Fretz Rainer, Schmid Daniela, Jelovcan Sandra, Tschertou Rosi, Krassnitzer Elke, Schirmer Michael, Hell Markus, Allerberger Franz
Austrian Agency for Health and Food Safety (AGES), Vienna, Austria.
Wien Klin Wochenschr. 2009;121(3-4):137-43. doi: 10.1007/s00508-008-1135-x.
Norovirus is easily spread from person to person by the fecal-oral route and through aerosols or by vehicles such as contaminated food or water. The virus is able to survive in the environment for many days, which enables outbreaks to be prolonged. We describe a norovirus outbreak and its control measures in an Austrian secondary-level hospital during December 2006 - February 2007.
A descriptive-epidemiological investigation of the outbreak was undertaken. We also determined outbreak costs, including the estimated lost revenue associated with department closures and the cost of sick leave and cleaning expenses. Selected stool specimens were tested for norovirus RNA.
In the hospital, 90 persons with symptoms and signs consistent with norovirus gastroenteritis with clinical onset between December 1, 2006 and February 13, 2007 were identified. Out of these, 56 patients and 14 persons among the hospital staff fulfilled the definition of an outbreak case (77.8%), and 20 cases (22.2%) were identified as non-outbreak cases including 13 community-acquired cases of norovirus gastroenteritis and 7 clinical-suspected cases of norovirus gastroenteritis associated with health care facilities other than the affected hospital. The Department of Internal Medicine was the mainly affected department (46 patient-cases and 6 staff-cases). Considering hospital patients, who have been hospitalised between December 1, 2006 and February 13, 2007 as cohort at risk of nosocomial norovirus infection, the nosocomial hospital outbreak attack-rate was 5.9% (56/947). A total of 120 hospital staff members worked in the period from December 1 to February 13, which makes an attack-rate among the hospital staff of 11.7% (14/120). Norovirus strain GII.4 variant 2006b was detected, which has been circulating widely in Europe since 2006. The total cost of the outbreak for the Department of Internal Medicine was
The significant disruption of patient care and the cost of this single nosocomial outbreak support strict implementations of adequate and timely control measures based on evidence-based recommendations.
诺如病毒很容易通过粪-口途径在人与人之间传播，也可通过气溶胶或受污染的食物、水等媒介传播。该病毒能够在环境中存活多日，这使得疫情能够持续很长时间。我们描述了2006年12月至2007年2月期间奥地利一家二级医院发生的一次诺如病毒疫情及其控制措施。
对此次疫情进行了描述性流行病学调查。我们还确定了疫情成本，包括因科室关闭估计损失的收入以及病假和清洁费用。对选定的粪便标本进行了诺如病毒RNA检测。
在该医院，确定了90名在2006年12月1日至2007年2月13日期间出现与诺如病毒胃肠炎相符症状和体征的患者。其中，56名患者和14名医院工作人员符合疫情病例定义（77.8%），20例（22.2%）被确定为非疫情病例，包括13例社区获得性诺如病毒胃肠炎病例和7例与受影响医院以外的其他医疗机构相关的临床疑似诺如病毒胃肠炎病例。内科是主要受影响科室（46例患者病例和6例工作人员病例）。将2006年12月1日至2007年2月13日期间住院的医院患者视为有医院感染诺如病毒风险的队列，医院内疫情罹患率为5.9%（56/947）。2006年12月至2月13日期间共有120名医院工作人员工作，医院工作人员的罹患率为11.7%（14/120）。检测到诺如病毒GII.4变异株2006b，自2006年以来该毒株在欧洲广泛传播。内科此次疫情的总成本为80138欧元。
患者护理受到的严重干扰以及此次单一医院内疫情的成本，支持严格按照基于循证建议及时实施适当的控制措施。
