The slide deck offers an example set of message maps for the foodborne pathogen Norovirus, which is the leading cause of foodborne illness in the United States. (www.MessageMaps.org)

1. Message Maps for Foodborne Outbreaks and Product Recalls
Noroviruses
www.MessageMaps.org | Rusty Cawley, APR
Sources: US Centers for Disease Control
US Food and Drug AdministraDon
US Department of Health and Human Services

2. Stakeholders: General public or news media
Ques8on : What are noroviruses?
Key message 1 Key message 2 Key message 3
Noroviruses are the leading
US cause of foodborne
illness.
People acquire the virus
orally.
CDC esDmates 19-to-21
million US cases annually.
SupporDng informaDon 1-1 SupporDng informaDon 2-1 SupporDng informaDon 3-1
They are hardy viruses that
spread in food and water.
Common vectors include
produce, shellfish, salads,
and sandwiches.
These include 1.9 million
outpaDent and 400,000
emergency visits.
SupporDng informaDon 1-2 SupporDng informaDon 2-2 SupporDng informaDon 3-2
They also spread quickly
from person to person.
Symptoms generally begin
within 12 to 48 hours of
exposure.
About 71,000 cases require
hospitalizaDon.
SupporDng informaDon 1-3 SupporDng informaDon 2-3 SupporDng informaDon 3-3
You can contract
noroviruses many Dmes in a
lifeDme.
They usually end within 3
days in otherwise healthy
people.
570 to 800 result in death,
usually among young
children and the elderly.

3. Stakeholders: General public or news media
Ques8on : What disease do noroviuses cause?
Key message 1 Key message 2 Key message 3
Norovirus infecDons are
oZen called “stomach flu.”
Most people recover within
3 days.
Young children, the elderly,
and people with weak
immunity are most at risk.
SupporDng informaDon 1-1 SupporDng informaDon 2-1 SupporDng informaDon 3-1
The best way to detect a
norovirus is with a stool
sample.
Symptoms include diarrhea,
vomiDng, nausea, and
stomach pain.
The most common
complicaDon is
dehydraDon.
SupporDng informaDon 1-2 SupporDng informaDon 2-2 SupporDng informaDon 3-2
Lab tesDng is essenDal to
idenDfy outbreaks.
Also, fever, headache, and
body aches.
DehydraDon is caused by
severe diarrhea and
vomiDng.
SupporDng informaDon 1-3 SupporDng informaDon 2-3 SupporDng informaDon 3-3
CDC and FDA monitor
outbreaks and track them.
See a doctor if symptoms
last more than 3 days.
Untreated, this can lead to
death.

4. Stakeholders: General public or news media
Ques8on : What can people do to avoid the pathogen?
Key message 1 Key message 2 Key message 3
PracDce proper hand
hygiene.
PracDce food safety. Clean and disinfect all
contaminated surfaces.
SupporDng informaDon 1-1 SupporDng informaDon 2-1 SupporDng informaDon 3-1
Wash your hands carefully
with soap and water.
Wash fruits and vegetables
carefully before preparing
them.
Typical disinfectants are
ineffecDve in killing
noroviruses.
SupporDng informaDon 1-2 SupporDng informaDon 2-2 SupporDng informaDon 3-2
Especially aZer using the
toilet or changing diapers.
Cook all seafood to at least
140 degrees F.
Use a chlorine beach
soluDon with 1000 to 5000
parts per million.
SupporDng informaDon 1-3 SupporDng informaDon 2-3 SupporDng informaDon 3-3
Always before eaDng,
preparing, and handling
food.
Avoid preparing food if you
are sick.
Or another disinfectant
registered as effecDve
against noroviruses.

5. Stakeholders: General public or news media
Ques8on : What can sick people to manage the disease and its symptoms?
Key message 1 Key message 2 Key message 3
Drink plenty of liquids to
replace those lost to
diarrhea and vomiDng.
If you suspect severe
dehydraDon, see a doctor.
Remember: If you are ill,
you are also highly
contagious.
SupporDng informaDon 1-1 SupporDng informaDon 2-1 SupporDng informaDon 3-1
Over-the-counter, oral-
rehydraDon products are
the best choice.
Severe dehydraDon may
required hospitalizaDon.
Wash your hands
frequently with soap and
water.
SupporDng informaDon 1-2 SupporDng informaDon 2-2 SupporDng informaDon 3-2
Sports drinks, caffeinated
drinks, and alcohol are less
effecDve.
Treatment may require
intravenous fluids.
Wash all of your laundry
thoroughly.
SupporDng informaDon 1-3 SupporDng informaDon 2-3 SupporDng informaDon 3-3
There is no specific drug for
norovirus illness.
This is especially true for
young children, the elderly,
and folks with low
immunity.
Disinfect any surfaces you
contaminate with vomit or
stool.

6. A word of cauDon
• The message maps in this document should
serve only as examples, and not necessarily as
final products to be deployed in the field.
• You should work with your subject-mader
experts to develop your own set of message
maps about this pathogen, preferably in
advance of an outbreak.

7. References
• Centers for Disease Control and PrevenDon, Norovirus), hdps://www.cdc.gov/
norovirus/index.html, Updated October 25, 2017. Accessed online May 24, 2018.
• Food and Drug AdministraDon. Bad Bug Book, Foodborne Pathogenic
Microorganisms and Natural Toxins. Second EdiDon. [Noroviruses, pp. 168-172].
2012.
• "Norovirus (Norwalk Virus)." FoodSafety.gov. August 24, 2009. Accessed May 25,
2018. hdps://www.foodsafety.gov/poisoning/causes/bacteriaviruses/norovirus/
index.html.