Key result
Care by nursing assistants with gastroenteritis symptoms resulted in a higher attack rate of GII.17 norovirus among residents compared to care by asymptomatic assistants (p<0.001).
Why the study?
Does care by symptomatic nursing assistants increase the attack rate of norovirus gastroenteritis in long-term care facility residents?
Cohort (n=34)
No
Does care by symptomatic nursing assistants increase the attack rate of norovirus gastroenteritis in long-term care facility residents?
Nursing assistants play a critical role in the secondary spread of norovirus in long-term care facilities, highlighting the need for improved personal hygiene and infection control.
Supports symptomatic staff exclusion policies in long-term care; hypothesis-generating from observational data and requires prospective confirmation.
More than 30 residents and nursing assistants in a geriatric nursing hospital developed acute gastroenteritis from December 7th to December 18th, 2014 in Shanghai, China. An immediate epidemiological investigation was conducted to identify the etiological agent of the outbreak, mode of transmission and the risk factors. Cases were investigated according to an epidemiological questionnaire. Samples from cases, highly transmissible environmental surfaces and drinking water were collected for pathogens detection. A retrospective cohort study was conducted to explore the transmission mode. A total of 34 cases were affected in this acute gastroenteritis outbreak, including 23 residents, 9 nursing assistants and 2 doctors. 13 out of 30 samples were positive for GII.17 norovirus, no other pathogen was detected. Nursing assistants who developed gastroenteritis symptoms had a higher attack rate in residents they cared than those who did not develop any gastroenteritis symptoms (p<0.001). The acute gastroenteritis outbreak was caused by GII.17 norovirus. Person-to-person close contact and contaminated environmental surfaces were the probable transmission route. Nursing assistants were considered to play an important role in the secondary spread of norovirus. The poor medical skill and personal hygiene habits of nursing assistants in China should be paid attention and improved urgently which is critically important to prevent hospital infections.
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Cui et al. (2017) conducted a cohort in Acute GII.17 norovirus gastroenteritis (n=34). Care by symptomatic nursing assistants vs. Care by asymptomatic nursing assistants was evaluated on Gastroenteritis attack rate in residents (p=<0.001). Care by nursing assistants with gastroenteritis symptoms resulted in a higher attack rate of GII.17 norovirus among residents compared to care by asymptomatic assistants (p<0.001).
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