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

Details

• Personal Author:
  Chapin AR ; Fornek M ; Gibson K ; Henning K ; Schwab E ; Schwab KJ ; Spencer C ; Wu HM
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Digestive System Digestive System Diseases Environmental Exposure Environmental Pollution Occupational Health Safety Viral Diseases
• Keywords:
  Environmental-contamination Environmental-exposure Gastrointestinal-system Gastrointestinal-system-disorders Infection-control Infectious-diseases Viral-diseases Viral-infections
• ISSN:
  0899-823X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  26
• Issue:
  10
• NIOSHTIC Number:
  nn:20037390
• Citation:
  Infect Control Hosp Epidemiol 2005 Oct; 26(10):802-810
• Contact Point Address:
  Henry Wu, MD, Drexel University College of Medicine, Mailstop 461, 245 N. 15th St., Philadelphia, PA 19102
• Email:
  hwu@drexelmed.edu
• Federal Fiscal Year:
  2006
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Infection Control and Hospital Epidemiology
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9f220b64a0a9f20372df66713490962a3c0ec41d00a1d81f6ca29fd59843dcc1cc201576c8f494b254e28c21d4902cd9e8b55c3a0443fc0ab42ac56c65b6b03c
• Download URL:
  https://stacks.cdc.gov/view/cdc/188489/cdc_188489_DS1.pdf
• File Type:
  [PDF - 606.52 KB ]