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Virology / Serology - Norovirus

Background

Norovirus (NV) symptoms include sudden onset of vomiting accompanied by watery diarrhea, nausea, abdominal cramps, fever, or headache, lasting anywhere from 12-60 hours. The incubation period is approximately 24-48 hours. Transmission may occur person-to-person or through the fecal-oral route via fecally contaminated food or water. Infection prevention and control measures include hand washing after using the bathroom and before handling food items, wearing masks when cleaning contaminated areas, handling soiled linens as little as possible, flushing or discarding any vomitus and/or stool in the toilet and making sure that the surrounding area is kept clean, and cleaning all surfaces with germicidal product (10% bleach).

Specimen Acceptance Policy

NCSLPH tests for norovirus during outbreak situations only. Local health departments should telephone the Communicable Disease Branch at (919) 733-3419 when enteric disease outbreaks are suspected in a day care center, nursing home, or restaurant. In addition, the Food, Lodging and Institutional Sanitation Branch of the Division of Environmental Health should be notified at (919) 733-2905 when restaurant or institution-associated illness is suspected.

Specimen Submission

To ensure that the event is eligible for outbreak investigation, contact the Communicable Disease Branch (CD) epidemiologists (919-733-3419). After approval by CD, submit one Clary-Blair (not raw stool) for each patient and request NV and enterics testing. Cary-Blair transport media for collection of feces is available through the NCSLPH online supply ordering system at this website. Each specimen must be clearly labeled with the patient's full first and last name and either SSN or date of birth. Complete one DHHS Enteric Bacteriology Form #3390 (PDF, 345 KB) for each specimen. Please submit at least five and no more than ten specimens for testing.

Specimen Shipping

To ship specimens to the NCSLPH, place completed Enteric Bacteriology DHHS Enteric Bacteriology Form #3390 (PDF, 345 KB) forms in outer container to avoid contamination in case of breakage or leakage. Follow all relevant packaging and shipping requirements. Unlabeled specimens will not be tested.

Results Reporting

For submissions of five or more samples, NV testing will be performed within one business day of receipt and results reported within two business days of receipt. For submissions less than five, samples will be tested for enterics and samples will be held until five samples from the same site are received. NV testing will be performed when five samples from the same outbreak are received. In this case, it may be five to seven business days until NV results are reported.

The results will be reported for a positive norovirus test as “NV RNA detected by RT-PCR” and for a negative norovirus test as “NV RNA not detected by RT-PCR”. The submitter will be notified by telephone of the results and the official report will be mailed. Additionally, CD will be notified of the tests results.

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Last Modified: February 27, 2013 2:17 PM