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Human noroviruses are the leading cause of foodbome disease in the United States, sickening 19 to 21 million Americans each year. Vomit and diarrhea are both highly concentrated sources of norovirus particles. For this reason, establishing appropriate cleanup procedures for these two substances is critical. Food service establishments in states that have adopted the 2009 or 2013 U.S. Food and Drug Administration Food Code are required to have a program detailing specific cleanup procedures. The aim of our study was to determine the alignment of existing vomit and diarrhea cleanup procedures with the 11 elements recommended in Annex 3 of the 2011 Supplement to the 2009 Food Code and to determine their readability and clarity of presentation. In July 2015, we located vomit and diarrhea cleanup procedures by asking Norovirus Collaborative for Outreach, Research, and Education stakeholders for procedures used by their constituency groups and by conducting a Google Advanced Search of the World Wide Web. We performed content analysis to determine alignment with the recommendations in Annex 3. Readability and clarity of presentation were also assessed. A total of 38 artifacts were analyzed. The mean alignment score was 7.0 ± 1.7 of 11 points; the mean clarity score was 6.7 ± 2.5 of 17 points. Only nine artifacts were classified as high clarity, high alignment. Vomit and diarrhea cleanup procedures should align with Annex 3 in the Food Code and should, as well, be clearly presented; yet, none of the artifacts completely met both conditions. To reduce the spread of norovirus infections in food service establishments, editable guidelines are needed that are aligned with Annex 3 and are clearly written, into which authors could insert their facility-specific information. [ABSTRACT FROM AUTHOR]

Human noroviruses sicken 19–21 million people in the U.S. each year, suggesting the need for education. The World Wide Web is an accessible source of information about how to prevent a norovirus infection but the accuracy and readability of information targeting consumers is unknown. The aim of the study was to evaluate the alignment and readability of web-based norovirus education materials targeting consumers using CDC evidence-based guidelines and Microsoft Word readability formulas. The search yielded 60 artifacts. Most did not address duration of handwashing (83%), use of hand sanitizers (83%), type of drying devices (92%), or avoidance of bare-hand contact with ready-to-eat foods (97%). Less than half (n = 29) recommended minimizing contact with sick persons. Two-thirds of the artifacts (n = 40) also did not mention the recommended concentration of sodium hypochlorite (bleach) solution to be used to disinfect surfaces contaminated with noroviruses. The mean Flesch Reading Ease score was 47.75 (score of >70 is easy to read), and the mean Flesch-Kincaid Grade Level was 10.36 so documents were written at a 10th grade level. The alignment and readability of web-based educational materials about noroviruses must be improved as knowledge is a prerequisite to application of behaviors that can prevent one from becoming infected with noroviruses. [ABSTRACT FROM AUTHOR]