Guidelines for the Prevention and Control of Norovirus Transmission in Healthcare Settings

Abstract

Norovirus is a leading cause of acute gastroenteritis and a frequent driver of outbreaks in healthcare settings, particularly among high-risk populations such as older adults and immunocompromised individuals. Because of its low infectious dose, environmental persistence, and multiple transmission routes, nosocomial spread can occur rapidly, imposing substantial clinical, operational, and economic burdens on patients, healthcare personnel, and institutions. This article synthesizes evidence-based recommendations from the U.S. Centers for Disease Control and Prevention (CDC), together with relevant empirical studies, to delineate practical strategies for prevention and control in healthcare facilities. Core components include patient cohorting and isolation precautions, strict adherence to hand hygiene, appropriate selection and use of personal protective equipment, and targeted environmental cleaning and disinfection. Alcohol-based hand rubs alone are insufficient; handwashing with soap and water remains the cornerstone of effective hand hygiene. During outbreaks, effective management of affected units is essential to contain transmission and maintain operational capacity. Environmental cleaning should prioritize high-touch surfaces, using disinfectants proven effective against norovirus to reduce environmental contamination and interrupt transmission. Complementary measures encompass workforce and visitor management policies, as well as effective risk communication and education to support timely detection and response. The review also outlines priorities for future research to strengthen the evidence base, optimize intervention effectiveness, and guide efficient, context-specific outbreak preparedness and control.