Residents had an increasing risk of norovirus gastroenteritis infection than health care workers during an outbreak in a nursing home.
OBJECTIVE
To study norovirus gastroenteritis infection among residents and health care workers (HCWs) during an outbreak in a nursing home by investigating the attack rate and positive diagnostic rate for norovirus by reverse transcription-polymerase chain reaction (RT-PCR).


METHODS
All members in a Chang Gung Memorial Hospital-affiliated nursing home from November 17, 2006, to November 25, 2006, including 236 residents and 125 HCWs, whose available medical records were available were consecutively included in the retrospective analysis. Fecal specimens of symptomatic residents and HCWs were tested for norovirus by RT-PCR. In addition, routine stool analysis and a stool culture study were conducted to identify the bacterial and parasitic agents. The fecal specimens of asymptomatic residents and HCWs were tested only for norovirus by RT-PCR.


RESULTS
The outbreak was controlled within 9 days during the outbreak period. There were 51 symptomatic cases, 41 residents and 10 HCWs, during the norovirus outbreak. The odds ratio (OR) of the attack rate in the residents was approximately 2.4 times higher than that in the HCWs (OR: 2.4; 95% confidence interval [CI]: 1.2-5.0; P = .015). Norovirus was detected in 59 (30.6%) of 193 residents and in 11 (10.5%) of 105 HCWs who provided stool specimens for the study by RT-PCR. The OR of the positive diagnostic rate for norovirus by RT-PCR in the residents was approximately 3.8 times higher than that in the HCWs (OR: 3.8; 95% CI: 1.9-7.5; P < .001).


CONCLUSIONS
During an outbreak of norovirus gastroenteritis in a nursing home, the infection can be easily transmitted from person to person and affects both residents and HCWs. In addition, residents had a higher risk of norovirus gastroenteritis infection than HCWs.
Yang
Li-Chu
LC
Infection Control Committee, Chang Gung Memorial Hospital, Taipei, Taiwan.
Chiang
Ping-Cherng
PC
Huang
Tzu-Hsin
TH
Chi
Su-Fen
SF
Chiu
Yueh-Pi
YP
Lin
Chun-Sui
CS
Chou
Yen-Fang
YF
Hsu
Su-Chu
SC
Zhang
Xiu-Se
XS
Huang
Chung-Guei
CG
Kao
Chen-Yi
CY
Lin
Chih-Ming
CM
D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000209:etiology; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000235:genetics / Q000472:pathogenicity*; D009735:Nursing Homes; D016017:Odds Ratio; D010361:Patients; D016133:Polymerase Chain Reaction; D018570:Risk Assessment; D017422:Sequence Analysis, DNA; D013624:Taiwan / Q000453:epidemiology