Comprehensive norovirus response successfully ended outbreak
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Key takeaways:
- Overall, 11 patients and 19 employees with gastrointestinal symptoms or confirmed norovirus were identified.
- Measures were implemented but discontinued after a week of no cases, successfully ending the outbreak.
SAN ANTONIO — After confirming reports of norovirus in a hematologic oncology and clinical trials unit, a comprehensive infection prevention plan was put in place, stopping further infections with no recurrence.
“An increase in patient norovirus cases, along with gastrointestinal symptoms in staff with epidemiological links to patient cases, prompted an investigation, and infection control measures were implemented,” Tessa Carter, MPH, infection preventionist at Memorial Sloan Kettering Cancer Center, told Healio.
For the outbreak response, which was presented at the Association for Professionals in Infection Control and Epidemiology (APIC) 2024 meeting, the infection prevention and control team held multidisciplinary meetings with stakeholders to implement control measures systematically as cases were identified.
The response, which was patient-focused, involved universal contact precautions, quarantine of exposed roommates, point prevalence unitwide testing, surveillance of gastrointestinal symptoms for newly admitted patients and restriction of unit admissions and transfers.
Environmental measures were also implemented and included unitwide bleach cleaning and restriction of pantry access.
According to the study, staff were also screened daily for symptoms and testing was coordinated among those who were symptomatic. The facility implemented a return-to-work clearance requirement for all sick staff, prohibition of cross coverage to other units and, ultimately, staff were grouped to affected patients.
In total, 11 confirmed patient norovirus cases were identified from Dec. 20, 2022, to Dec. 31, 2022, as well as 19 employee cases of concurrent gastrointestinal symptoms and/or confirmed norovirus.
The first control measures were implemented on December 27 after identification of the outbreak due to the increase in cases. In total, 13 patients were quarantined, of whom two were probable cases and one tested positive.
After 1 full week of no new cases, response measures were discontinued, and no recurrence was reported.
Carter noted that this outbreak occurred on a hematologic oncology and clinical trials unit at a tertiary oncology hospital among a high-risk patient population. Because of this, and because norovirus poses a high risk to oncology patients, she believes the infection prevention response could be adapted for other patient populations.
“The reduction measures outlined in the poster should be considered as interventions for norovirus outbreaks in high-risk patient populations,” she concluded.
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