Patient isolation in their own rooms is the most important factor in controlling outbreaks of norovirus within hospitals, according to a report in the Journal of Infectious Diseases.

Investigators surveyed six London hospitals for a 3-month period to gather data concerning norovirus outbreaks. They assessed two teaching hospitals with 230 and 780 beds, respectively; one specialist center with 160 beds; two district general hospitals with 284 and 650 beds, respectively; and one 100-bed community hospital. There were 20 norovirus outbreaks during the survey period involving 57 patients and 7 staff members, said Martina Cummins, a nurse consultant and deputy director, Infection Prevention and Control, Bart’s Health NHS Trust, Ilford (England) and Derren Ready, a clinical scientist at Public Health England, London.

The number of outbreaks varied markedly among the different hospitals. The smaller teaching hospital and the smaller district general hospital had zero outbreaks, while the specialist hospital and the community hospital had only one outbreak each involving only three and six patients, respectively. The larger teaching hospital had two outbreaks involving only four patients in total. In contrast, the larger district general hospital, which had an older infrastructure, had 16 separate outbreaks involving 44 patients, and it was the only facility in which staff members (7) also became ill.

The ability to control an outbreak of norovirus hinged on the availability of isolation rooms. All the hospitals with two or fewer outbreaks had easily available isolation rooms, while the hospital that had numerous outbreaks did not. The most severely affected hospital had large wards caring for up to 26 patients, with limited or no barriers between beds. The beds in these wards were closer together (within 2.3 meters) than those in all the other hospitals. In addition, this hospital had limited care facilities, including only two sinks per ward for staff members to use and only four shared toilets per ward, Ms. Cummins and Mr. Ready said ( J Infect Dis. 2016;213[S1]:S12-S14. doi:10.1093/infdis/jiv529 ).

Norovirus outbreaks among patients can have a major impact on the affected departments, wards, or clinical areas, but those that extend to staff members can lead to severe staffing shortages that close down whole wards or even entire hospitals, they noted.

No sponsor or funding source was identified for this study. Ms. Cummins and Mr. Ready reported having no relevant financial disclosures.


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