Skip to main content Accessibility help
×
Home

Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures

Published online by Cambridge University Press:  02 January 2015

Vincent C. C. Cheng
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Lisa M. W. Wong
Affiliation:
Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Josepha W. M. Tai
Affiliation:
Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Jasper F. W. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Kelvin K. W. To
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Iris W. S. Li
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Ivan F. N. Hung
Affiliation:
Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China
K. H. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
P. L. Ho
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
K. Y. Yuen
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Corresponding
E-mail address:

Abstract

Background.

Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.

Methods.

Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.

Results.

Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.

Conclusions.

Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

Access options

Get access to the full version of this content by using one of the access options below.

References

1.Kampf, G, Kramer, A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004;17:863893.CrossRefGoogle ScholarPubMed
2.Lopman, B, Vennema, H, Kohli, E, et al.Increase in viral gastroenteritis outbreaks in Europe and epidemic spread of new no-rovirus variant. Lancet 2004;363:682688.CrossRefGoogle Scholar
3.Ho, EC, Cheng, PK, Lau, AW, Wong, AH, Lim, WW. Atypical norovirus epidemic in Hong Kong during summer of 2006 caused by a new genogroup II/4 variant. J Clin Microbiol 2007;45:22052211.CrossRefGoogle Scholar
4.Tsang, oT, Wong, AT, Chow, CB, Yung, RW, Lim, WW, Liu, SH. Clinical characteristics of nosocomial norovirus outbreaks in Hong Kong. J Hosp Infect 2008;69:135140.CrossRefGoogle ScholarPubMed
5.Hansen, S, Stamm-Balderjahn, S, Zuschneid, I, et al.Closure of medical departments during nosocomial outbreaks: data from a systematic analysis of the literature. J Hosp Infect 2007;65:348353.CrossRefGoogle Scholar
6.Wu, HM, Fornek, M, Schwab, KJ, et al.A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination. Infect Control Hosp Epidemiol 2005;26:802810.CrossRefGoogle Scholar
7.Johnston, CP, Qiu, H, Ticehurst, JR, et al.Outbreak management and implications of a nosocomial norovirus outbreak. Clin Infect Dis 2007;45:534540.CrossRefGoogle ScholarPubMed
8.Cheng, VC, Tai, JW, Wong, LM, et al.Prevention of nosocomial transmission of swine-origin pandemic influenza virus A/H1N1 by infection control bundle. J Hosp Infect 2010;74:271277.CrossRefGoogle ScholarPubMed
9.Hong Kong Observatory. 2010. Climate of Hong Kong, http://www.hko.gov.hk/cis/climahk_e.htm Accessed July 22, 2010.Google Scholar
10.Billgren, M, Christenson, B, Hedlund, KO, Vinjé, J.Epidemiology of Norwalk-like human caliciviruses in hospital outbreaks of acute gastroenteritis in the Stockholm area in 1996. J Infect 2002;44:2632.CrossRefGoogle ScholarPubMed
11.Tai, JW, Mok, ES, Ching, PT, Seto, WH, Pittet, D. Nurses and physicians' perceptions of the importance and impact of healthcare-associated infections and hand hygiene: a multi-center exploratory study in Hong Kong. Infection 2009;37:320333.CrossRefGoogle ScholarPubMed
12.Pittet, D, Allegranzi, B, Boyce, J; World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol 2009;30:611622.CrossRefGoogle ScholarPubMed
13.Chan, KH, Yam, WC, Pang, CM, et al.Comparison of the NucliSens easyMAG and Qiagen BioRobot 9604 nucleic acid extraction systems for detection of RNA and DNA respiratory viruses in nasopharyngeal aspirate samples. J Clin Microbiol 2008;46:21952199.CrossRefGoogle ScholarPubMed
14.Kageyama, T, Kojima, S, Shinohara, M, et al.Broadly reactive and highly sensitive assay for Norwalk-like viruses based on realtime quantitative reverse transcription-PCR. J Clin Microbiol 2003;41:15481557.CrossRefGoogle Scholar
15.Gallimore, CI, Iturriza-Gomara, M, Xerry, J, Adigwe, J, Gray, JJ. Inter-seasonal diversity of norovirus genotypes: emergence and selection of virus variants. Arch Virol 2007;152:12951303.CrossRefGoogle ScholarPubMed
16.Belliot, G, Kamel, AH, Estienney, M, Ambert-Balay, K, Pothier, P. Evidence of emergence of new GGII.4 norovirus variants from gastroenteritis outbreak survey in France during the 2007-to-2008 and 2008-to-2009 winter seasons. J Clin Microbiol 2010;48:994998.CrossRefGoogle ScholarPubMed
17.Cheng, VC, Wu, AK, Cheung, CH, et al.Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks. J Hosp Infect 2007;67:336343.CrossRefGoogle ScholarPubMed
18.Cheng, VC, Tai, JW, Ho, YY, Chan, JF. Successful control of norovirus outbreak in an infirmary with the use of alcohol-based hand rub. J Hosp Infect 2009;72:370371.CrossRefGoogle Scholar
19.Doultree, JC, Druce, JD, Birch, CJ, Bowden, DS, Marshall, JA. Inactivation of feline calicivirus, a Norwalk virus surrogate. J Hosp Infect 1999;41:5157.CrossRefGoogle ScholarPubMed
20.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. J Hosp Infect 2004;56:4955.CrossRefGoogle Scholar
21.Siebenga, JJ, Vennema, H, Zheng, DP, et al.Norovirus illness is a global problem: emergence and spread of norovirus GII.4 variants, 2001-2007. J Infect Dis 2009;200:802812.CrossRefGoogle ScholarPubMed
22.Lopman, BA, Andrews, N, Sarangi, J, Vipond, IB, Brown, DW, Reacher, MH. Institutional risk factors for outbreaks of nosocomial gastroenteritis: survival analysis of a cohort of hospital units in south-west England, 2002-2003. J Hosp Infect 2005;60:135143.CrossRefGoogle Scholar
23.Cáceres, VM, Kim, DK, Bresee, JS, et al.A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff. Infect Control Hosp Epidemiol 1998;19:162167.CrossRefGoogle ScholarPubMed
24.Marx, A, Shay, DK, Noel, JS, et al.An outbreak of acute gastroenteritis in a geriatric long-term-care facility: combined application of epidemiological and molecular diagnostic methods. Infect Control Hosp Epidemiol 1999;20:306311.CrossRefGoogle Scholar
25.Weber, DJ, Sickbert-Bennett, EE, Vinjé, J, et al.Lessons learned from a norovirus outbreak in a locked pediatric inpatient psychiatric unit. Infect Control Hosp Epidemiol 2005;26:841843.CrossRefGoogle Scholar
26.Iijima, Y, Tanaka, S, Ohishi, H. Multiple outbreaks of gastroenteritis due to a single strain of genotype GII/4 norovirus in Kobe, Japan, 2006: risk factors for norovirus spread in health care settings. Jpn J Infect Dis 2008;61:419422.Google ScholarPubMed
27.Turcios-Ruiz, RM, Axelrod, P, St John, K, et al.Outbreak of necrotizing enterocolitis caused by norovirus in a neonatal intensive care unit. J Pediatr 2008;153:339344.CrossRefGoogle Scholar

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 31 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 27th January 2021. This data will be updated every 24 hours.

Hostname: page-component-898fc554b-8ljtz Total loading time: 0.377 Render date: 2021-01-27T14:34:48.826Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *