MCH Outbreaks of Viral Gastroenteritis in Healthcare Facilities

NH Department of Health and Human Services (NH DHHS) recommends:

  • Increased awareness and vigilance for suspect gastrointestinal outbreaks in healthcare facilities
  • Timely reporting of all suspect outbreaks to the NH DHHS Communicable Disease Control and Surveillance Section at 603-271-4496 (after hours 1-800-852-3345 ext.5300)
  • Strict adherence to infection control practices during a suspect outbreak (see recommendations below)

Background:
NH DHHS has received reports of gastrointestinal outbreaks predominantly in healthcare facilities. Many of these outbreaks are caused by Norovirus and are transmitted person-to-person or through contact with contaminated surfaces. Noroviruses are one of the most common causes of acute viral gastroenteritis in the United States. These viruses are highly communicable and can be transmitted in a number of ways including person-to-person contact, consumption of contaminated food and water, airborne droplets of vomit, and contact with contaminated surfaces. Infection is primarily characterized by vomiting and diarrhea, which may also be accompanied by abdominal cramps, nausea, fever, and headache. Symptoms of infection may last between 12 and 60 hours. Aside from supportive therapy for dehydration in severe cases, there is no treatment given for Norovirus infection since it is a viral agent and symptoms usually resolve within 48 hours.

Infection Control Recommendations During an Outbreak:

  1. Promptly clean areas contaminated with vomit and feces and follow up disinfections with freshly prepared 0.1% (1000 ppm) hypochlorite solutions (5 tablespoons bleach per gallon of water).
  2. Review kitchen hygiene practices and health status of all food workers, exclude any symptomatic food handlers from work until full recovery.
  3. Assess health status of all heath care workers and exclude all symptomatic individuals from direct patient care until full recovery.
  4. Practice frequent hand washing and gloving by all food and health workers in the facility.
  5. Practice frequent hand washing by all patients/residents.
  6. Restrict or defer admissions to affected units and wards.
  7. Stop temporarily all group activities.
  8. Exclude non-essential staff from affected areas.
  9. Interrupt the movement of any non-essential inter-departmental staff.
  10. Use gloves and aprons whenever contact with an affected individual or contaminated environment is anticipated.
  11. Wash hands after contact with affected individuals, on leaving affected areas or before handling food or drinks.
  12. Notify visitors and instruct regarding hand washing.
  13. Clean soiled carpets and soft furnishings with hot water and detergent or steam clean; avoid vacuum cleaning.
  14. Clean frequently handled objects such as water taps, door handles, and toilet or bath rails.
  15. Conduct terminal cleaning 72 hours after resolution of the last case.

To report suspect outbreaks, call the Bureau of Disease Control and Health Statistics at 603-271-4496, or toll free at 800-852-3345, ext. 4496. After hours, call 800-852-3345, ext. 5300, and ask for the public health professional on call.

When outbreaks are reported, Disease Control staff will discuss appropriate management including laboratory testing. To discuss specific questions about laboratory testing and specimen submission you may also contact the NH Public Health Laboratories at (603) 271-4620.

Download Norvirus Fact Sheet PDF

This Article was published on 09 Jan 2008.
For more information, please contact
LAURA GINGRAS