In a reported norovirus outbreak with staff and patients, what is the guidance for a nurse who had diarrhea on Tuesday and returned on Wednesday?

• A. Remain at home until Friday.
• B. Return to work on Thursday morning.
• C. Return to work after 24 hours of no symptoms.
• D. Return after a negative viral test.

Answer: (A)

Norovirus outbreaks in healthcare require strict exclusion of staff who have gastroenteritis until they have been free of symptoms for a full 48-hour period. This minimizes the risk of transmitting the virus to vulnerable patients and other staff, since people can continue to shed the virus even after feeling better.

In this case, having diarrhea on Tuesday means the last symptom occurred then. Returning to work on Wednesday does not satisfy the 48-hour symptom-free window. Staying home until Friday ensures at least two full days without symptoms have passed, aligning with infection-control guidance to delay return until after this contagious period has ended.

Returning to work after 24 hours with no symptoms isn’t enough, because contagious shedding can continue beyond that. A negative viral test isn’t used to clear healthcare workers for norovirus, since tests don’t reliably reflect contagiousness and results aren’t the basis for clearance.