All Papers Relate To Homes
Overall this review illustrates the considerable amount of inaccurate reporting of this issue
and suggests that this is a significant cause of current misunderstanding and mistrust
amongst consumers about infection risks and the importance of hygiene. Most particularly it
shows that inconsistent and misleading terminology used in these articles is likely to have
contributed to the confusion.
Although the consumer responses recorded here, do not represent a true cross section of
consumer opinion, it highlights the need to do further studies to elucidate what consumers
understand about how infections are spread and the role of hygiene in infection prevention.
Also to find out where consumers obtain their knowledge, and to what extent media
Across the world, government and non-government agencies recognise the profound
impact of infectious disease on global health and prosperity, and the need for greater
emphasis on infection prevention as a central pillar in the fight against infection. One of the
current drivers for promoting hygiene, is the fundamental part it now plays in the global
strategy to tackle antibiotic resistance – but it also reflects factors such as the growing
number of people at greater risk of infection being cared for, or caring for themselves in the
This report illustrates the common misconceptions about hygiene which have developed,
which threaten to undermine efforts to promote higher standards of public hygiene. The
extent to which this has occurred suggests that change is unlikely to happen unless we
also work to change hygiene perceptions. There is need to develop consistent and more
accurate public messaging to ensure firstly that people better understand the issues, and
secondly that advice about sustaining exposure to vital microbes through appropriate
lifestyle does not conflict with vital hygiene messages such as those about handwashing2
Reducing the risks of transmission of norovirus in the home
Based on the evidence outlined above, a number of hygiene measures are indicated in
situations where someone in the house has a norovirus infection, in order to reduce the risks
of spread to other family members. It must be borne in mind that norovirus may be shed by
people who have no symptoms, both those who have apparently recovered and those who
have not yet developed symptoms:
• Handwashing is the single most important hygiene measure because it is the last line of
defence. This applies to both ill people and other family members.
• Special care should be taken in preparation of food in the kitchen to avoid spread of
norovirus from or via hands, cleaning cloths and food preparation surfaces to food. Ill
people should stay away from the kitchen and should not prepare food for others. People
affected by norovirus should not prepare food for others for at least 48 hours after
symptoms have ceased.
• Toilets (potties, commodes etc) should be disinfected regularly. If someone has diarrhoea
(or vomits into the toilet), the toilet, toilet seat, lid and flush handle should be disinfected
after each time they use it.
• Any spillages of contaminated material (e.g. faecal matter or vomit) should be cleaned up
immediately and the surface disinfected.
• Surfaces, particularly hand contact surfaces and items in the bathroom/toilet, and places
that an ill person may touch (e.g. bedside items, doorknobs, switches) should be
Norovirus Review – January 2008 Page 7/9
• Cleaning cloths and sponges should be disinfected after use by boiling or soaking in
disinfectant and thoroughly dried. A clean cloth should be used for each separate task to
ensure that the virus is not spread around the home.
• An ill person should not share towels, face cloths etc with others. The ill person’s
laundry and bed linen should be kept and washed separately.
• Where possible, ill people should stay in their own room and use their own facilities,
cutlery, crockery etc.
• Ill people should particularly avoid contact with those who may be more vulnerable to
infection and their personal items.
• Where young children are ill, or at particular risk:
o their handwashing, personal and toilet hygiene may need supervision
o nappies should be disposed of safely, or cleaned, disinfected and washed.
Contrary to popular perception, the faeces of babies can be highly infectious.
This paper highlights the major contribution that hygiene in home and everyday life makes to reducing the social
and economic burden of infectious disease and tackling antibiotic resistance (sections 2.1 – 2.3). Alongside this,
section 2.4 considers the ongoing conflict between hygiene and the issues undermining current efforts to achieve
hygiene behaviour change, such as environmental and toxicity issues, antimicrobial resistance, etc. From section
2.4, we conclude that, partly because of the extensive publicity afforded to these issues, and partly due to lack of
a unified voice advocating on behalf of HEDL hygiene, these issues have tended to take precedence. Section 2.2.4
also shows how consumer understanding and motivation towards adopting good hygiene is being undermined by
unbalanced publicity given to these issues as opposed to the importance of hygiene.
Since biocides, used responsibly, form an integral part of infection prevention
through good hygiene, not only in hospitals but also in the home, it is
important to address concerns that use of biocides may contribute to the
development of biocide resistance in practical use. Although laboratory studies
provide evidence that prolonged exposure to low levels of certain biocides can
be associated with reduced microbial susceptibility, this decreased
susceptibility is small relative to concentrations of biocides used in practice.
There is currently no evidence to suggest that biocide usage at its current
levels (i.e., in domestic and other settings) compromises the effectiveness of
hygiene procedures under in-use conditions.