At the end of February I wrote to both the Australian Government Department of Health and Ageing (DoHA) and also the NSW State Health Department about “Stop Gastro Spread” in order to highlight some issues that I felt were necessary to address with regards to the expected Norovirus epidemic this winter.
My issues for NSW Health are some inconsistencies in online health guidelines regarding ‘return back’ to work, school and daycare. NSW Health advocates a 48 hour waiting period after being ill with gastro (Norovirus) but there are a couple of documents that erroneously state the waiting period should be 24 hours. This is potentially confusing for members of the population who may well be using internet searches for information on gastro at this particular time. I have asked that they rectify these documents before the winter season is here.
The issues I highlighted in an email to the Hon Tanya Plibersek, the Federal Minister for Health in the DoHA, were to do with the different ‘return back’ guidelines between states. Although I am aware that local state governments are permitted to uphold their own health legislations, I was concerned by the fact that at least two of the Australian states advocated a ‘return back’ period of 24 hours (Western Australia and Queensland) . I found this confusing considering the fact that governments should be basing their health policy on a solid (and so unified?) evidence base.
The solid evidence base for the period of continuing infectivity after gastro is documented as at least a 48 hour period after the last symptom (but most likely even longer!). This is mirrored in the health policy of other developed countries such as the UK and also the USA. In fact the Centre for Disease Control even states that the infectivity period may be 72 hours and for this reason upholds that Food Handlers wait this long before returning to work. What is particularly odd is that one Queensland document actually states that people are infectious for 48 hours after their last symptom, but still advocates ‘return to school’ at the 24 hour mark (see here). Puzzling.
Anyway, I thought that it would be good to encourage some unification between states considering the severity of the virus spread in the recent European Winter.
The Response from DoHA
Here is a summary of what the Department have emailed back: From the Health Emergency Management Branch, asked to respond on behalf of the Minister
- Norovirus Pandemics occur every few years or so.
- Norovirus is a nationally non-notifiable disease. Some states may hold mandatory notifications for certain institutions such as Nursing Homes and Day-care Centres.
- Each State has their own legislation and is entitled to uphold whatever health policy is suited to their means.
- The Communicable Diseases Network Australia offers strategic advice to states and territories
- Good personal hygiene, including Hand washing is important in preventing virus spread
- “While I am aware that states and territories describe different exclusion period the key theme is to keep people away from child care, school or work while symptomatic.”
- A link to a public fact sheet produced by DoHA with guidelines to help states and territories manage Gastro outbreaks.
While I am very impressed the Minister organised this response so rapidly (I haven’t heard a word from NSW Health), my problems with Queensland and Western Australia policies still exist. The main focus for ‘Stop Gastro Spread’ is to alert members of the population to the 48 hour waiting window before returning to the public domain. While I appreciate the background information put forward by the author of the letter, it is information that I am naturally, already aware of.
I feel that by focusing on these background facts, the issue has been side stepped. And this is an issue of certain Australian states lagging behind Federal and International Guidelines for effective management of Norovirus.