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Characteristics of norovirus gastroenteritis outbreaks in a psychiatric centre

  • C. Y. TSENG (a1) (a2), C. H. CHEN (a3), S. C. SU (a4), F. T. WU (a5), C. C. CHEN (a6), G. Y. HSIEH (a7), C. H. HUNG (a5) and C. P. FUNG (a8)...

Summary

Noroviruses are an important aetiological agent of acute gastroenteritis. They are responsible for large outbreaks of disease in the community, hospitals and long-term-care facilities. The clinical manifestations of norovirus outbreaks in psychiatric units are rarely described. The disease burden and impact highlight the importance of timely notification and investigation of these outbreaks. We analysed the characteristics of four norovirus outbreaks which occurred during a 3-year period in an in-patient psychiatric care unit. A total of 184 patients were affected which included 172 hospitalized patients, seven healthcare workers (HCWs) and five psychiatric nursing-home residents. The mean incidence rate of norovirus gastroenteritis (NVG) in hospitalized patients during these outbreaks was 12·7%. These outbreaks were characterized by higher incidence in middle-aged male patients, predominant sickness of diarrhoea, short duration of illness, peaks in late winter and early spring, and higher susceptibility in acute psychiatric patients. HCWs had longer duration of illness than psychiatric patients. More than 10% of affected patients experienced ⩾2 infections. Infection control measures were instituted and a comprehensive, responsive standard operating procedure for NVG and outbreak management was developed. After implementation of these measures, no further outbreaks of NVG occurred during the study period.

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Copyright

Corresponding author

*Author for correspondence: Dr C. P. Fung, Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan. (Email: cpfung@vghtpe.gov.tw)

References

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1.Barker, J, Vipond, IB, Bloomfield, SF. Effects of cleaning and disinfection in reducing the spread of norovirus contamination via environmental surfaces. Journal of Hospital Infection 2004; 58: 4249.
2.Johnston, CP, et al. Outbreak management and implications of a nosocomial norovirus outbreak. Clinical Infectious Diseases 2007; 45: 534540.
3.Cooper, E, Blamey, S. A norovirus gastroenteritis epidemic in a long-term-care facility. Infection Control and Hospital Epidemiology 2005; 26: 256258.
4.Fankhauser, RL, et al. Molecular epidemiology of ‘Norwalk-like viruses’ in outbreaks of gastroenteritis in the United States. Journal of Infectious Diseases 1998; 178: 15711578.
5.Sartorius, B, et al. Outbreak of norovirus in Västra Götaland associated with recreational activities at two lakes during August 2004. Scandinavian Journal of Infectious Diseases 2007; 39: 323331.
6.Vinje, J, Altena, SA, Koopmans, MP. The incidence and genetic variability of small round-structured viruses in outbreaks of gastroenteritis in The Netherlands. Journal of Infectious Diseases 1997; 176: 13741378.
7.Green, KY, et al. A predominant role for Norwalk-like viruses as agents of epidemic gastroenteritis in Maryland nursing homes for the elderly. Journal of Infectious Diseases 2002; 185: 133146.
8.Lopman, BA, et al. Two epidemiologic patterns of norovirus outbreaks: surveillance in England and Wales, 1992–2000. Emerging Infectious Diseases 2003; 9: 7177.
9.Radford, AD, Gaskell, RM, Hart, CA. Human norovirus infection and the lessons from animal caliciviruses. Current Opinion in Infectious Diseases 2004; 17: 471478.
10.Centers for Disease Control and Prevention. ‘Norwalk-like viruses’: public health consequences and outbreak management. Morbidity and Mortality Weekly Report 2001; 50: 113.
11.Caul, EO. Viral gastroenteritis: small round structured viruses, caliciviruses and astroviruses. Part II. The epidemiological perspective. Journal of Clinical Pathology 1996; 49: 959964.
12.Rockx, B, et al. Natural history of human calicivirus infection: A prospective cohort study. Clinical Infectious Diseases 2002; 35: 246253.
13.Wu, FT, et al. Genetic diversity of noroviruses in Taiwan between November 2004 and March 2005. Archives of Virology 2006; 151: 13191327.
14.Marks, PJ, et al. A school outbreak of Norwalk-like virus: evidence for airborne transmission. Epidemiology and Infection 2003; 131: 727736.
15.Siegel, JD, et al. Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. American Journal of Infection Control 2007; 35: S65–S164.
16.Jones, EL, et al. Role of fomite contamination during an outbreak of norovirus on houseboats. International Journal of Environmental Health Research 2007; 2: 123131.
17.Centers for Disease Control and Prevention. Norovirus activity – United States, 2002. Morbidity and Mortality Weekly Report 2003; 52: 4145.
18.Weber, DJ, et al. Lessons learned from a norovirus outbreak in a locked pediatric inpatient psychiatric unit. Infection Control and Hospital Epidemiology 2005; 26: 841843.
19.Wu, HM, et al. A norovirus outbreak at a long-tern-care facility: The role of environmental surface contamination. Infection Control and Hospital Epidemiology 2005; 26: 802810.
20.Simon, A, et al. Norovirus outbreak in a pediatric oncology unit. Scandinavian Journal of Gastroenterology 2006; 41: 693699.
21.Cheng, FWT, et al. Rapid control of norovirus gastroenteritis outbreak in an acute paediatric ward. Acta Pædiatrica 2006; 95: 581586.
22.Mattner, F, et al. Risk groups for clinical complications of norovirus infections: an outbreak investigation. Clinical Microbiology and Infection 2006; 12: 6974.
23.Lopman, BA, et al. Clinical manifestation of norovirus gastroenteritis in health care settings. Clinical Infectious Diseases 2004; 39: 318324.
24.Bresee, JS, et al. Foodborne viral gastroenteritis: challenges and opportunities. Clinical Infectious Diseases 2002; 35: 748753.
25.Chadwick, PR, et al. Management of hospital outbreaks of gastro-enteritis due to small round structured viruses. Journal of Hospital Infection 2000; 45: 110.
26.Hart, CA, Radford, AD. Calicivirus. In: Fuchs, J, Podda, M, eds. Encyclopedia of Medical Genomics and Proteomics. New York: Marcel Dekker, 2005, pp. 180184.
27.Gehrke, C, Steinmann, J, Goroncy-Bermes, P. Inactivation of feline calicivirus, a surrogate of norovirus (formerly Norwalk-like viruses), by different types of alcohol in vitro and in vivo. Journal of Hospital Infection 2004; 56: 4955.
28.Sattar, SA. Microbicides and the environmental control of nosocomial viral infections. Journal of Hospital Infection 2004; 56: S64S69.
29.World Alliance for Patient Safety. Global patient safety challenge 2005–2006: Clean care is safer care. WHO Guidelines on Hand Hygiene in Health Care (Advanced Draft), April 2006.
30.Kampf, G, Grotheer, D, Steinmann, J. Efficacy of three ethanol-based hand rubs against feline calicivirus, a surrogate virus for norovirus. Journal of Hospital Infection 2005; 60: 144149.
31.Said, MA, Perl, TM, Sears, CL. Gastrointestinal flu: norovirus in health care and long-term care facilities. Clinical Infectious Diseases 2008; 47: 12021208.
32.Doultree, JC, et al. Inactivation of feline calicivirus, a Norwalk virus surrogate. Journal of Hospital Infection 1999; 41: 5157.
33.Patel, MM, et al. Systematic literature review of role of noroviruses in sporadic gastroenteritis. Emerging Infectious Diseases 2008; 14: 12241231.

Keywords

Characteristics of norovirus gastroenteritis outbreaks in a psychiatric centre

  • C. Y. TSENG (a1) (a2), C. H. CHEN (a3), S. C. SU (a4), F. T. WU (a5), C. C. CHEN (a6), G. Y. HSIEH (a7), C. H. HUNG (a5) and C. P. FUNG (a8)...

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