On norovirus outbreaks and transmission in hospitals
Abstract
Abstract Noroviruses are now the leading cause of gastroenteritis worldwide. Noroviruses are effectively transmitted due to a low infectious dose, viral shedding in high concentrations, environmental stability, and they induce only a limited immunity after infection. Especially, the norovirus variants of genotype II.4 (GII.4) have seemed greatly adapted for pandemic spread. The high infectivity of noroviruses result in frequent outbreaks, particularly at healthcare facilities. Hospital norovirus outbreaks cause excess morbidity among vulnerable inpatients, ill staff, shortage of beds and economic loss. In the first study, using two outbreak surveillance methods, based on either clinical reporting or clustering of positive laboratory results, incidence of norovirus outbreaks at all hospital wards in Skåne was estimated to 0.5 to 0.2 per ward and winter season, 2010-2012. In total, 135 outbreaks were detected, 74 with both methods, 18 only by clinical reporting and 43 only with laboratory surveillance. Laboratory surveillance performed better at identifying outbreaks and seem a stable option for continuous surveillance, but the combination of both surveillance methods would be preferred. In the second study, the first patient in each outbreak (n 65), was compared with patients not involved in any outbreak (n 186), to analyse factors associated with outbreak development. Sharing room with other patients, old age, comorbidities, onset of disease at the ward and vomiting were…
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