Infectious Norovirus: What Can We Learn from Vomiting Larry?

The robot’s name may be fanciful, but the task it’s tackling is quite serious. Researchers at the Health and Safety Laboratory in Derbyshire in Great Britain are using “Vomiting Larry” to learn more about how the infectious norovirus spreads. Vomiting Larry is a humanoid simulated vomiting system that expels a water and fluorescent liquid mixture enabling ultraviolet light to track the pattern and distance of expulsion, if you will.

That pattern is particularly important in understanding the spread of norovirus, a highly contagious virus that causes vomiting and diarrhea. In most cases, it is extremely unpleasant for a few days, but under some conditions it can be very dangerous or even fatal.

Named for an early outbreak at a high school in Norwalk, Ohio, norovirus is the leading cause of foodborne disease and the cause of half of all worldwide gastroenteritis outbreaks, according to the report Noroviruses: The Perfect Human Pathogens?  from the Centers for Disease Control (CDC). The CDC estimates that norovirus caused 21 million cases of acute gastroenteritis annually in the U.S. alone.

When norovirus invades human cells in the intestinal tract, it rapidly multiplies, and causes the violent emptying symptoms, referred to above. The expelled fluids contain billions of infectious doses of the norovirus, and many paths exist for transmitting those doses to a new host.

Noroviruses are notoriously robust, able to survive freezing and heating as well as many common chemical disinfectants, and can live on surfaces for up to two weeks. Among the ways infectious noroviruses can spread is through ingestion of airborne or aerosolized particles. With such potent doses of the virus carried in such small amounts of fluid, it’s critical that all surfaces and objects in range of those aerosolized particles be effectively disinfected, or discarded.

That’s why Larry is vomiting fluorescent fluid: to determine how far and wide expelled fluid can travel. Some of that fluorescent fluid has been traced more than three meters from Larry. So an object or surface about ten feet away from an incident that was contaminated two weeks ago could still cause transmission of the norovirus. The researchers intend to publish their more detailed findings in relevant journals and hope that the results can contribute to healthcare and procedure guidance in hospitals other medical facilities.

The robustness of the norovirus makes prevention and control of outbreaks particularly difficult. The CDC recommends rigorous hand hygiene (especially mechanical washing with soap and water), exclusion and isolation when possible, environmental disinfection (particularly with a high concentration of chlorine bleach), and thorough cooking of food whenever possible.

Meanwhile, let’s hope Larry is doing what he does, so we won’t have to.

 

“Vomiting Larry” helps researchers understand the spread of infectious norovirus
Warning: This video shows the robot doing what he was built to do. If you’re a little squeamish, please don’t press ‘Play.”

 

PurThreadTM Technologies Inc. is dedicated to developing proprietary antimicrobial textile technology. Our patent-pending, integration technology and fiber formulations incorporate an EPA-registered antimicrobial additive into every fiber and yarn to protect the fabric from degradation. Learn more about our antimicrobial textile technology.

PurThread hopes to help hospitals reduce bioburden on fabric surfaces in the patient environment. Our linens, privacy curtains, and scrubs are easy substitutes for current healthcare textiles. We are researching the impact of these products in the clinical environment. A recent article in the journal Infection Control and Hospital Epidemiology (ICHE) cited encouraging preliminary results from a randomized, controlled clinical study that incorporated privacy curtains using PurThread technology. The EPA has not yet reviewed any potential public health claims for PurThread products.

PurThread also makes a range of freshness products for other markets such as the military, emergency first responders and performance athletic wear in which our next-generation technology and fiber formulations expand the high performance options available to protect fabrics from odor, mold and mildew causing bacteria.

Cleanliness is Next to … Infection Control

In addition to helping create a great first impression and contributing to sustainability ratings, patient satisfaction and staff morale, Environmental Services (ES) teams are increasingly being recognized for their role in improving infection rates.Environmental Services’ role in battling hospital infections

In addition to helping create a great first impression and contributing to sustainability ratings, patient satisfaction and staff morale, Environmental Services (ES) teams are increasingly being recognized for their role in improving infection rates.

Keeping hospital rooms and overall environment clean and ridding them of microscopic germs is essential to controlling infections. Here are some of the best practices we’ve gleaned from several success stories.

Communication and collaboration.

ES should be part of the multidisciplinary team that defines infection program goals and standards and reviews progress toward those goals. ES early and constant participation assures their full buy-in.

Improved cleaning procedures.

ES teams can define more aggressive cleaning procedures, and develop ES staff training to implement them, as well as standards for supervisorial monitoring. For example, teams might increase concentration on high touch areas and use an “all-or-nothing” checklist approach whereby all components of checklist must be completed for room to be considered cleaned. Since staff turnover is often an issue in ES, infection control training may need to be repeated.

Enabling and monitoring compliance.

ES can specify and maintain waterless hand hygiene stations and supplies of personal protective equipment (gloves and masks) at key locations. Adding touchless paper towel dispensers can reduce waste and more importantly improve hygiene and reduce the risk of cross-contamination. ES staff can and should receive training on hand hygiene procedures and help monitor all staff compliance (“see something, say something”).

Improvement is a process, not a project.

Infection control takes constant vigilance and monitoring. That certainly applies to the ES team and continued supervisorial focus. Feedback on the importance and effectiveness of their work in reducing or controlling infection rates can help maintain morale. When the ES teams are part of programs that improve infection rates, their success can be a great motivator and source of pride.