title: Burden of gastroenteritis outbreaks: specific epidemiology in a cohort of institutions caring for dependent people.
abstract: BACKGROUND
  In institutions caring for dependent people, viral gastroenteritis occurs frequently and is highly contagious. In elderly persons, these episodes can lead to hospitalization and occasionally death.
  
  
  OBJECTIVE
  To study the impact of gastroenteritis outbreaks (GOs) in institutions caring for dependent people.
  
  
  METHODS
  This study was conducted on 18 sites consisting of 35 units from four different disciplines (geriatric medicine and rehabilitation, psychogeriatrics, geriatric nursing homes, and specialized care homes for adults with physical and mental disabilities). Spatio-temporal analysis of GOs was performed during six winter seasons, and clinical and viral data were analysed with regard to structural parameters (size of the sites and dining-room organization), virus epidemiology and chronology of the outbreaks and type of activities.
  
  
  RESULTS
  A total of 98 outbreaks were recorded in the 35 units. The risk of GO was high even outside national epidemic periods. Viruses were searched for in 86 outbreaks and were identified in 96.5% (83/86) of these outbreaks: norovirus genotype GII.4 (59.0%, 49/83), other viruses (41.0%, 34/83). There were variations between surveillance periods in terms of GO frequencies and attack rates and types of viruses. Dining-room organization could be a factor in cross-infection at a site.
  
  
  CONCLUSIONS
  Specific surveillance that takes into account the precise epidemiology needs to be developed in institutions caring for dependent people in order to improve infectious disease control and information for healthcare workers.
authors.affiliation: Hospital Hygiene Service, Rouffach Hospital Center, Rouffach, France; UMR 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France. Electronic address: ph.gaspard@ch-rouffach.fr.
authors.forename: P
authors.initials: P
authors.lastname: Gaspard
authors.affiliation: National Reference Center for Enteric Viruses, Laboratory of Virology, CHU Dijon, Dijon, France.
authors.forename: K
authors.initials: K
authors.lastname: Ambert-Balay
authors.affiliation: Open Rome, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mosnier
authors.affiliation: Department of Hospital Epidemiology and Infection Control, CHU Dijon, Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Aho-Glélé
authors.affiliation: Hospital Hygiene Service, Rouffach Hospital Center, Rouffach, France.
authors.forename: C
authors.initials: C
authors.lastname: Roth
authors.affiliation: Hospital Hygiene Service, Rouffach Hospital Center, Rouffach, France.
authors.forename: S
authors.initials: S
authors.lastname: Larocca
authors.affiliation: Co-ordination Centre for Nosocomial Infection Control, Eastern Regions, CHU Nancy, Nancy, France.
authors.forename: L
authors.initials: L
authors.lastname: Simon
authors.affiliation: Co-ordination Centre for Nosocomial Infection Control, Eastern Regions, CHU Nancy, Nancy, France.
authors.forename: D
authors.initials: D
authors.lastname: Talon
authors.affiliation: Co-ordination Centre for Nosocomial Infection Control, Eastern Regions, CHU Nancy, Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Rabaud
authors.affiliation: National Reference Center for Enteric Viruses, Laboratory of Virology, CHU Dijon, Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Pothier
mesh_terms: D000328:Adult; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology; D004196:Disease Outbreaks; D062665:Epidemiological Monitoring; D005602:France / Q000453:epidemiology; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology / Q000379:methods; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012621:Seasons; D062211:Spatio-Temporal Analysis
keywords: Elderly; Gastroenteritis; Infectious disease control; Norovirus; Outbreaks