Rotavirus outbreak on a pediatric oncology floor: possible association with toys.
BACKGROUND
Several outbreaks of rotavirus gastroenteritis have occurred in hospitals and day care centers. In the spring of 1997, an outbreak of rotavirus occurred on our pediatric unit. Aggressive infection control measures were instituted, and potential lapses in infection control were assessed.


METHODS
Memorial Sloan-Kettering Cancer Center is a 434-bed cancer hospital in New York City. The pediatric unit is a 42-bed ward with both bone marrow transplant patients and non-bone marrow transplant oncology patients. Nosocomially acquired rotavirus was defined as diarrhea, vomiting, or gastrointestinal upset with onset 48 hours or more after hospital admission, accompanied by a positive enzyme immunoassay for rotavirus antigen.


RESULTS
Between February 24 and April 4, 1997, 8 patients on the pediatric unit had nosocomial rotavirus. Aggressive infection control measures were instituted. Patients with rotavirus were cohorted and placed on contact precautions (strict handwashing, gloves, and gown). Investigation by the infection control team revealed that communal toys in the playroom were not being cleaned according to the weekly protocol.


CONCLUSIONS
An outbreak of nosocomial rotavirus occurred on our pediatric oncology unit. Shared toys may have served as fomites in the transmission of rotavirus.
Rogers
M
M
Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Weinstock
D M
DM
Eagan
J
J
Kiehn
T
T
Armstrong
D
D
Sepkowitz
K A
KA
D002173:Cancer Care Facilities; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D017053:Infection Control; D015278:Intensive Care Units, Pediatric; D008297:Male; D009519:New York City / Q000453:epidemiology; D010988:Play and Playthings; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000635:transmission