The literature review identified 5 strategies for controlling norovirus:
- Personal hygiene
- Food handling
- Washing and cooking food
- Surface and uniform cleaning
- Fitness to work
Visits to food catering establishments involved in-depth interviews, surveys, and structured environmental and behavioural observations.
Strongest evidence was found for:
- inadequate hand washing;
- not washing hands before gloving;
- using bare hands when preparing food;
- not regularly changing gloves;
- food handlers instead of trained staff cleaning areas where people vomited;
- not washing uniform correctly;
- and returning to work too early after being ill.
Data analysis and behavioural theories were used to rank behaviours which risk spreading Norovirus in relation to the control strategies, according to the strength of evidence that food handlers were expressing these behaviours.