The where is norovirus control lost (WINCL) study: an enhanced surveillance project to identify norovirus index cases in care settings in the UK and Ireland

Curran, E. T., Wilson, J., Haig, C. , Mccowan, C. , Leanord, A. and Loveday, H. (2016) The where is norovirus control lost (WINCL) study: an enhanced surveillance project to identify norovirus index cases in care settings in the UK and Ireland. Journal of Infection Prevention, 17(1), pp. 8-14. (doi:10.1177/1757177415613133)

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Abstract

Background: Norovirus outbreaks have a significant impact on all care settings; little is known about the index cases from whom these outbreaks initiate. Aim: To identify and categorise norovirus outbreak index cases in care settings. Methods: A mixed-methods, multi-centre, prospective, enhanced surveillance study identified and categorised index cases in acute and non-acute care settings. Results: From 54 participating centres, 537 outbreaks were reported (November 2013 to April 2014): 383 (71.3%) in acute care facilities (ACF); 115 (21.4%) in residential or care homes (RCH) and 39 (7.3%) in other care settings (OCS). Index cases were identified in 424 (79%) outbreaks. Of the 245 index cases who were asymptomatic on admission and not transferred within/into the care setting, 123 (50%) had been an inpatient/resident for 4 days. Four themes emerged: missing the diagnosis, care service under pressure, delay in outbreak control measures and patient/resident location and proximity. Conclusion: The true index case is commonly not identified as the cause of a norovirus outbreak with at least 50% of index cases being misclassified. Unrecognised norovirus cross-transmission occurs frequently suggesting that either Standard Infection Control Precautions (SICPs) are being insufficiently well applied, and or SICPs are themselves are insufficient to prevent outbreaks.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Leanord, Professor Alistair and Mccowan, Professor Colin and Curran, Ms Evonne and Haig, Dr Caroline
Authors: Curran, E. T., Wilson, J., Haig, C., Mccowan, C., Leanord, A., and Loveday, H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Infection Prevention
Publisher:Sage Publications Ltd.
ISSN:1757-1774
ISSN (Online):1757-1782

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