HEALTH / WELL-BEING

Norovirus Genotype II Outbreak in a Homeless Veterans’ Residential Facility

Article

An article which details a norovirus outbreak at a homeless Veterans’ Residential facility.

Abstract

Background: Norovirus is the most frequent cause of acute gastroenteritis outbreaks. It is an extremely contagious virus that can be transmitted from an infected person, contaminated food or water, and contaminated surfaces. Norovirus can spread quickly in a homeless Veterans' residential facility due to close person-to-person interaction and socialization. Methods: Three men (44, 44, 34 years old) presented in our Veterans Affairs emergency room the morning of September 27, 2017. The infection control (IC) nursing team was alerted as all men came from an affiliated homeless Veterans' residential facility on campus. All three men awoke with abdominal pain and diarrhea during the night. 2 out of 3 had vomiting. None had fever. All had eaten, the previous night, food that was delivered to their dormitory from an outside vendor. Upon consultation, with an infectious disease specialist, stool was obtained for viral testing. Environmental rounds by the IC team, at the facility, lead to the sequestration of food that was the likely culprit of the outbreak. Four more cases were identified presenting with similar symptoms. All cases were placed on contact isolation, educated on strict hand washing and group activities were cancelled. The local department of health was notified. The common areas, pantry and bathrooms were terminally cleaned with bleach and all patients were advised to launder their clothing. Results: Stool cultures were negative for bacterial pathogens and Clostridium difficile. Results for all three Real-Time Polymerase Chain Reaction (PCR) came back positive for norovirus GII on October 2nd. The last suspect case for norovirus was reported on September 28th. Ultimately, seven persons were infected. Conclusions: Norovirus can cause a rapid outbreak, especially, in a residential facility. Rapid recognition of a possible norovirus outbreak via strategic implementation of targeted infection control measures and confirmation by rapid PCR testing led to our expedited control of the outbreak.

Full Reference

Barrett, Nancy R. ; Bailey, Lisa C. ; Ford, Florence ; Kaplun, Olga ; LeMaitre, Beth ; Lobo, Zeena ; Psevdos, George. (2018). Norovirus Genotype II Outbreak in a Homeless Veterans' Residential Facility. American journal of infection control, Vol: 46 (6), p.107.