title: Viral gastrointestinal outbreaks in residential care facilities: an examination of the value of public health unit involvement.
abstract: OBJECTIVE
  To evaluate the value of notification to public health units (PHUs) in the management of viral gastrointestinal outbreaks in residential care facilities (RCFs) in Queensland.
  
  
  METHODS
  Routine outbreak characteristics and control measures were collected at notification and conclusion of outbreaks notified between May and August 2008. This was supplemented with detailed interviews with RCFs and PHUs, including perceptions of the value of the RCF-PHU interaction.
  
  
  RESULTS
  Norovirus was the confirmed aetiological agent in 39 (68%) of 60 outbreaks. A significant association was found between increased outbreak duration and longer (≥4 days) time to outbreak notification (p<0.01) and larger facility size (≥150 people; p<0.05). Increased attack rate was not significantly associated with either time to outbreak notification or facility size, but was significantly associated with difficulty in cohorting (p<0.05). Most (92%) RCFs considered that outbreak notification was important and that PHU support was useful (97%). Most PHUs (77%) also considered that outbreak notification was important.
  
  
  CONCLUSIONS
  This study demonstrates an association between prompt notification of viral gastroenteritis outbreaks to PHUs and shorter duration of outbreaks.
  
  
  CONCLUSIONS
  This study provides evidence to support recommendations in current Australian guidelines that notification of outbreaks should occur promptly.
authors.affiliation: Communicable Diseases Unit, Department of Health, Queensland; National Centre for Epidemiology and Population Health, The Australian National University, Australian Capital Territory; School of Population Health, The University of Queensland.
authors.forename: Craig
authors.initials: C
authors.lastname: Davis
authors.forename: Hassan
authors.initials: H
authors.lastname: Vally
authors.forename: Robert
authors.initials: R
authors.lastname: Bell
authors.forename: Frances
authors.initials: F
authors.lastname: Sheehan
authors.forename: Frank
authors.initials: F
authors.lastname: Beard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017250:Caliciviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D018563:Disease Notification; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D029322:Norovirus; D011634:Public Health; D011793:Queensland / Q000453:epidemiology; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012307:Risk Factors; D012621:Seasons
keywords: disease outbreaks; gastroenteritis; norovirus; notification of outbreaks; residential care facilities