TY - JOUR
T1 - Effect of exclusion policy on the control of outbreaks of suspected viral gastroenteritis
T2 - Analysis of outbreak investigations in care homes
AU - Vivancos, Roberto
AU - Sundkvist, Torbjorn
AU - Barker, Deborah
AU - Burton, Janice
AU - Nair, Pat
PY - 2010/3
Y1 - 2010/3
N2 - Background: Norovirus is an important cause of gastroenteritis outbreaks in care homes. Differences exist in the recommended duration of exclusion for affected staff during an outbreak. Methods: We conducted a retrospective analysis of outbreak reports in 2006 and 2007 managed by health protection staff in 2 counties with differing exclusion policies, one advising exclusion of affected staff and isolation of residents for 72 hours and the other for 48 hours after the resolution of symptoms. We compared attack rates and average numbers of cases in residents and staff, adjusting for type of care home and staffing rate. Results: A total of 96 outbreaks were managed, 63 with a 72-hour exclusion policy and 33 with a 48-hour exclusion policy. The longer exclusion policy resulted in lower mean number of cases among staff (6.5 vs 9.6; P = .044) and a lower overall attack rate (32.6% vs 35.1%; P = .05). No differences in the mean number of cases or the attack rate among residents were seen. Conclusion: This brief study suggests that a longer exclusion policy reduces the number of cases among staff affected with viral gastroenteritis, possibly resulting in less staff absences. This could have potential benefits, particularly when resources are limited.
AB - Background: Norovirus is an important cause of gastroenteritis outbreaks in care homes. Differences exist in the recommended duration of exclusion for affected staff during an outbreak. Methods: We conducted a retrospective analysis of outbreak reports in 2006 and 2007 managed by health protection staff in 2 counties with differing exclusion policies, one advising exclusion of affected staff and isolation of residents for 72 hours and the other for 48 hours after the resolution of symptoms. We compared attack rates and average numbers of cases in residents and staff, adjusting for type of care home and staffing rate. Results: A total of 96 outbreaks were managed, 63 with a 72-hour exclusion policy and 33 with a 48-hour exclusion policy. The longer exclusion policy resulted in lower mean number of cases among staff (6.5 vs 9.6; P = .044) and a lower overall attack rate (32.6% vs 35.1%; P = .05). No differences in the mean number of cases or the attack rate among residents were seen. Conclusion: This brief study suggests that a longer exclusion policy reduces the number of cases among staff affected with viral gastroenteritis, possibly resulting in less staff absences. This could have potential benefits, particularly when resources are limited.
KW - Norovirus
KW - exclusion policy
KW - health care
KW - infection control
KW - outbreak control
UR - http://www.scopus.com/inward/record.url?scp=76849097230&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2009.02.011
DO - 10.1016/j.ajic.2009.02.011
M3 - Article
C2 - 19853969
AN - SCOPUS:76849097230
VL - 38
SP - 139
EP - 143
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
IS - 2
ER -