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Management of hospital outbreaks of gastro-enteritis due to small round structured viruses

Management of hospital outbreaks of gastro-enteritis due to small round structured viruses
Management of hospital outbreaks of gastro-enteritis due to small round structured viruses
Small round structured viruses (SRSVs, Norwalk-like viruses, NLVs) are the most common cause of outbreaks of gastro-enteritis in hospitals and also cause outbreaks in other settings such as schools, hotels, nursing homes and cruise ships. Hospital outbreaks often lead to ward closure and major disruption in hospital activity. Outbreaks usually affect both patients and staff, sometimes with attack rates in excess of 50%. For this reason, staff shortages can be severe, particularly if several wards are involved at the same time. SRSVs may be spread by several routes: faecal–oral; vomiting/aerosols; food and water. Viruses may be introduced into the ward environment by any of these routes and then propagated by person-to-person spread. In an outbreak setting, the diagnosis can usually be made rapidly and confidently on clinical and epidemiological grounds, particularly if vomiting is a prominent symptom. By the time an SRSV outbreak has been recognized at ward level, most susceptible individuals will have been exposed to the virus and infection control efforts must prioritize the prevention of spread of infection to other clinical areas by containment of infected/exposed individuals (especially the prevention of patient and staff movements to other areas), hand-hygiene and effective environmental decontamination.
This report of the Public Health Laboratory Service Viral Gastro-enteritis Working Group reviews the epidemiology of outbreaks of infection due to SRSVs and makes recommendations for their management in the hospital setting. The basic principles which underpin these recommendations will also be applicable to the management of some community-based institutional outbreaks.
0195-6701
1-10
Chadwick, P. R.
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Beards, G.
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Brown, D.
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Caul, E. O.
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Cheesbrough, J.
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Clarke, I. N.
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Curry, A.
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O'Brien, S.
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Quigley, K.
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Sellwood, J.
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Westmoreland, D.
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Chadwick, P. R.
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Beards, G.
788329ad-41d2-4516-af96-e856e9bb5fd8
Brown, D.
066e8669-5678-4f7c-96eb-e8e29a9a4cfb
Caul, E. O.
91f307fa-d4ba-43f7-829a-6a60b0827b12
Cheesbrough, J.
3fd2e384-fd82-415a-aeb4-b1a6aa535e59
Clarke, I. N.
ff6c9324-3547-4039-bb2c-10c0b3327a8b
Curry, A.
f6589489-ff60-40ee-98b0-bab9c1be4597
O'Brien, S.
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Quigley, K.
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Sellwood, J.
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Westmoreland, D.
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Chadwick, P. R., Beards, G., Brown, D., Caul, E. O., Cheesbrough, J., Clarke, I. N., Curry, A., O'Brien, S., Quigley, K., Sellwood, J. and Westmoreland, D. (2000) Management of hospital outbreaks of gastro-enteritis due to small round structured viruses. Journal of Hospital Infection, 45 (1), 1-10. (PMID:10833336)

Record type: Article

Abstract

Small round structured viruses (SRSVs, Norwalk-like viruses, NLVs) are the most common cause of outbreaks of gastro-enteritis in hospitals and also cause outbreaks in other settings such as schools, hotels, nursing homes and cruise ships. Hospital outbreaks often lead to ward closure and major disruption in hospital activity. Outbreaks usually affect both patients and staff, sometimes with attack rates in excess of 50%. For this reason, staff shortages can be severe, particularly if several wards are involved at the same time. SRSVs may be spread by several routes: faecal–oral; vomiting/aerosols; food and water. Viruses may be introduced into the ward environment by any of these routes and then propagated by person-to-person spread. In an outbreak setting, the diagnosis can usually be made rapidly and confidently on clinical and epidemiological grounds, particularly if vomiting is a prominent symptom. By the time an SRSV outbreak has been recognized at ward level, most susceptible individuals will have been exposed to the virus and infection control efforts must prioritize the prevention of spread of infection to other clinical areas by containment of infected/exposed individuals (especially the prevention of patient and staff movements to other areas), hand-hygiene and effective environmental decontamination.
This report of the Public Health Laboratory Service Viral Gastro-enteritis Working Group reviews the epidemiology of outbreaks of infection due to SRSVs and makes recommendations for their management in the hospital setting. The basic principles which underpin these recommendations will also be applicable to the management of some community-based institutional outbreaks.

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More information

Published date: May 2000
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 336235
URI: http://eprints.soton.ac.uk/id/eprint/336235
ISSN: 0195-6701
PURE UUID: 84c21d25-78ea-48de-808b-32750f15e39e
ORCID for I. N. Clarke: ORCID iD orcid.org/0000-0002-4938-1620

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Date deposited: 20 Mar 2012 11:12
Last modified: 23 Jul 2022 01:32

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Contributors

Author: P. R. Chadwick
Author: G. Beards
Author: D. Brown
Author: E. O. Caul
Author: J. Cheesbrough
Author: I. N. Clarke ORCID iD
Author: A. Curry
Author: S. O'Brien
Author: K. Quigley
Author: J. Sellwood
Author: D. Westmoreland

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