Norovirus (NoV)

Characteristics

Morphology Family: Caliciviridae; Genus: Norovirus; Species: Norwalk. There are six genogroups (G). Single stranded RNA virus; Non-enveloped, 27-32 nm virion
Growth Conditions Human norovirus cannot be cultured in vitro. Surrogate viruses that can be maintained in vitro: coliphage MS2, murine norovirus (MNV) and feline calicivirus (FCV). 

Health Hazards

Host Range GI, GII & GIV: human; GIII: bovine; GV: mice

Modes of Transmission

Norovirus must enter the digestive track in order to initiate infection. Frequent routes include: fecal-oral, contaminated food or water, person-to-person, contaminated fomites or body fluids, and aerosolized contaminated particles.

Signs and Symptoms

After exposure: vomiting, diarrhea, abdominal pain; symptoms may last for 24-72h. Usually it is self-limiting

Infectious Dose 18 to 103 virus particles
Incubation Period Incubation 12-48 h

Medical Precautions/Treatment

Prophylaxis Hand washing with soap and water, limiting contact with contaminated food, water, surfaces or body fluids. Note: Alcohol-based hand disinfectants are not effective
Vaccines None
Treatment No specific therapy other than electrolyte and fluid replacement.

Surveillance

Monitor for symptoms; confirm by detection of viral RNA.

Emory Requirements Report all exposures.

Laboratory Hazards

Laboratory Acquired Infections (LAIs) None
Sources Contaminated food, water, fomites, aerosol and body fluids (vomit and stool). Shedding of virus in stool occur before symptoms appear, during clinical symptoms and during recovery.

Supplemental References

Containment

BSL-2 BSL-2 practices and containment equipment for all activities involving the virus or any infectious or potentially infectious body fluids or tissues

Spill Procedures

Small Notify others working in the lab. Allow aerosols to settle. Don appropriate PPE. Cover area of the spill with paper towels and apply an EPA registered disinfectant with a label claim for norovirus,, working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials.
Large

Contact Emory’s Biosafety Officer (404-727-8863),
the EHSO Office (404-727-5922), or
The Spill Response Team (404-727-2888).

Exposure Procedures

Mucous membrane Flush eyes, mouth or nose for 15 minutes at eyewash station.
Other Exposures Contaminated surfaces: allow aerosols to settle; wearing protective clothing, gently cover the spill with absorbent paper towel and apply 1% sodium hypochlorite starting at the perimeter and working towards the middle; allow sufficient contact time (30 min) before clean up. Wash hands thoroughly with soap and water after removing gloves. Alcoholbased hand disinfectants are NOT effective.
Reporting Immediately report incident to supervisor, complete an employee incident report in PeopleSoft.
Medical Followup 

7am-4pm (OIM): EUH (404-686-7941) EUHM (404-686-7106) WW (404-728-6431)

After Hours: OIM NP On Call 404-686-5500 PIC# 50464

Needle Stick (OIM): EUH (404-686-8587) EUHM (404-686-2352)

Yerkes: Maureen Thompson Office (404-727-8012) Cell (404-275-0963)

Viability

Disinfection

1000–5000 ppm of chlorine bleach; any other EPA registered disinfectant with a label claim for Norovirus

Inactivation Steam sterilization, chemical disinfection, incineration
Survival Outside Host Highly stable, at least 61 days

Personal Protective Equipment (PPE)

Minimum PPE Requirements At minimum, personnel are required to don gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with Norovirus. Additional PPE may be required depending on lab specific SOPs.
Additional Precautions

None

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