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Containing norovirus

The FSA has published a report, ‘Food handlers and Norovirus transmission (FS101143)’, on research carried out by Ipsos MORI [5]. The study aimed to help stop the 'winter vomiting bug' norovirus from spreading by understanding and improving food handler behaviours.

A literature review identified five strategies for controlling norovirus:

1. Personal hygiene

2. Food handling

3. Washing and cooking food

4. Surface and uniform cleaning

5. Fitness to work

Visits to food catering establishments involved in-depth interviews, surveys and structured environmental and behavioural observations. The strongest evidence for risk of norovirus spreading was:

• inadequate hand washing

• not washing hands before gloving

• using bare hands when preparing food

• not regularly changing gloves

• food handlers instead of trained staff cleaning areas where people vomited

• not washing uniform correctly

• returning to work too early after being ill.

Data analysis and behavioural theories were used to rank behaviours that risk spreading norovirus in relation to the control strategies. Several behavioural interventions were recommended based on the findings.

There was strong evidence for inadequate knowledge about norovirus and how to stop it spreading, so educational training for food handlers and FBOs was highly recommended. FSA is exploring the design and delivery of future interventions.

Environmental barriers were often identified both in terms of characteristics of the setting (time scarcity, busyness, workload, and in the case of returning to work, money and pay) and the physical design and infrastructure of food handling environments. Both frequent micro-behaviours (e.g. hand washing, glove use, surface cleaning) and less frequent behaviours (e.g. uniform cleaning and exclusion from work) were environmentally influenced.

There was a lack of social pressure or expectation to engage in recommended behaviours (which may also be related to not knowing what is appropriate), as well as the assumption that recommended practice is already happening.

Certain behaviours (most obviously hand hygiene and surface cleaning) had become routinised and habitual but were typically not aligned with recommended practice.



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