A foodborne norovirus outbreak in a nursing home and spread to staff and their household contacts

Abstract

On 16 March 2018, a nursing home notified a possible acute gastroenteritis outbreak that affected 11 people. Descriptive and case-control studies and analysis of clinical and environmental samples were carried out to determine the characteristics of the outbreak, its aetiology, the transmission mechanism and the causal food. The extent of the outbreak in and outside the nursing home was determined and the staff factors influencing propagation were studied by multivariate analysis. A turkey dinner on March 14 was associated with the outbreak (OR 4.22, 95% CI 1.11-16.01). Norovirus genogroups I and II were identified in stool samples. The attack rates in residents, staff and household contacts of staff were 23.49%, 46.22% and 22.87%, respectively. Care assistants and cleaning staff were the staff most frequently affected. Cohabitation with an affected care assistant was the most important factor in the occurrence of cases in the home (adjusted OR 6.37, 95% CI 1.13-36.02). Our results show that staff in close contact with residents and their household contacts had a higher risk of infection during the norovirus outbreak.

Keywords: Acute gastroenteritis; household contacts; norovirus; nursing home; outbreaks.

Fig. 1.

Distribution of clinical cases by day of onset in residents, staff and household contacts.