A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff.
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.
Cáceres
V M
VM
Division of Field Epidemiology, Epidemiology Program Office, Center for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Kim
D K
DK
Bresee
J S
JS
Horan
J
J
Noel
J S
JS
Ando
T
T
Steed
C J
CJ
Weems
J J
JJ
Monroe
S S
SS
Gibson
J J
JJ
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