Norovirus-Ausbruch in einem Altenheim und Krankenhaus in Österreich

Abstract

On November 9, 2004, a resident in a nursing home experienced a severe episode of vomiting in the dining room, in the presence of most of the other residents and members of staff. Following that episode, 17 of the 23 (73.9%) other residents and 7 of the 18 (38.9%) staff members fell ill with diarrhea and/or vomiting in the period up to November 17. A second cluster of gastroenteritis occurred between November 11 and 28, 2004, in a nearby hospital to which eight cases among the nursing home residents had been referred. Ten of 46 (21.7%) other hospital patients and 18 of 60 (30%) members of the hospital staff suffered from vomiting or diarrhea. Epidemiological and laboratory investigations proved a causal relationship between the two institutional clusters of short-lived gastroenteritis related by time and place, and identified Norovirus genotype GGII.4 (Jamboree-like) as the causative pathogen. Control measures for Norovirus, based on epidemiological and clinical features of the outbreak, were effectively implemented in the nursing home without waiting for virological confirmation. At the hospital, specific measures were not implemented until after virological confirmation of the causative agent, by which time 16 cases had already occurred. In a suspected Norovirus outbreak it is of great importance -- especially within closed and semiclosed settings -- to implement control measures as soon as possible, even before laboratory confirmation of the agent.

Active hospital-based surveillance of rotavirus diarrhea in Austrian children, period 1997 to 2003

“…Rotavirus is the most common pathogen in infants and young children among the many viruses causing diarrhea worldwide [1][2][3][4]. The highest incidence of rotavirus infection is observed during the first three to five years of life [1].…”

Enhanced Hygiene Measures and Norovirus Transmission during an Outbreak

“…No antiviral treatment exists for norovirus infection, and although norovirus vaccines are in development (12), none are available yet. Early studies suggested that norovirus outbreaks could be contained by rapid implementation of enhanced hygiene measures, such as washing hands, thoroughly cleaning contaminated surfaces, avoiding contact between sick and healthy persons, and requesting caretakers and cleaning staff to wear gloves and aprons (13)(14)(15)(16). However, in nursing homes or on cruise ships, norovirus can cause consecutive outbreaks, even after implementation of strict hygiene protocols (9,17,18).…”

Wie bedeutend ist die Noroviren-bedingte Gastroenteritis?

“…In der vorliegenden Ausgabe der Wiener klinischen Wochenschrift berichten Schmid und Kollegen von einer Verkettung zweier NV-Ausbrüche in einem Altenheim und in einer Abteilung eines nahe gelegenen Krankenhauses im November 2004 [9]. Ihre Arbeit beschreibt mehrere wesentliche epidemiologische Charakteristika der NV, welche hier nochmals aufgegriffen und in einen Gesamtkontext gebracht werden sollen.…”