Early Isolation of Patients Suffering from Infectious Gastroenteritis and Prevention of a Nosocomial Outbreak: An Observational Study

Abstract

Five outbreaks of gastroenteritis caused by norovirus occurred in our hospital in 2007, and we had to restrict admission of new patients to the affected wards to terminate the outbreaks. Isolation of the proband of gastroenteritis from the ward took two to five days in every outbreak. Assuming that rapid isolation of the proband of gastroenteritis from the ward would be helpful to prevent gastroenteritis outbreaks, we have since tried to discover and isolate patients suffering from infectious gastroenteritis as quickly as possible. Consequently, the number of gastroenteritis outbreaks decreased to one in 2008, one in 2009, and zero in 2010. To investigate the risks of gastroenteritis outbreaks in the wards, 168 cases (85 inpatients and 83 healthcare workers) of gastroenteritis reported to the infection control team between April 2006 and March 2009 were analyzed. Sixty-four inpatients suffering from infectious gastroenteritis were isolated from the ward on the day of onset, and no gastroenteritis outbreaks subsequently occurred. Eleven inpatients suffering from infectious gastroenteritis were isolated from the ward on the day after onset, and one gastroenteritis outbreak subsequently occurred. Five inpatients suffering from infectious gastroenteritis were isolated from the ward on the second day after onset, and two gastroenteritis outbreaks subsequently occurred. Five inpatients suffering from infectious gastroenteritis were isolated from the ward on the third to fifth day after onset, and five gastroenteritis outbreaks subsequently occurred. Eighty-one of the 83 healthcare workers suffering from infectious gastroenteritis were isolated from the ward by the second day after onset, and no subsequent gastroenteritis outbreak occurred. From these observations, we emphasize the importance of early discovery and isolation of patients suffering from infectious gastroenteritis from the ward to prevent nosocomial outbreaks of norovirus infection. © 2012, Japanese Society for Infection Prevention and Control. All rights reserved.