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A Norovirus Outbreak at a Long-Term-Care Facility: The Role of Environmental Surface Contamination

Published online by Cambridge University Press:  21 June 2016

Henry M. Wu ,
Mary Fornek ,
Kellogg J. Schwab ,
Amy R. Chapin ,
Kristen Gibson ,
Edna Schwab ,
Charles Spencer  and
Kelly Henning
Henry M. Wu*
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Mary Fornek
Affiliation:
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Kellogg J. Schwab
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Amy R. Chapin
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Kristen Gibson
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Edna Schwab
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Charles Spencer
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Kelly Henning
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
*
Drexel University College of Medicine, Mailstop 461, 245 N. 15th St., Philadelphia, PA 19102kwu@drexelmed.edu
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Abstract

Background:

The role of environmental surface contamination in the propagation of norovirus outbreaks is unclear. An outbreak of acute gastroenteritis was reported among residents of a 240-bed veterans long-term-care facility.

Objectives:

To identify the likely mode of transmission, to characterize risk factors for illness, and to evaluate for environmental contamination in this norovirus outbreak.

Methods:

An outbreak investigation was conducted to identify risk factors for illness among residents and employees. Stool and vomitus samples were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR). Fourteen days after outbreak detection, ongoing cases among the residents prompted environmental surface testing for norovirus by RT-PCR.

Results:

One hundred twenty-seven (52%) of 246 residents and 84 (46%) of 181 surveyed employees had gastroenteritis. Case-residents did not differ from non-case-residents by comorbidities, diet, room type, or level of mobility. Index cases were among the nursing staff. Eight of 11 resident stool or vomitus samples tested positive for genogroup II norovirus. The all-cause mortality rate during the month of the outbreak peak was significantly higher than the expected rate. Environmental surface swabs from case-resident rooms, a dining room table, and an elevator button used only by employees were positive for norovirus. Environmental and clinical norovirus sequences were identical.

Conclusion:

Extensive contamination of environmental surfaces may play a role in prolonged norovirus outbreaks and should be addressed in control interventions.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 10 , October 2005 , pp. 802 - 810
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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