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An Outbreak of Acute Gastroenteritis Caused by a Small Round Structured Virus in a Geriatric Convalescent Facility

Published online by Cambridge University Press:  21 June 2016

George A. Gellert
Affiliation:
Harvard Institute for International Development, Cambridge, Massachusettes
Stephen H. Waterman
Affiliation:
The Los Angeles County Department of Health Services, Los Angeles, California
Donnell Ewert
Affiliation:
The Los Angeles County Department of Health Services, Los Angeles, California
Lyndon Oshiro
Affiliation:
The Centers for Disease Control, Atlanta, Georgia
Marjorie P. Giles
Affiliation:
The Los Angeles County Department of Health Services, Los Angeles, California
Stephen S. Monroe
Affiliation:
The Centers for Disease Control, Atlanta, Georgia
Leo Gorelkin
Affiliation:
The Centers for Disease Control, Atlanta, Georgia
Roger I. Glass
Affiliation:
The Centers for Disease Control, Atlanta, Georgia

Abstract

An outbreak of acute gastroenteritis (AGE) occurred in a 201-bed geriatric convalescent facility in Los Angeles County during December 1988 through January 1989. The attack rate was 55% among residents and 25% among employees. Illnesses were characterized by vomiting and diarrhea to a lesser extent, and the absence of fever. Bacterial and parasitic tests in a sample of patients were negative. A 27nm small round structured virus (SRSV) was identified in one of 30 stools studied by immune electron microscopy (IEM). While rotavirus and influenza A and B were found in three, one and three cases, respectively, no alternative etiologic agent could be demonstrated for most cases. The outbreak met Centers for Disease Control (CDC) clinical and epidemiologic criteria for Norwalk-like gastroenteritis. The death rate of residents was not elevated beyond baseline during the outbreak; however, one healthy employee had diarrhea and dehydration and died after developing an arrhythmia. An autopsy showed moderate, diffuse lymphocytic and neutrophilic myocarditis, and viral studies found influenza A in left ventricular tissue. Fourteen (25%) of 57 employee cases worked in occupations without routine stool or patient contact. At least nine of these employees lacked evidence of direct fecal contact, and transmission of infection in these cases may have been airborne. (Infect Control Hosp Epidemiol. 1990;11:459-464.)

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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References

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