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A large-scale gastroenteritis outbreak associated with Norovirus in nursing homes

Published online by Cambridge University Press:  04 October 2004

R. CALDERON-MARGALIT ,
R. SHEFFER ,
T. HALPERIN ,
N. ORR ,
D. COHEN  and
T. SHOHAT
R. CALDERON-MARGALIT
Affiliation:
Hadassah Braun School of Public Health, Hebrew University, Jerusalem, Israel
R. SHEFFER
Affiliation:
Tel-Aviv District Authority, Israel Ministry of Health, Israel
T. HALPERIN
Affiliation:
Center for Vaccine Development and Evaluation, Israel Defense Forces, Israel
N. ORR
Affiliation:
Center for Vaccine Development and Evaluation, Israel Defense Forces, Israel
D. COHEN
Affiliation:
Center for Vaccine Development and Evaluation, Israel Defense Forces, Israel Department of Epidemiology and Biostatistics, Tel-Aviv University, Israel
T. SHOHAT
Affiliation:
Tel-Aviv District Authority, Israel Ministry of Health, Israel Department of Epidemiology and Biostatistics, Tel-Aviv University, Israel
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Abstract

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An increase in gastroenteritis outbreaks due to Norovirus has been reported worldwide. We investigated a large-scale outbreak affecting 246 residents and 33 staff members in six nursing homes in the Tel-Aviv district, Israel, during 3 weeks in 2002. Person-to-person spread was noticed in all nursing homes. The spread of disease could not be attributed to social interactions. Among the elderly residents, the hospitalization rate was 10·2% and the case-fatality rate was 2·0%. Bacteriological cultures were negative. Overall, 7 out of 15 stool specimens were positive for Norovirus by RT–PCR. All were sequenced and found to be 90% identical. The characteristics of this outbreak and the RT–PCR results suggest that illness was caused by Norovirus. Due to the high case-fatality rate of Norovirus gastroenteritis, there should be a high index of suspicion when encountering a gastroenteritis outbreak among the elderly. This will enable prompt action to stop the spread of illness.

Type
Research Article
Information
Epidemiology & Infection , Volume 133 , Issue 1 , February 2005 , pp. 35 - 40
Copyright
2004 Cambridge University Press