title: Management and investigation of viral gastroenteritis nosocomial outbreaks: lessons learned from a recent outbreak, Greece, 2012.
abstract: BACKGROUND
  A nosocomial outbreak in a 740-bed hospital in Athens, Greece, was investigated in January-February 2012.
  
  
  METHODS
  Recommendations on infection control measures were given and two case-control studies were conducted among patients (study A) and health care workers (HCWs) (study B). Compliance to control measures was evaluated.
  
  
  RESULTS
  The absence of a routine recording system of nosocomial-acquired gastroenteritis cases led to a 10 days delay in outbreak identification. In total, 63 gastroenteritis cases were identified; 30 HCWs and 33 patients. In the multivariable analysis of study A the disease incidence among patients was statistical significantly associated with a prior incident of vomitus in their room (OR=7.96, 95% CI=1.29-49.2). In study B, the incidence was associated with the history of direct contact with a symptomatic patient (OR=3.03, 95%CI 1.01-9.12). Twenty one (75%) of the symptomatic HCWs reported absence from work for a median of 2 days (range: 1-4). Seven (25.0%) continued to work despite being symptomatic. Only, 11.1% of patients were isolated or cohorted after developing symptoms. In-hospital virological testing was not feasible and one specimen sent to a university laboratory was positive for norovirus.
  
  
  CONCLUSIONS
  An appropriately designed protocol regarding the detection, the management and the laboratory investigation of nosocomial gastroenteritis outbreaks should be followed in order effective containment to be reassured. Hippokratia 2014; 18 (3): 204-208.
authors.affiliation: Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Sideroglou
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Kontopidou
authors.affiliation: Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Mellou
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Maragos
authors.affiliation: Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Potamiti-Komi
authors.affiliation: Sotiria General Hospital, Athens, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Gerakis
authors.affiliation: Sotiria General Hospital, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Vogiatzakis
authors.affiliation: Sotiria General Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Pefanis
authors.affiliation: Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Georgakopoulou
authors.affiliation: Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors.forename: Hc
authors.initials: H
authors.lastname: Maltezou
keywords: gastroenteritis; hospital; norovirus; nosocomial; outbreak