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A Viral Gastroenteritis Outbreak Associated with Person-to-Person Spread Among Hospital Staff

1998; Cambridge University Press; Volume: 19; Issue: 3 Linguagem: Inglês

10.1086/647788

1559-6834

Victor M. Cáceres, David K. Kim, Joseph S. Bresee, John M. Horan, Jacqueline S. Noel, Tamie Ando, Connie Steed, J. John Weems, Stephan S. Monroe, James J. Gibson,

Evolution and Genetic Dynamics

To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis.A regional referral hospital in upstate South Carolina.We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996.The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples.This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings.