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A Viral Gastroenteritis Outbreak Associated with Person-to-Person Spread Among Hospital Staff

Published online by Cambridge University Press:  02 January 2015

Victor M. Cáceres ,
David K. Kim ,
Joseph S. Bresee ,
John Horan ,
Jacqueline S. Noel ,
Tamie Ando ,
Connie J. Steed ,
J. John Weems ,
Stephan S. Monroe  and
James J. Gibson
Victor M. Cáceres*
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia South Carolina Department of Health and Human Environmental Control, Columbia, South Carolina
David K. Kim
Affiliation:
Division of Viral and Rickettsial Diseases, the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Joseph S. Bresee
Affiliation:
Division of Viral and Rickettsial Diseases, the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
John Horan
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Jacqueline S. Noel
Affiliation:
South Carolina Department of Health and Human Environmental Control, Columbia, South Carolina
Tamie Ando
Affiliation:
Division of Viral and Rickettsial Diseases, the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Connie J. Steed
Affiliation:
Greenville Hospital System, Greenville, South Carolina
J. John Weems
Affiliation:
Greenville Hospital System, Greenville, South Carolina
Stephan S. Monroe
Affiliation:
Division of Viral and Rickettsial Diseases, the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Centers for Disease Control and Prevention, National Immunization Program, Mailstop E-05, Polio Eradication Activity, 1600 Clifton Rd, Atlanta, GA 30333
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Abstract

Objective:

To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis.

Setting:

A regional referral hospital in upstate South Carolina.

Methods:

We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996.

Results:

The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples.

Conclusion:

This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 3 , March 1998 , pp. 162 - 167
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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