Noroviruses: Outbreak Management and Disinfectant Choice

By James Derham (BSc (hons)), Liam Grimshaw (MSc by research, BSc (hons))

Enteric virus (EV) outbreaks are prevalent in the care home community, with 73% of cases of outbreaks in weeks 43-44 in 2022 attributed to them (UKHSA, 2022). Typically spread via contact with faeces, infection can spread easily via surfaces, food and close contact from someone with the virus (NHS UK, 2021). Norovirus is a small, non-enveloped virus that’s very difficult to destroy with traditional disinfectants owing to its small size and external capsid structure (GOV, 2012).

It is vital to choose a disinfectant that is efficacious against Noroviruses. Chlorine-based products (bleach, NaDCC tablets and chlorine dioxide) lose efficacy in soiled conditions, where Noroviruses are prevalent. This means that they require an additional detergent cleaning step prior to use in order to still maintain efficacy.

An excellent alternative is peracetic acid (PAA), which outshines chlorine-based products because PAA is not hindered by soiled conditions. PAA is widely used in the food industry, water treatments, agriculture and many other high-level industries. Independent studies have shown that 85 – 250 ppm peracetic acid was effective in reaching 99.99 % reduction in viral particles with a contact time of 1 – 5 mins. It was also found that even in the presence of synthetic faeces, 85 ppm peracetic acid with a contact time of 1 minute was not hindered by soiling (Girard et al., 2015).

Peracetic acid in any format is the most effective active ingredient to use against noroviruses. PAA is safest and easiest to use for healthcare environments in its in-situ format, containing the pre-cursors to PAA, for “step-up” dilution (from 0ppm to 1000ppm for example). This minimises corrosion typically associated with PAA, allows for addition of ingredients to enhance cleaning properties, is suited for use on hard and soft surfaces, and provides a more sustainable option to your care home.

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