Norovirus Linked To One-Fifth Of Hospital Infections

Norovirus has been linked to about one-fifth of all hospital infections, according to the results of an emerging survey

The nationwide survey covered outbreaks that took place in 289 United States hospitals. In addition to its part in hospital infections, Norovirus was to blame for 65% of all ward closings, said MedScape. Survey results appear in the February issue of the American Journal of Infection Control.

As we’ve explained, norovirus are a group of viruses that cause swelling in the linings of both the stomach and intestines, according to the U.S. Centers for Disease Control and Prevention (CDC). A highly contagious, severe gastrointestinal illness commonly referred to as the so-called “stomach flu,” norovirus spreads quickly because it transmits easily through the vomit and feces of people sick with the illness. Contact with only a few particles can make a person ill.

Norovirus, which can survive for weeks on surfaces at room temperature, can be difficult to eliminate, and can only be killed with chorine bleach. Alcohol-based hand sanitizers and other preparations are not helpful. People are generally considered to be contagious from when they feel ill to about three days after their symptoms subside; however, the virus can still be active in their vomit or stool for two weeks or more.

“Norovirus is emerging as an increasingly common hospital-associated organism, causing outbreaks in nonacute settings, and may lead to unit/department closures,” wrote Emily Rhinehart, RN, MPH, CIC, from the Department of Global Loss Prevention, Chartis Insurance, Atlanta, Georgia, and colleagues, said MedScape. The researchers also noted that while hospital-associated infections have been studied for decades, not very many published reports focus on how often these outbreaks occur, how long they last, and in how many cases the infections necessitate hospital ward closures.

To answer these questions, the team reviewed survey results from 822 hospitals in 7 states: California, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas. Hospital size and structure varied and facilities included rural; university-affiliated teaching; and specialty healthcare facilities (such as pediatric) hospitals, MedScape explained, noting that the survey was conducted in early 2010 and the outbreaks took place 2008 – 2009, for a total of 386 outbreak investigations in 289 hospitals. Of the responding hospitals, 533 said they did not report outbreak investigations.

For 60% of the outbreaks, four organisms were involved, with norovirus being the most common at 18.2%. Staphylococcus aureus (17.5%), Acinetobactor spp (13.7%), and Clostridium difficile (10.3%) made up the remaining three, said MedScape. Norovirus was most popular in behavioral and rehabilitation/long-term healthcare facilities, while other pathogens were more commonly seen in medical and surgical units. About 25.7% of outbreak investigations occurred in medical/surgical units, with the next most common location being surgical units (15.9%).

Rehabilitation units, long-term acute care facilities, emergency departments, psychiatric facilities, and skilled nursing facilities accounted for 29.2% of outbreaks and one-quarter of reported cases involved units; norovirus accounted for 65% of the cases, said MedScape.

Although most state regulations mandate infectious outbreaks in healthcare facilities be reported to state authorities, according to the survey, only about half followed this mandate, said MedScape.