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Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team

Published online by Cambridge University Press:  01 July 2015

Joshua B. Gaither ,
Rianne Page ,
Caren Prather ,
Fred Paavola  and
Andrew L. Garrett
Joshua B. Gaither*
Affiliation:
United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Office of Emergency Management, National Disaster Medical System, Tucson, Arizona USA University of Arizona College of Medicine, Arizona Emergency Medicine Research Center, Department of Emergency Medicine, Tucson, Arizona USA
Rianne Page
Affiliation:
United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Office of Emergency Management, National Disaster Medical System, Tucson, Arizona USA
Caren Prather
Affiliation:
United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Office of Emergency Management, National Disaster Medical System, Tucson, Arizona USA
Fred Paavola
Affiliation:
United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Office of Emergency Management, National Disaster Medical System, Tucson, Arizona USA
Andrew L. Garrett
Affiliation:
United States Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Office of Emergency Management, National Disaster Medical System, Tucson, Arizona USA
*
Correspondence: Joshua B. Gaither, MD 1501 North Campbell Avenue Tucson, Arizona 85724, USA E-mail: jgaither@aemrc.arizona.edu
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Abstract

Introduction

In late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident.

Hypothesis/Problem

Describe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team.

Methods

The number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment.

Results

The shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively.

Conclusion

Medical teams providing shelter care during viral gastroenteritis outbreaks are susceptible to contracting the virus while caring for patients. When responding to similar incidents in the future, teams should not only be ready to implement aggressive infectious control measures but also be prepared to care for team members who become ill.

GaitherJB , PageR , PratherC , PaavolaF , GarrettAL . Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team. Prehosp Disaster Med. 2015;30(4):1–4.

Keywords

cyclonic stormsdisasterdisease outbreakgastroenteritisinfection control
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 4 , August 2015 , pp. 355 - 358
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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References

1. Blake, ES, Berg, RJ, Cangialosi, JP, Beven, JL. Tropical cyclone report, Huricane Sandy. www.nhc.noaa.gov/data/tcr/AL182012_Sandy.pdf. Published 2012. Accessed May 23, 2013.Google Scholar
2. Yee, EL, Palacio, H, Atmar, RL, et al. Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large “megashelter” in Houston, Texas: lessons learned for prevention. Clin Infect Dis. 2007;44(8):1032-1039.Google Scholar
3. Said, MA, Perl, TM, Sears, CL. Health care epidemiology: gastrointestinal flu: norovirus in health care and long-term care facilities. Clin Infect Dis. 2008;47(9):1202-1208.Google Scholar
4. Friedman, DS, Heisey-Grove, D, Argyros, F, et al. An outbreak of norovirus gastroenteritis associated with wedding cakes. Epidemiol Infect. 2005;133(6):1057-1063.Google Scholar
5. Yap, J, Qadir, A, Liu, I, Loh, J, Tan, BH, Lee, VJ. Outbreak of acute norovirus gastroenteritis in a military facility in Singapore: a public health perspective. Singapore Med J. 2012;53(4):249-254.Google Scholar
6. Green, KY, Belliot, G, Taylor, JL, et al. A predominant role for Norwalk-like viruses as agents of epidemic gastroenteritis in Maryland nursing homes for the elderly. J Infect Dis. 2002;185(2):133-146.Google Scholar
7. Johnston, CP, Qiu, H, Ticehurst, JR, et al. Outbreak management and implications of a nosocomial norovirus outbreak. Clin Infect Dis. 2007;45(5):534-540.CrossRefGoogle ScholarPubMed
8. Siebenga, JJ, Beersma, MF, Vennema, H, van Biezen, P, Hartwig, NJ, Koopmans, M. High prevalence of prolonged norovirus shedding and illness among hospitalized patients: a model for in vivo molecular evolution. J Infect Dis. 2008;198(7):994-1001.Google Scholar
9. 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(4):348-353.Google Scholar
10. 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(5):802-812.Google Scholar
11. Mead, PS, Slutsker, L, Dietz, V, et al. Food-related illness and death in the United States. Emerg Infect Dis. 1999;5(5):607-625.Google Scholar
12. MacCannell, T, Umscheid, CA, Agarwal, RK, et al. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in health care settings. Infect Control Hosp Epidemiol. 2011;32(10):939-969.Google Scholar
13. Okada, M, Tanaka, T, Oseto, M, Takeda, N, Shinozaki, K. Genetic analysis of noroviruses associated with fatalities in health care facilities. Arch Virol. 2006;151(8):1635-1641.Google Scholar
14. Murray, KO, Kilborn, C, DesVignes-Kendrick, M, et al. Emerging disease syndromic surveillance for Hurricane Katrina evacuees seeking shelter in Houston’s Astrodome and Reliant Park Complex. Public Health Rep. 2009;124(3):364-371.Google Scholar
15. Centers for Disease Control and Prevention. Norovirus. CDC Web site. http://www.cdc.gov/norovirus/. Accessed May 23, 2013.Google Scholar
16. Barker, J, Vipond, IB, Bloomfield, SF. Effects of cleaning and disinfection in reducing the spread of norovirus contamination via environmental surfaces. J Hosp Infect. 2004;58(1):42-49.Google Scholar
17. Cook, JV, Dickinson, HO, Eccles, MP. Response rates in postal surveys of health care professionals between 1996 and 2005: an observational study. BMC Health Serv Res. 2009;9:160.Google Scholar