in hospitality, especially chefs, FB management and GM's

What do do in case of an outbreak

• Hotels and restaurants will be scratching their heads and checking their HACCP and food handling for the first 3-4 days– while this virus spreads like wildfire. UNLIKE food poisoning – it is VERY contagious. If one or more of the 10 tell tale signs above are present, get an immediate stool sample from the infected guest and have it sent for viral testing to check for Norovirus, rotavirus and norwalk-like virus
  
• Call an immediate meeting and put in place an action plan. Make sure all employees and management understand what this is and how it spreads, and what is required of each person as part of the action plan
  
• Log and record all infections from the very first.
  Log all of the following on an excel sheet: infected guest room numbers, any meals eaten, the outlets they were eaten at, guest nationality, guests previous location before arriving, and any relevant movements prior to and since getting sick.
  This will help you establish a pattern at some point, and help to confirm or rule out norovirus as the cause of illness
  
• Call in professional help.
  In case of a hotel or chain business, notify HQ or corporate office,
  Call your cleaning chemical company for support if you use someone like Ecolab or Johnson Diversey. They are experienced in handling outbreaks and have specialised consultants

• Double the recommended dilution strength of all commercial sanitisers and germicides

• Assign specific people full-time to do nothing but sanitise all public surfaces: special attention to door handles, phones, toilets, computer keyboards, hand rails

• Make all staff and management aware of human contact – shaking hands, swapping business cards, carrying guest bags – disinfect hands and use a strong hand sanitizer regularly

• Have a staff member at the toilets with hand sanitizer, sanitizing guest hands as they exit toilets and also doing taps, doors, soap dispensers and toilet flush buttons and seats.

• Stop just WASHING things. Immediately. Wash, and then BLEACH or use a commercial SANITIZER (the solution should be at double strength for an outbreak)
  
• Place complimentary hand sanitisers in all restaurants and public areas
  
• Close any buffets or shared food sources
  
• Make sure housekeeping staff do not sanitise different areas or rooms with the same cloths, gloves or equipment.
  This will spread the disease from one room to another on the cleaning equipment. Use disposable gloves and heavy commercial chlorine based sanitisers at double strength, and treat all used cleaning equipment, cloths and gloves as contaminated.
  
• Pay special attention to bathrooms and toilets. These must be repeatedly sanitised many times until a month past the last case of infection
  
• Be aware of guests, especially children, vomiting in any public area. Minute microscopic particles will spread through the air and infect guests, furniture and equipment up to a 10 metre radius. Ensure if anybody vomits, the whole room is considered contaminated and completely sanitised at double strength
  
• VERY important – if any staff vomit or get diarrhoea – then they have to stay home until AT LEAST 3 days after they feel better. You will be short-staffed in a time of crisis– but this WILL backfire on you if you have a Norovirus-infected staff member on duty as it will be easily passed on to more staff and guests. 

  Be aware – and PLEASE PASS THIS KNOWLEDGE ON to everybody you know in hospitality, or dealing with high volumes of people in enclosed areas

Some more helpful links

http://en.wikipedia.org/wiki/Norovirus

Norovirus infection fact sheet Toronto Public Health

Viral gastroenteritis or 'stomah flu'

Note: The author experienced  a norovirus outbreak in 2009, and successfully identified it using the steps above.
All of the above information is based on personal experience, and knowledge gained through working with professionals in the field of disease control