Effect of exclusion policy on the control of outbreaks of suspected viral gastroenteritis: Analysis of outbreak investigations in care homes
published online 26 October 2009.
Background
Norovirus is an important cause of gastroenteritis outbreaks in care homes. Differences exist in the recommended duration of exclusion for affected staff during an outbreak.
Methods
We conducted a retrospective analysis of outbreak reports in 2006 and 2007 managed by health protection staff in 2 counties with differing exclusion policies, one advising exclusion of affected staff and isolation of residents for 72hours and the other for 48hours after the resolution of symptoms. We compared attack rates and average numbers of cases in residents and staff, adjusting for type of care home and staffing rate.
Results
A total of 96 outbreaks were managed, 63 with a 72-hour exclusion policy and 33 with a 48-hour exclusion policy. The longer exclusion policy resulted in lower mean number of cases among staff (6.5 vs 9.6; P=.044) and a lower overall attack rate (32.6% vs 35.1%; P=.05). No differences in the mean number of cases or the attack rate among residents were seen.
Conclusion
This brief study suggests that a longer exclusion policy reduces the number of cases among staff affected with viral gastroenteritis, possibly resulting in less staff absences. This could have potential benefits, particularly when resources are limited.
aCheshire & Merseyside Health Protection Unit, Health Protection Agency, Liverpool L33 7XW, UK
bSchool of Medicine Health Policy & Practice, University of East Anglia, Norwich NR4 7TJ, UK
cNorfolk Suffolk and Cambridgeshire Health Protection Unit, Health Protection Agency, Thetford IP24 1JD, UK
Address correspondence to Dr Roberto Vivancos, School of Medicine, Health Policy & Practice, University of East Anglia, Norwich NR4 7TJ, UK.
All of the authors were funded by the Health Protection Agency. The statistical software used is under license to the University of East Anglia. The authors declare no conflicts of interest.
ABSTRACT