An outbreak of Escherichia coli O157 gastroenteritis in a care home for the elderly

Abstract

In the summer of 2001 an outbreak of Escherichia coli O157 gastroenteritis affected staff and residents of a care home for the elderly in the West Midlands, UK. E. coli O157 phage type 2 was isolated from faeces in eight patients and 12 staff members. Thirty-five staff and 40 residents met the case definition for clinical gastrointestinal infection. Serological testing identified a further 14 possible cases of infection amongst asymptomatic staff and residents. The outbreak was atypical, as the disease seemed to be milder than has been observed in past outbreaks in similar settings. The index case, a member of staff, developed bloody diarrhoea and haemolytic-uraemic syndrome (HUS), but only one resident developed bloody diarrhoea and required hospitalization. No deaths occurred, despite the high-risk nature of the affected population. The source of the outbreak could not be identified. The prolonged nature of the outbreak and observed lapses in infection control practices indicated that person-to-person spread was the likely route of transmission. This outbreak illustrates the importance of observing appropriate infection control measures in the institutions providing residential and nursing care to the elderly.

Hospitalization of the Elderly in the United States for Nonspecific Gastrointestinal Diseases: A Search for Etiological Clues

“…Fluctuations in environmental parameters such as ambient and water temperatures, 11---13 ultraviolet radiation, 14---16 humidity or apparent temperature, 17,18 and precipitation 19 have been linked to infectious disease seasonality. With respect to social parameters, consumption of contaminated foods, 20---23 exposure to contaminated environments, 24,25 and institutionalization in a nursing home or hospital 26,27 are common risk factors in the elderly.…”

Impact of hand hygiene on the infectious risk in nursing home residents: A systematic review

“…Among the 46 remaining studies, 33 investigated multifaceted interventions which covered other aspects of infection control besides HH, 39,43,46,50,52,53,56,59,61,63,65 whereas 13 described interventions based on HH only. 10,45,[47][48][49]51,54,55,57,58,60,62,64 The interventions on HH were diverse and included educational programs for the staff and the residents (in 57% of the 46 studies describing interventions), 10,14,20,21,23,27,29,39,43,45,47,48,50,51,53,55-65 implementation of new guidelines (28% of studies), [10][11][12][13]15,17,19,20,22,26,…”

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