JSTOR

Infection Control and Hospital Epidemiology Publication Info

Article DOI: 10.1086/502497
Stable URL: http://www.jstor.org/stable/10.1086/502497
A Norovirus Outbreak at a Long‐Term–Care Facility: The Role of Environmental Surface Contamination • 
Henry M. Wu , MD, Mary Fornek , BSN, MBA, Kellogg J. Schwab , PhD, Amy R. Chapin , MPH, PhD, Kristen Gibson , BS, Edna Schwab , MD, Charles Spencer , MD, PhD and Kelly Henning , MD
Infection Control and Hospital Epidemiology , Vol. 26, No. 10 (October 2005), pp. 802-810
Article DOI: 10.1086/502497
Article Stable URL: http://www.jstor.org/stable/10.1086/502497
Original Articles

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

Formats Available in JSTOR: PDF

Abstract(back to top)

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.

Bibliographic Information(back to top)

  • A Norovirus Outbreak at a Long‐Term–Care Facility: The Role of Environmental Surface Contamination
  • Henry M. Wu , MD, Mary Fornek , BSN, MBA, Kellogg J. Schwab , PhD, Amy R. Chapin , MPH, PhD, Kristen Gibson , BS, Edna Schwab , MD, Charles Spencer , MD, PhD and Kelly Henning , MD
  • Infection Control and Hospital Epidemiology
  • Vol. 26, No. 10 (October 2005) (pp. 802-810)

Author Information(back to top)

Henry M. Wu , MD; Mary Fornek , BSN, MBA; Kellogg J. Schwab , PhD; Amy R. Chapin , MPH, PhD; Kristen Gibson , BS; Edna Schwab , MD; Charles Spencer , MD, PhD; Kelly Henning , MD

Notes and References(back to top)

This item contains 1 note(s).

Notes

Drs. Wu, E. Schwab, Spencer, and Henning are from the University of Pennsylvania School of Medicine; and Ms. Fornek and Drs. E. Schwab, Spencer, and Henning are from the Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania. Drs. K. J. Schwab and Chapin and Ms. Gibson are from the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Supported in part by The Center for a Livable Future at the Johns Hopkins Bloomberg School of Public Health (the JHU portion of this research) and the Howard Hughes Medical Institute Predoctoral Fellowship in Biological Sciences (ARC).Address reprint requests to Henry Wu, MD, Drexel University College of Medicine, Mailstop 461, 245 N. 15th St., Philadelphia, PA 19102. The authors thank Donald Stieritz, Department of Pathology, Philadelphia VA Medical Center, for his assistance in processing clinical specimens; Barry Perry and Stanley Reynolds, Virology and Immunology Section, Division of Clinical Microbiology, Pennsylvania Department of Health, for initial NoV testing of clinical samples; Richard Hodinka, Clinical Virology Laboratory, Children’s Hospital of Philadelphia, for testing clinical samples for non‐NoV viral pathogens; and Farzad Mostashari, Division of Epidemiology, New York City Department of Health and Mental Hygiene, for statistical assistance.Presented in part at the 41st Annual Meeting of the Infectious Diseases Society of America, October 9‐12, 2003, San Diego, CA; and the 2nd World Calicivirus Conference, November 6‐10, 2004, Dijon, France.

Items Citing this Item (back to top)

5 item(s) in JSTOR cite this item

© 2005 by The Society for Healthcare Epidemiology of America. All rights reserved.