title: Two rotavirus outbreaks caused by genotype G2P[4] at large retirement communities: cohort studies.
abstract: BACKGROUND
  Outbreaks of rotavirus gastroenteritis in elderly adults are reported infrequently but are often caused by G2P[4] strains. In 2011, outbreaks were reported in 2 Illinois retirement facilities.
  
  
  OBJECTIVE
  To implement control measures, determine the extent and severity of illness, and assess risk factors for disease among residents and employees.
  
  
  METHODS
  Cohort studies using surveys and medical chart abstraction.
  
  
  METHODS
  Two large retirement facilities in Cook County, Illinois.
  
  
  METHODS
  Residents and employees at both facilities and community residents with rotavirus disease.
  
  
  METHODS
  Attack rates, hospitalization rates, and rotavirus genotype.
  
  
  RESULTS
  At facility A, 84 of 324 residents (26%) were identified with clinical or laboratory-confirmed rotavirus gastroenteritis (median age, 84 years) and 11 (13%) were hospitalized. The outbreak lasted 7 weeks. At facility B, 90 case patients among 855 residents (11%) were identified (median age, 88 years) and 19 (21%) were hospitalized. The facility B outbreak lasted 9.3 weeks. Ill employees were identified at both locations. In each facility, attack rates seemed to differ by residential setting, with the lowest rates among those in more separated settings or with high baseline level of infection control measures. The causative genotype for both outbreaks was G2P[4]. Some individuals shed virus detected by enzyme immunoassay or genotyping reverse transcription polymerase chain reaction for at least 35 days. G2P[4] was also identified in 17 of 19 (89%) samples from the older adult community but only 15 of 40 (38%) pediatric samples.
  
  
  CONCLUSIONS
  Medical or cognitive impairment among residents limited the success of some interviews.
  
  
  CONCLUSIONS
  Rotavirus outbreaks can occur among elderly adults in residential facilities and can result in considerable morbidity. Among older adults, G2P[4] may be of unique importance. Health professionals should consider rotavirus as a cause of acute gastroenteritis in adults.
  
  
  BACKGROUND
  None.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Cristina V
authors.initials: CV
authors.lastname: Cardemil
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Cortese
authors.forename: Andrew
authors.initials: A
authors.lastname: Medina-Marino
authors.forename: Supriya
authors.initials: S
authors.lastname: Jasuja
authors.forename: Rishi
authors.initials: R
authors.lastname: Desai
authors.forename: Jessica
authors.initials: J
authors.lastname: Leung
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodriguez-Hart
authors.forename: Gissela
authors.initials: G
authors.lastname: Villarruel
authors.forename: Julia
authors.initials: J
authors.lastname: Howland
authors.forename: Osbourne
authors.initials: O
authors.lastname: Quaye
authors.forename: Ka Ian
authors.initials: KI
authors.lastname: Tam
authors.forename: Michael D
authors.initials: MD
authors.lastname: Bowen
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006707:Homes for the Aged; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D012179:Retirement; D012307:Risk Factors; D012401:Rotavirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology*; D017201:Virus Shedding