Outbreak of acute gastroenteritis among emergency department staff

Vardy, J; Love, Andrew John; Dignon, N

doi:10.1136/emj.2006.045427

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…Contact precautions-EDs frequently care for patients infected or colonized with multidrug-resistant organisms (MDRO) including methicillin-resistant Staphylococcus aureus (MRSA), [87][88][89][90][91] vancomycin-resistant Enterococcus (VRE), 87,91 and a growing number of multidrug-resistant Gram-negative bacteria (e.g., Acinetobacter baumannii, Pseudomonas aeruginosa, and various Enterobacteriaceae). 92 Clostridium difficile 93,94 and other enteric pathogens 95 are likewise commonly encountered in patients with diarrheal illness. Transmission of these pathogens and others, including SARS and highly pathogenic influenza, can occur through direct contact with patients or their immediate surroundings.…”

Section: Transmission-based Precautionsmentioning

confidence: 99%

Infection Prevention in the Emergency Department

Liang

Theodoro

Schuur

et al. 2014

Annals of Emergency Medicine

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Infection prevention remains a major challenge in emergency care. Acutely ill and injured patients seeking evaluation and treatment in the emergency department (ED) not only have the potential to spread communicable infectious diseases to healthcare personnel and other patients, but are vulnerable to acquiring new infections associated with the care they receive. This article will evaluate these risks and review the existing literature for infection prevention practices in the ED, ranging from hand hygiene, standard and transmission-based precautions, healthcare personnel vaccination, and environmental controls to strategies for preventing healthcare-associated infections. We will conclude by examining what can be done to optimize infection prevention in the ED and identify gaps in knowledge where further research is needed. Successful implementation of evidence-based practices coupled with innovation of novel approaches and technologies tailored specifically to the complex and dynamic environment of the ED are the keys to raising the standard for infection prevention and patient safety in emergency care.

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Section: Transmission-based Precautionsmentioning

confidence: 99%

Infection Prevention in the Emergency Department

Liang

Theodoro

Schuur

et al. 2014

Annals of Emergency Medicine

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“…Episodes last 12-60 h and mainly entail vomiting and diarrhea. Although NoV illness is usually selflimiting, the burden of disease is considerable, with many people affected and a potentially great impact in health-care settings [5][6][7]. Between 1994 and 2005, a total of 74% of all reported outbreaks of viral gastroenteritis in the Netherlands were caused by NoV, and up to 68% of these were caused by GII.4 strains [1,8].…”

mentioning

confidence: 99%

High Prevalence of Prolonged Norovirus Shedding and Illness among Hospitalized Patients: A Model for In Vivo Molecular Evolution

et al. 2008

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During a 2-year survey in an academic hospital, 8 (8.4%) of all norovirus (NoV)-positive patients showed prolonged norovirus illness and shedding (duration, 21-182 days). All patients had underlying illnesses, resulting in some level of immunodeficiency in 5. Four patients were admitted to the hospital with gastroenteritis, 2 acquired norovirus while hospitalized, and 2 were outpatients. Genotypes GII.4 and GIIb-GII.3 were found. Reinfection occurred in 3 patients. Full capsid sequences were determined from strains detected in sequentially collected stool specimens to study evolution. The greatest number of amino acid mutations in a given patient was 11; they were detected in NoV isolates recovered over a 119-day period and were mapped to positions at or near putative antigenic sites. In the patient with most severe immune dysfunction, only 5 amino acids mutated over 182 days, suggesting immune-driven selection. The severe impact on patients and hospitals and the potential role of prolonged shedders as a reservoir for viral antigenic variants lead us to stress the importance of confinement of outbreaks of NoV infection that occur in hospitals.

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“…A ratio equal or higher than 0.5 was derived for 13 outbreaks (30.2%) (Cunney et al 2000;Khanna et al 2003;Baum von et al 2004;Gallimore et al 2004;Meyer et al 2004;Fretz et al 2005;Zingg et al 2005;Sukhrie et al 2012;Schulz-Stübner et al 2016;). A ratio of exactly one was obtained for a hospital outbreak in Scotland that affected exclusively staff (Vardy et al 2007). Overall, an average ratio of 0.37 (standard deviation: 0.24) was determined for the outbreaks in the first category (median: 0.35; Fig.…”

Section: Resultsmentioning

confidence: 99%

Significance of norovirus in occupational health: a review of published norovirus outbreaks in Central and Northern Europe

Hofmann

Olawumi

Michaelis

et al. 2020

Int Arch Occup Environ Health

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Objectives Globally, norovirus (NoV) is the leading cause of gastroenteritis infection among all ages. The development of prevention strategies in the field of occupational health requires a detailed knowledge about the impact of the disease on employees. This review article aims not only at evaluating the burden of NoV outbreaks on staff but also at discussing implications for future prevention strategies. Methods Published NoV outbreaks in Central and Northern Europe were identified via a systematic literature search. Additionally, published NoV outbreaks in Germany were detected via a manual literature search. Key epidemiological data, as the number of symptomatic staff, was then extracted. The proportion of affected employees was calculated for each dataset (single NoV outbreaks or aggregated data of multiple outbreaks). Results Overall, 116 datasets were extracted from 72 relevant articles. 144,852 persons were affected by NoV gastroenteritis, 25,408 out of them (17.5%) were employees. 23,874 (94.0%) of them fell sick during outbreaks in hospitals and related settings. NoV cases among personnel in food establishments were reported only sporadically (mean ratio: 0.01). Conclusions Employees in hospitals and community facilities seem quantitatively to be most vulnerable towards NoV epidemics. Therefore, high quality of prevention measures in these settings, respective compliance with prevention strategies should have the highest priority. The disease can be considered as an occupational disease, even regularly without long-term consequences. Following work safety rules, a vaccination for vulnerable groups should be recommended if the vaccine development turns out to be successful.

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Outbreak of acute gastroenteritis among emergency department staff

Cited by 11 publications

References 15 publications

Infection Prevention in the Emergency Department

Infection Prevention in the Emergency Department

High Prevalence of Prolonged Norovirus Shedding and Illness among Hospitalized Patients: A Model for In Vivo Molecular Evolution

Significance of norovirus in occupational health: a review of published norovirus outbreaks in Central and Northern Europe

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