Norwalk-Like Viral Gastroenteritis Outbreak in U.S. Army Trainees

Norovirus is the major cause of viral gastroenteritis in the hospital setting worldwide. It affects people of all ages. Outbreaks in hospitals lead to major disruptions, sometimes leading to ward closures. Although Kaplan criteria have been used to determine the probability of a viral gastroenteritis outbreak, this is hampered by its low sensitivity. Reverse-transcriptase polymerase chain reaction (RT-PCR) is now the preferred method for detection with the greatest sensitivity. Management of individual cases remain supportive, although death has been associated with immunosuppression. Stringent infection control management, such as strict isolation and closure of affected bays, limiting non-essential personnel and visitors entering the ward, and adherence to soap and water handwashing are key to managing ward outbreaks.

Download Full-text

Incidence of Post-Infectious Irritable Bowel Syndrome and Functional Intestinal Disorders Following a Water-Borne Viral Gastroenteritis Outbreak

The American Journal of Gastroenterology ◽

10.1038/ajg.2012.102 ◽

2012 ◽

Vol 107 (6) ◽

pp. 891-899 ◽

Cited By ~ 95

Author(s):

Barbara Zanini ◽

Chiara Ricci ◽

Floriana Bandera ◽

Francesca Caselani ◽

Alberto Magni ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Viral Gastroenteritis ◽

Gastroenteritis Outbreak ◽

Irritable Bowel ◽

Post Infectious ◽

Water Borne

Download Full-text

First detection of human astrovirus in gastroenteritis outbreak in Hungary

Orvosi Hetilap ◽

10.1556/oh.2011.29013 ◽

2011 ◽

Vol 152 (2) ◽

pp. 45-50 ◽

Cited By ~ 3

Author(s):

Péter Pankovics ◽

Ákos Boros ◽

Melinda Rovács ◽

Erika Nagy ◽

Erika Krisztián ◽

...

Keyword(s):

Nucleotide Sequence ◽

Care Center ◽

Epidemiological Data ◽

Oral Route ◽

Viral Gastroenteritis ◽

Gastroenteritis Outbreak ◽

Etiological Role ◽

Human Astroviruses ◽

Stool Samples

Human astroviruses are one of the known pathogens of gastroenteritis in infants, children and rarely in elderly. It causes 4.2-7.3% of the sporadic gastroenteritis cases with diarrhea and vomiting in children. The etiological role of astrovirus has not been confirmed yet in outbreaks of gastroenteritis in Hungary. Aims: The first description of the detection and molecular epidemiology of astrovirus in outbreaks of gastroenteritis in Hungary. Materials and methods: Stool samples originated from Komárom-Esztergom County, from a day-care center (nursery) where a gastroenteritis outbreak occurred in June, 2010. Astrovirus was detected by RT-PCR methods. The nucleotide sequence of the nearly complete genome was sequenced. Clinical and epidemiological data were collected by epidemiological investigation. Results: Out of the 29 exposed persons (24 children and 5 adults) 7 (24.1%) children had gastroenteritis with diarrhea, and vomiting in one case, in the period of June 4-15, 2010. Bacterial pathogens, rotavirus, adenovirus and norovirus were not detected, but genotype 1 astrovirus could be identified in 3 (42.8%) stool samples (HQ398856). The nucleotide sequence of the astrovirus ORF1a/ORF1b/ORF2/3’UTR regions was determined. The source of the outbreak was presumably the firstly recognized ill child and the virus was spread by fecal-oral route with direct contact in the children community. Conclusions: Epidemiologic and clinical characteristics of the astrovirus outbreak in the nursery are described in details to prove that the possible etiological role of astroviruses in viral gastroenteritis which should not forget in order after rotaviruses, caliciviruses (norovirus and sapovirus) and enteric adenoviruses. Orv. Hetil., 2011, 152, 45–50.

Download Full-text

Gastroenteritis outbreaks and the association of safer cleaning

Journal of Infection Prevention ◽

10.1177/1757177419846270 ◽

2019 ◽

Vol 20 (5) ◽

pp. 254-258

Author(s):

Elizabeth E Gillespie ◽

Eldho Paul ◽

Rhonda L Stuart

Keyword(s):

Hand Hygiene ◽

Infection Control ◽

Infection Control Practice ◽

Viral Gastroenteritis ◽

Gastroenteritis Outbreak ◽

Biocidal Activity ◽

Cleaning Method ◽

Control Practice

Background: Physical removal of soil rather than biocidal activity is the focus for this safer cleaning method. Methods: We compared 11 years of Victorian healthcare norovirus and suspected viral gastroenteritis outbreak data. Results: Improvements in infection control practice, including the Victorian hand hygiene program corresponds with reduced illness across Victoria during that time. Monash Health reductions are statistically significant and coincide with the implementation of a novel cleaning methodology. Conclusion: Cleaning without chemicals has not increased the risk of norovirus or suspected viral gastroenteritis illness at Monash Health.

Download Full-text

Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team

Prehospital and Disaster Medicine ◽

10.1017/s1049023x15004872 ◽

2015 ◽

Vol 30 (4) ◽

pp. 355-358 ◽

Cited By ~ 4

Author(s):

Joshua B. Gaither ◽

Rianne Page ◽

Caren Prather ◽

Fred Paavola ◽

Andrew L. Garrett

Keyword(s):

Hurricane Sandy ◽

Control Measures ◽

Viral Gastroenteritis ◽

Medical Team ◽

Gastroenteritis Outbreak ◽

Team Members ◽

Medical Response ◽

Returning Home ◽

Medical Teams ◽

The Impact

AbstractIntroductionIn late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident.Hypothesis/ProblemDescribe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team.MethodsThe number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment.ResultsThe shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively.ConclusionMedical teams providing shelter care during viral gastroenteritis outbreaks are susceptible to contracting the virus while caring for patients. When responding to similar incidents in the future, teams should not only be ready to implement aggressive infectious control measures but also be prepared to care for team members who become ill.GaitherJB, PageR, PratherC, PaavolaF, GarrettAL. Impact of a hurricane shelter viral gastroenteritis outbreak on a responding medical team. Prehosp Disaster Med. 2015;30(4):1–4.

Download Full-text

A waterborne norovirus gastroenteritis outbreak in a school, eastern China

Epidemiology and Infection ◽

10.1017/s0950268815002526 ◽

2015 ◽

Vol 144 (6) ◽

pp. 1212-1219 ◽

Cited By ~ 8

Author(s):

N. ZHOU ◽

H. ZHANG ◽

X. LIN ◽

P. HOU ◽

S. WANG ◽

...

Keyword(s):

Drinking Water ◽

Water Sample ◽

Eastern China ◽

Viral Gastroenteritis ◽

Gastroenteritis Outbreak ◽

Policy Makers ◽

Clinical Specimens ◽

Norovirus Gastroenteritis ◽

Close Relationship ◽

And Control

SUMMARYIn late 2014, a gastroenteritis outbreak occurred in a school in Shandong Province, eastern China. Hundreds of individuals developed the symptoms of diarrhoea and vomiting. Epidemiological investigation showed that food consumption was not linked to this outbreak, and unboiled direct drinking water was identified as the independent risk factor with a relative risk of 1·37 (95% confidence interval 1·03–1·83). Furthermore, examination of common bacterial and viral gastroenteritis pathogens was conducted on different specimens. Norovirus GI.1, GI.2, GI.6, GII.4, GII.6 and GII.13 were detected in clinical specimens and a water sample. GII.4 sequences between clinical specimens and the water sample displayed a close relationship and belonged to GII.4 variant Sydney 2012. These results indicate that direct drinking water contaminated by norovirus was responsible for this gastroenteritis outbreak. This study enriches our knowledge of waterborne norovirus outbreaks in China, and presents valuable prevention and control practices for policy-makers. In future, strengthened surveillance and supervision of direct drinking-water systems is needed.

Download Full-text