Politics of Infectious Employees and Norovirus Outbreaks

In the spring of 2006, Yellowstone County experienced a massive norovirus outbreak resulting in over 1,200 cases. Since the initial outbreak, smaller ones have periodically occurred, primarily concentrated in nursing home and assisted living facilities. A key issue that has arisen from these outbreaks is the problem of healthcare workers, food handlers, and day care providers working while still infectious. Unpaid sick leave and uncooperative supervisors have compelled many individuals to return to work while they are still symptomatic, increasing the risk of transmitting the virus to patients, the general public, and coworkers. Yellowstone City-County Health Department (YCCHD) has worked extensively with long term care facilities, food establishments, and day care centers to educate administrators on the importance of ill workers staying home. YCCHD has also worked with the local media to reiterate these messages to the general public. Through its outreach to both providers and the media, YCCHD has been able to navigate the politics of supporting providers while ensuring that timely and accurate information is conveyed to the public. In addition, YCCHD is developing an outbreak definition policy to guide facilities' awareness of and response to norovirus.