scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018

2019 ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P Harris ◽  
Sarah J O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01-1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60-0.91), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018

2019 ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P Harris ◽  
Sarah J O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with submitted stool samples. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 5.92, 95% CI 2.30-16.50) and larger care homes (aOR 2.35, 95% CI 1.05-5.38), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018

2019 ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P Harris ◽  
Sarah J O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 50% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01-1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60-0.91), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016–2018

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P. Harris ◽  
Sarah J. O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01–1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60–0.91), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

scholarly journals Study Protocol: Understanding SARS-Cov-2 infection, immunity and its duration in care home residents and staff in England (VIVALDI)

2020 ◽  
Vol 5 ◽  
pp. 232
Author(s):  
Maria Krutikov ◽  
Tom Palmer ◽  
Alasdair Donaldson ◽  
Fabiana Lorencatto ◽  
Gill Forbes ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Elderly Care ◽  
Qualitative Interviews ◽  
Care Home ◽  
The Elderly ◽  
Care Homes ◽  
Test Results ◽  
Care Home Staff ◽  
Co Morbidity ◽  
The Impact

Global infection and mortality rates from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are disproportionately high in certain populations, including the elderly. Care home residents are frequently exposed to infection due to contact with staff and other residents, and are highly susceptible to infection due to their age and co-morbidity. In England, official statistics suggest that at least 25% of all deaths in care home residents since the start of pandemic are linked to coronavirus disease 2019 (COVID-19), but limited testing for SARS-CoV-2 early in the pandemic means estimates of the true burden of disease are lacking. Additionally, little is known about patterns of transmission between care homes, the community and hospitals, or the relationship between infection and immunity in care home staff and residents. The VIVALDI study plans to address these questions. VIVALDI is a prospective cohort study aiming to recruit  6,500 staff and 5000 residents from 105 care homes across England. Successive rounds of testing for infection will be performed over a period of 12 months.  Nasopharyngeal swabs will detect evidence of viral RNA and therefore active infection (accompanied by collection of data on symptoms), whereas blood tests will detect antibodies and evidence of cellular immunity to SARS-CoV-2. Whole genome sequencing of viral isolates to investigate pathways of transmission of infection is planned in collaboration with the COVID-19 Genomics UK Consortium. Qualitative interviews with care home staff will investigate the impact of the pandemic on ways of working and how test results influence infection control practices and behaviours. Data from residents and staff will be linked to national datasets on hospital admissions, antibody and PCR test results, mortality and care home characteristics.  Data generated will support national public health efforts to prevent transmission of COVID-19 and protect care home staff and residents from infection. Protocol registration: ISRCTN14447421 05/06/2020

scholarly journals Introduction to and spread of COVID-19 in care homes in Norfolk, UK

2020 ◽  
Author(s):  
Julii Suzanne Brainard ◽  
Steven Rushton ◽  
Tim Winters ◽  
Paul R Hunter
Keyword(s):  
Care Home ◽  
Secondary Analysis ◽  
The Elderly ◽  
Staff Nurses ◽  
Care Homes ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Homes For The Elderly ◽  
Care Workers ◽  
Working Practices

BACKGROUND: Residential care homes for the elderly have been important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. METHODS: We undertook a secondary analysis of a dataset about 248 care homes in the county of Norfolk, eastern England. The dataset recorded categories of staff (nurses, care workers and non-care workers), their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) in the period 6 April -6 May 2020. Counts of residents (if any) at each care home with COVID-19 were also available, as well as descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and Sanitiser). PPE access was categorised as (most to least) green, amber or red. We undertook two stage modelling, first for any detection of COVID-19 in the homes, and a second model to relate any increases in case counts after introduction to staffing or PPE levels. RESULTS: We found that the counts of non-care workers had strongest relationships (and only link significant at p < 0.05) to any introduction of SARS-CoV-2 to the homes. After a home had at least one detected case, higher staff levels and more severe PPE shortages were most linked to higher case counts (p < 0.05) during the monitoring period. CONCLUSION: Better managing aspects of staff interaction with residents and some working practices should help reduce ingression to and spread of COVID-19 within residential homes for the elderly.

Scabies outbreaks in care homes for the elderly

2018 ◽  
Vol 18 (12) ◽  
pp. 1308-1309 ◽  
Author(s):  
Sally Millership ◽  
Smita Kapadia
Keyword(s):  
The Elderly ◽  
Care Homes ◽  
Homes For The Elderly

A helping hand

2020 ◽  
Vol 16 (5) ◽  
pp. 248-250
Author(s):  
Amanda McLaughlin
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Oral Health ◽  
Residential Care ◽  
Care Home ◽  
The Elderly ◽  
Oral Health Care ◽  
Care Homes ◽  
Residential Care Home

Amanda McLaughlin considers the importance of oral health care in nursing and residential care homes Aim The reader should be able to understand the importance of introducing and maintaining effective oral health care in nursing and residential care home and nursing home settings. Objectives To have an overview of UK statistics. To understand the implications of poor oral health on overall wellbeing To understand ways in which teams can improve the oral health of the elderly.

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