Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115765

Marangellie Trujillo¹, Linda Y. Wilson¹, Pierre Vigilance, MD, MPH², and Pierre Vigilance, MD, MPH². (1) Acute Communicable Diseases, Baltimore City Health Department, 210 Guilford 3rd floor, HCDP Division, Baltimore, MD 21202, 410-396-4436, marangellie.trujillo@baltimorecity.gov, (2) Baltimore City Health Department, Division of Health Promotion and Disease Prevention, Assistant Commissioner, 210 Guilford Ave, Baltimore, MD 21202

OBJECTIVE: Noroviruses (NV) are a common cause of outbreaks of viral gastroenteritis and can result in significant hospital disruption. We report our experience with the first outbreak in an acute-care hospital in Maryland between February and April 2004. The transmission modes, risk factors, and the role of infection control practices in limiting the spread were studied.

METHODS: A case definition was developed to include 3 or more patients who didn't have gastroenteritis-related illness upon admission or staff from a single unit who developed gastroenteritis within a 7-day period after February 2, 2004. Epidemiological data on illness among residents and employees were collected in conjunction with stool specimens to be further characterized by reverse-transcriptase polymerase chain reaction (RT-PCR) and nucleotide sequencing. Environmental inspections were also performed.

RESULTS: A total of 505 cases were identified during the outbreak, which lasted 63 days. The index case was a nurse who worked in the unit that was affected first. During the outbreak no patients or employees died. The mean duration for symptoms was 43 hours. No water or food consumption association was found with gastroenteritis. No environmental violations were found. Bacterial cultures were negative. Results from the RT-PCR indicated the causative agent was the Farmington Hills virus.

CONCLUSIONS: Person-to-person transmission or airborne droplet transmission among patients and employees of the hospital were of major importance in transmission of NV infection during the outbreak, therefore, infection control practices were key determinants in controlling the outbreak. Strategies to prevent similar outbreaks in hospital settings are discussed.

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