Chamber and committees

Estimates of the cost to the NHS of norovirus outbreaks is not centrally available as the total number of patients and staff affected by the virus cannot be derived from census-based national surveillance systems.

Health Protection Scotland plans to have a fully automated electronic laboratory reporting system for selected pathogens, including norovirus, in place by July 2010.

The HAI Task Force has commissioned the West of Scotland Specialist Virology Centre to study the relationship between norovirus, other gastroenteritis viruses and Clostridium difficile. This is a detailed and lengthy study which is ongoing, but it is anticipated that work will be completed by summer 2011.

Norovirus is an organism which is required to be notified by laboratories to the local NHS board and to Health Protection Scotland under the Public Health etc (Scotland) Act 2008 with effect from 1 January 2010.

Norovirus is the most common cause of infectious gastroenteritis (diarrhoea and vomiting). Outbreaks of norovirus gastroenteritis are more likely in semi-closed environments such as hospitals, nursing homes, schools and cruise ships.

Poor hygiene is probably the main factor that starts outbreaks especially if catering and waiting staff are suffering from gastrointestinal infection. Norovirus is highly infectious and, for example, individuals tend to vomit in a very profuse and projectile manner. This can produce an aerosol of viruses that infect people who have had no other contact with the individual and despite their keeping good hygiene.

Outbreaks may also be due to contamination of food. Recent outbreaks across the UK have been due to oysters that have probably been contaminated by human faecal contamination of oyster beds.

There is established weekly reporting of all hospital wards that are closed with presumed or confirmed cases of norovirus. This is the only UK system providing real-time data on norovirus outbreaks.

There is also mandatory reporting of all hospital infection incidents which are assessed using the Hospital Infection Incident Assessment Tool (HIIAT) as amber or red.

There are also two voluntary reporting systems in place. The first addresses outbreaks of infectious intestinal disease wherever they occur (ObSurv) and the second addresses all outbreaks in hospitals (The Scottish Hospital Outbreak Reporting System: SHORS). SHORS is currently being updated.

This information is not held centrally. health boards across Scotland are, however, fully committed to involving the public in the planning and delivery of local healthcare services. One of the ways this is done is through Public Partnership Forums, which continue to be a vital and effective mechanism for communities to make their views known to the health board about local services.

I am pleased to advise that a bid for funding along with a Scottish national strategy was submitted to the EU for consideration in January 2010. We expect to be advised of the outcome by the end of April 2010.

This information can be found in the School Meals Survey which is published each year. The last version was published in June 2009 and can be accessed using the following link http://www.scotland.gov.uk/Publications/2009/06/22104701/0.

An new survey is currently underway and is expected to be published this summer.

Since 21 January 2010, Health Protection Scotland (HPS) have been publishing weekly unvalidated data on norovirus outbreaks on its website. The web link is:

http://www.hps.scot.nhs.uk/haiic/ic/noroviruspointprev.aspx.

The HPS guidance on control measures was updated in December 2009 and is under close review. The web link is http://www.hps.scot.nhs.uk/haiic/ic/publicationsdetail.aspx?id=43440.