New guidelines are hot off the press regarding the management of Norovirus infection in acute and community health and social care settings.

Those guidelines, prepared after collaboration between the British Infection Association, Healthcare Infection Society, Infection Prevention Society, Health Protection Agency, NHS Confederation and the National Concern for Healthcare Infections are full of practical information but sadly, and perhaps predictably, light on information about waste and waste disposal.

Most outbreaks generate vast amounts of waste but the document muddles healthcare waste and clinical waste, and then fails to consider the categorisation of that clinical waste. It refers repeatedly to sacks for wet waste, commonly vomitus, but ignores the practicality of waste packaging and the likelihood of seepage of spillage of fluids. Though procedures for spillage are mentioned, there are in the context of patients vomiting in the clinical environment and not the seepage of fluids from waste sacks as these bounce along the disposal chain.

Hygiene precautions are stressed, but once more this is restricted to those in the clinical environment. The same hygiene standards will apply to ward orderly and ancillary staff, to porters and waste handlers, but the guidelines do take the out-of-sight out-of-mind approach to the welfare of support staff. That might be OK, but Norovirus infections in clinical waste handlers exposed to clinical wastes from Norovirus outbreaks and these staff should not be ignored in this way. But was it ever thus?