Environmental Factors Associated with Norovirus Transmission in Long-Term Care Facilities in South Carolina

In the U.S., 60% of norovirus outbreaks are attributed to long-term care facilities (LTCFs). A descriptive study of 26 LTCFs in South Carolina was conducted to determine the presence of environmental factors associated with transmission of human noroviruses. Sanitary conditions in one common area, one staff/visitor bathroom, and the main kitchen were assessed using two audit forms. While surfaces in all kitchens were in good sanitary condition, 23 LTCFs used quaternary ammonium-based sanitizers and three LTCFs used chlorine bleach for kitchen sanitization. All common areas were also clean and in good condition; however, 20 LTCFs had upholstered chairs, and five LTCFs had carpeted floors. Seven facilities used quaternary ammonium-based disinfectants exclusively, whereas six LTCFs used chlorine bleach exclusively, and eight LTCFs used both to disinfect common areas. Seven staff/visitor bathrooms were accessible to residents, and hand washing signage was missing from 10. These results reveal the presence of environmental factors that might facilitate norovirus transmission within LTCFs.