Epidemiology and cost of nosocomial gastroenteritis, Avon, England, 2002-2003

Abstract

Healthcare-associated outbreaks of gastroenteritis are an increasingly recognized problem, but detailed knowledge of the epidemiology of these events is lacking. We actively monitored three hospital systems in England for outbreaks of gastroenteritis in 2002 to 2003. A total of 2,154 patients (2.21 cases/1,000-hospital-days) and 1,360 healthcare staff (0.47 cases/1,000-hospital-days) were affected in 227 unit outbreaks (1.33 outbreaks/unit-year). Norovirus, detected in 63% of outbreaks, was the predominant etiologic agent. Restricting new admissions to affected units resulted in 5,443 lost bed-days. The cost of bed-days lost plus staff absence was calculated to be 635,000 pounds sterling (US. 1.01 million dollars) per 1,000 beds. By our extrapolation, gastroenteritis outbreaks likely cost the English National Health Service 115 million pounds sterling (US 184 million dollars) in 2002 to 2003. Outbreaks were contained faster (7.9 vs. 15.4 days, p = 0.0023) when units were rapidly closed to new admissions (<4 days). Implementing control measures rapidly may be effective in controlling outbreaks.

Figure 1

Definition of an outbreak of gastroenteritis in healthcare settings.

Figure 2

Monthly outbreaks of gastroenteritis in hospitals: Avon, England, April 2002–March 2003 (n = 227).

Figure 3

Monthly distribution of outbreaks with diagnostic results (n = 122). Negative outbreaks followed a similar seasonal pattern to norovirus outbreaks. u, unconfirmed (only one positive specimen).