Appendix 4: Cleaning and disinfection

This information is to assist Public Health Units and staff in institutions to manage cleaning and disinfecting when there is an
outbreak of norovirus.

General guidelines for cleaning and disinfecting

The following general guidance applies to cleaning areas soiled with faeces or vomit during an outbreak. The environmental surfaces need to be cleaned free of vomit or faeces using a neutral detergent and warm water prior to disinfecting with bleach solution.

Clean soiled areas

1. Isolate the area where a vomiting or diarrhoea incident has occurred.
2. Wear disposable gloves and a mask.
3. Absorb and remove as much of the vomit/faeces as possible with disposable paper towels or disposable cloths.
4. Discard the disposable paper towel or cloth into a leak proof plastic bag.
5. Clean soiled areas with detergent and warm water using a disposable cloth and discard immediately into a leak proof plastic bag.

6. Discard used gloves and apply clean gloves before disinfecting the soiled areas.

Disinfect soiled areas

1. Use freshly-made bleach solution and follow manufacturer’s instructions for appropriate dilution and use (see below for dilution instructions).
2. Wipe the area with bleach solution with disposable paper towels or a disposable cloth.
3. Dispose of gloves and mask in a leak proof plastic bag.
4. Wash hands thoroughly using soap and water and then pat dry using a disposable paper or single cloth towel. If water is unavailable, decontaminate hands using an alcohol-based rub or gel.

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Preparation of disinfection solution

Household bleach comes in a variety of strengths of the active ingredient—hypochlorous acid—and you can find this information on the product label.

Table 1. Recipes to achieve a 1000 ppm (0.1%) bleach solution

Original strength of bleach		Disinfectant recipe		Volume of bleach in a standard 10 litre bucket
%	Parts per million	Parts of bleach	Parts of water
1	10,000	1	9	1000 ml
2	20,000	1	19	500 ml
3	30,000	1	29	333 ml
4	40,000	1	39	250 ml
5	50,000	1	49	200 ml

Note:

• When a disinfectant is required for cleaning, the manufacturer’s recommendations for use (usually written on container) and occupational health and safety instructions (in workplace handbook on OH&S for hospitals) should be followed.
• Gloves should be worn when handling and preparing bleach solutions.
• Protective eye wear needs to be worn in case of splashing.
• Bleach solution should be made up daily.
• Bleach should be used mainly on hard, non-porous surfaces.
• Bleach can damage textiles and are corrosive to metals.

Sufficient time is required to kill the virus – at least 10 minutes contact time.