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An Outbreak of Norovirus Infection in a Long-Term-Care Unit in Spain

Published online by Cambridge University Press:  21 June 2016

Gemma Navarro ,
Rosa M. Sala ,
Ferran Segura ,
César Arias ,
Pilar Varela ,
Pilar Peña ,
Teresa Llovet ,
Isabel Sanfeliu ,
Maria Canals  and
Guadalupe Serrate
...Show all authors
Gemma Navarro*
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Rosa M. Sala
Affiliation:
Epidemiological Surveillance Unit of Central Region, Department of Health and Social Security, Terrassa, Barcelona, Spain
Ferran Segura
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
César Arias
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Pilar Varela
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Pilar Peña
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Teresa Llovet
Affiliation:
Hospital Santa Creu i Sant Pau, Barcelona, Spain
Maria Canals
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Guadalupe Serrate
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
Antonio Nogueras
Affiliation:
Corporació Pare Taulí, Sabadell, Barcelona, Spain
*
Unitat d'Epidemiologia I Avaluado, Corporació Parc Tauli, Parc Tauli s/n, 08208 Sabadell, Barcelona, Spain[email protected]
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Abstract

Background:

Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward.

Methods:

Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed.

Results:

The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected.

Conclusion:

This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 3 , March 2005 , pp. 259 - 262
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Chin, J. Control of Communicable Diseases Manual, ed. 17. Washington, DC: American Public Health Association; 2000.Google Scholar
2.Mandeli, GL, Bennett, JE, Dolin, R, eds. Principles and Practice of Infectious Diseases, ed. 5. Philadelphia: Churchill Livingstone; 2000.Google Scholar
3.Caceres, 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;19:162–167.Google Scholar
4.McEvoy, M, Blake, W, Brown, D, Green, J, Cartwright, R. An outbreak of viral gastroenteritis on a cruise ship. Commun Dis Rep 1996;6:188–192.Google Scholar
5.Marshall, JA, Yuen, LK, Catton, MG, et al.Multiple outbreaks of Norwalk-like virus gastroenteritis associated with a Mediterranean-style restaurant. J Med Microbiol 2001;50:143–151.Google Scholar
6.González, MF, Moreno, CA, de Mateo, OS, et al.Nosocomial epidemic outbreak of acute gastroenteritis by Norwalk-like virus. Med Clin (Bare) 2002;118:611–615.Google Scholar
7.Jiang, X, Wang, M, Wang, K, Estes, MK. Characterization of SRSVs using RT-PCR and a new antigen ELISA. Arch Virol 1995;140:363–374.CrossRefGoogle Scholar
8.Fankhauser, RL, Boel, JS, Monroe, SS, Ando, T, Glass, RI. Molecular epidemiology of Norwalk-like viruses in outbreak of gastroenteritis in the United States. J Infect Dis 1998;178:1571–1578.Google Scholar
9.Berg, DE, Kohn, MA, Farley, TA, McFarland, LM. Multi-state outbreaks of acute gastroenteritis traced to fecal-contaminated oysters harvested in Louisiana. J Infect Dis 2000;181(suppl 2):S381–S386.Google Scholar
10.Patterson, W, Haswell, P, Fryers, PT, Green, J. Outbreak of small round structured virus gastroenteritis arose after kitchen assistant vomited. Commun Dis Rep 1997;7:101–103.Google Scholar
11.Becker, KM, Moe, CL, Southwick, KL, MacCormack, JN. Transmission of Norwalk virus during football game. N Engl J Med 2000;343:1223–1227.Google Scholar
12.Herwaldt, BL, Lew, JF, Moe, CL, et al.Characterization of a variant strain of Norwalk virus from a food-borne outbreak of gastroenteritis on a cruise ship in Hawaii. J Clin Microbiol 1994;32:861–866.Google Scholar
13.Lo, SV, Connolly, AM, Palmer, SR, Wright, D, Thomas, PD, Joynson, D. The role of the presymptomatic food handler in a common source outbreak of food-borne SRSV gastroenteritis in a group of hospitals. Epidemiol Infect 1994;113:513–521.CrossRefGoogle Scholar
14.Götz, H, Ekdahl, K, Lindbäck, J, de Jong, B, Hedlund, K, Giesecke, J. Clinical spectrum and transmission characteristics of infection with Norwalk-like virus: findings from a large community outbreak in Sweden. Clin Infect Dis 2001;33:622–628.CrossRefGoogle ScholarPubMed
15.Miller, M, Carter, L, Scott, K, Millard, G, Lynch, B, Guest, C. Norwalk-like virus outbreak in Canberra: implications for infection control in aged care facilities. Commun Dis Intell 2002;26:555–561.Google ScholarPubMed
16.Centers for Disease Control and Prevention. Norwalk-like viruses: public health consequences and outbreak management. MMWR 2001;50:1–18.Google Scholar
17.Le Guyader, F, Estes, MK, Hardy, ME, et al.Evaluation of a degenerate primer for the PCR detection of human caliciviruses. Arch Virol 1996;141:2225–2235.CrossRefGoogle ScholarPubMed
18.Dedman, D, Laurichesse, H, Caul, EO, Wall, PG. Surveillance of small round-structures virus (SRSV) infection in England and Wales, 1990-1995. Epidemiol Infect 1998;121:139–149.CrossRefGoogle Scholar
19.Gaulin, C, Levesque, B, Gauvin, D, Krizanova, V. Outbreak of non-bacterial gastroenteritis in a school. Can J Public Health 1996;87:264–267.Google Scholar
20.Arnedo, A, González, F, Bellido, J, Marti, JV, Safont, L, Calvo, C. Food poisoning outbreak probably of viral etiology caused by Norwalk virus. Gac Sanit 1991;5:161–173.Google Scholar
21.Kaplan, JE, Feldman, R, Campbell, DS, Lookabuag, C, Gary, GW. The frequency of a like-pattern of illness in outbreaks of acute gastroenteritis. Am J Public Health 1982;72:1329–1332.Google Scholar
22.McCall, J, Smithson, R. Rapid response and strict control measures can contain a hospital outbreak of Norwalk-like virus. Commun Dis Public Health 2002;5:243–246.Google Scholar
23.Ando, T, Noel, JS, Frankhauser, RL. Genetic classification of Norwalk-like viruses. J Infect Dis 2000;181:336–348.Google Scholar
24.Chriss, A. Norwalk-like viruses: when the runs can slow you down. CMAJ 2003;168:1.Google Scholar
25.Godoy, P, Prat, A, Alseda, M, Torres, J, Dominguez, A, Salleras, L. Outbreak of foodborne disease by Norwalk-like viruses genogroup II [in Spanish]. Med Clin (Bare) 2002;119:13–15.CrossRefGoogle ScholarPubMed
26.Stevenson, P, McCann, R, Duthie, R, Glew, E, Ganguli, L. A hospital outbreak due to Norwalk virus. J Hosp Infect 1994;26:261–272.CrossRefGoogle ScholarPubMed
27.Green, J, Wright, PA, Gallimore, CI, Mitchell, O, Morgan-Capner, P, Brown, DW. The role of environmental contamination with small round structured viruses in a hospital outbreak investigated by reverse-transcriptase polymerase chain reaction assay. J Hosp Infect 1998;39:39–45.Google Scholar
28.Augustin, AK, Simor, AE, Shorrock, C, McCausland, J. Outbreaks of gastroenteritis due to Norwalk-like virus in two long-term care facilities for the elderly. Canadian Journal of Infection Control 1995;10:111–113.Google Scholar
29.Cunney, RJ, Costigan, P, McNamara, EB, et al.Investigation of an outbreak of gastroenteritis caused by Norwalk-like virus, using solid phase immune electron microscopy. J Hosp Infect 2000;44:113–118.Google Scholar
30.Itoda, I, Hidai, H, Kikuchi, K, Yamaura, H, Totsuka, K. Hospital outbreak of viral gastroenteritis attributed to Norwalk-like viruses in Japan. Journal of the Japanese Association for Infectious Diseases 2002;76:32–40.Google Scholar
31.Ward, J, Neill, A, McCall, B, Stafford, R, Smith, G, Davison, R. Three nursing home outbreaks of Norwalk-like virus in Brisbane in 1999. Commun Dis Meli 2000;24:229–233.Google ScholarPubMed
32.Sair, AI, D'Souza, DH, Moe, CL, Jaykus, LA. Improved detection of human enteric viruses in foods by RT-PCR. J Virol Methods 2002;100:57–69.Google Scholar
33.Russo, PL, Spelman, DW, Harrington, GA, et al.Hospital outbreak of Norwalk-like virus. Infect Control Hosp Epidemiol 1997;18:576–579.CrossRefGoogle ScholarPubMed
34.Chadwick, PR, Beards, G, Brown, D, et al.Management of hospital outbreaks of gastro-enteritis due to small round structured viruses. J Hosp Infect 2000;45:1–10.Google Scholar