A large-scale gastroenteritis outbreak associated with Norovirus in nursing homes.
An increase in gastroenteritis outbreaks due to Norovirus has been reported worldwide. We investigated a large-scale outbreak affecting 246 residents and 33 staff members in six nursing homes in the Tel-Aviv district, Israel, during 3 weeks in 2002. Person-to-person spread was noticed in all nursing homes. The spread of disease could not be attributed to social interactions. Among the elderly residents, the hospitalization rate was 10.2% and the case-fatality rate was 2.0%. Bacteriological cultures were negative. Overall, 7 out of 15 stool specimens were positive for Norovirus by RT-PCR. All were sequenced and found to be 90% identical. The characteristics of this outbreak and the RT-PCR results suggest that illness was caused by Norovirus. Due to the high case-fatality rate of Norovirus gastroenteritis, there should be a high index of suspicion when encountering a gastroenteritis outbreak among the elderly. This will enable prompt action to stop the spread of illness.
Calderon-Margalit
R
R
Hadassah Braun School of Public Health, Hebrew University, Jerusalem, Israel. ronitca@hadassah.org.il
Sheffer
R
R
Halperin
T
T
Orr
N
N
Cohen
D
D
Shohat
T
T
D000328:Adult; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000821:virology*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification*; D009735:Nursing Homes; D020133:Reverse Transcriptase Polymerase Chain Reaction