title: [Norovirus outbreaks in geriatric centers: importance of an early detection].
abstract: OBJECTIVE
  Acute gastroenteritis (AGE) outbreaks of norovirus (NV) occur frequently in nursing homes. Gastrointestinal disorders and degree of dependence of residents complicate early detection and implementation of control measures. Our study's aim was to determine the incidence of NV in elderly care centers, transmission mechanisms and circulating genotypes.
  
  
  METHODS
  An epidemiological study of NV outbreaks reported to the Public Health Agency of Barcelona 2010-2012 was performed. The attack rate, outbreak duration, symptomatology and identified NV genotypes were analyzed.
  
  
  RESULTS
  In total, 27 NV outbreaks were reported and 5 (18.5%) occurred in nursing homes (95 cases with lethality of 1.05%). The etiology of one of the five outbreaks could not be confirmed because of late notification. Four of the outbreaks were attributed to person-to-person transmission. The outbreak duration and attack rate among resident person-to-person transmission were significantly higher compared to common exposure transmission. Genotype GII.4 was predominant.
  
  
  CONCLUSIONS
  The identification of critical points and the use of clinical alarm systems could prevent and minimize the spreading and severity of these outbreaks.
authors.affiliation: Agencia de Salud Pública de Barcelona (ASPB), Barcelona, España; CIBER Epidemiología y Salud Pública CIBERESP, España. Electronic address: amoreno@aspb.cat.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Agencia de Salud Pública de Barcelona (ASPB), Barcelona, España.
authors.forename: Sandra
authors.initials: S
authors.lastname: Manzanares-Laya
authors.affiliation: Laboratorio de la ASPB, Barcelona, España.
authors.forename: Efren
authors.initials: E
authors.lastname: Razquin
authors.affiliation: Grupo de virus entéricos, Departamento de Microbiología, Universidad de Barcelona, Barcelona, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Guix
authors.affiliation: CIBER Epidemiología y Salud Pública CIBERESP, España; Departamento de Salud Pública de la Universidad de Barcelona, Barcelona, España.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Domínguez
authors.affiliation: Laboratorio de la ASPB, Barcelona, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: de Simón
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017250:Caliciviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D004196:Disease Outbreaks; D042241:Early Diagnosis; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D006306:Health Surveys; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification; D009735:Nursing Homes / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology
keywords: Brotes; Gastroenteritis; Geriátricos; Norovirus; Nursing homes; Outbreaks