title: A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff.
abstract: OBJECTIVE
  To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis.
  
  
  METHODS
  A regional referral hospital in upstate South Carolina.
  
  
  METHODS
  We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996.
  
  
  RESULTS
  The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples.
  
  
  CONCLUSIONS
  This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings.
authors.affiliation: Division of Field Epidemiology, Epidemiology Program Office, Center for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: V M
authors.initials: VM
authors.lastname: Cáceres
authors.forename: D K
authors.initials: DK
authors.lastname: Kim
authors.forename: J S
authors.initials: JS
authors.lastname: Bresee
authors.forename: J
authors.initials: J
authors.lastname: Horan
authors.forename: J S
authors.initials: JS
authors.lastname: Noel
authors.forename: T
authors.initials: T
authors.lastname: Ando
authors.forename: C J
authors.initials: CJ
authors.lastname: Steed
authors.forename: J J
authors.initials: JJ
authors.lastname: Weems
authors.forename: S S
authors.initials: SS
authors.lastname: Monroe
authors.forename: J J
authors.initials: JJ
authors.lastname: Gibson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000635:transmission*; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology*; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D008875:Middle Aged; D009663:Norwalk virus; D009741:Nursing Staff, Hospital; D013022:South Carolina / Q000453:epidemiology