Highlights
- •Prevention and control strategies for human noroviruses were assessed.
- •Gaps were identified in long-term care facility policies in South Carolina.
- •Most facilities used disinfectants that are ineffective against human noroviruses.
- •Most vomit and fecal matter clean-up procedures did not account for aerosolization.
- •Outbreak practices might not control against person-to-person transmission.
Background
Long-term care facilities (LTCFs) are the most common setting for human norovirus
(HuNoV) outbreak. Our study aimed to determine gaps in prevention and control practices
for HuNoV in LTCFs in South Carolina (SC).
Methods
Two researchers visited a convenience sample of 26 LTCFs in SC during July-November
2013. Directors were interviewed to determine facility prevention and control practices.
Relative frequencies and means were calculated using SAS 9.3 (SAS Institute, Cary,
NC).
Results
Most directors had little knowledge of proper sanitizing and disinfecting products
and reported missing written procedures for cleaning staff-visitor bathrooms. Only
18 had recommendations for when residents should wash hands. Many used the wrong products
for pathogen removal after vomit-fecal events, had no written procedures for cleaning
contaminated soft surfaces, did not remove other individuals during clean-up of vomit-fecal
episodes, and did not clean a large area surrounding vomit-fecal episodes. Eighteen
did not assign specific staff to care for sick; 16 did not designate specific toilets
for sick; and 15 did not restrict visitors during an outbreak.
Conclusion
Directors' responses indicated gaps in prevention and control practices for HuNoV
in LTCFs in SC.
Key Words
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References
- Updated norovirus outbreak management and disease prevention guidelines.MMWR Morb Mortal Wkly Rep. 2011; 60: 1-15
- Long-term care services in the United States: 2013 overview.National Center for Health Statistics, Hyattsville [MD]2013
- Vital signs: foodborne norovirus outbreaks – United States, 2009-2012.MMWR Morb Mortal Wkly Rep. 2014; 63: 491-495
- Gastroenteritis and food-borne disease in elderly people living in long-term care.Clin Infect Dis. 2010; 50: 397-404
- Hospitalizations and mortality associated with norovirus outbreaks in nursing homes 2009-2010.JAMA. 2012; 308: 1668-1675
- Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings.Infect Control Hosp Epidemiol. 2011; 32: 939-969
- OCSPP 810.2000: general considerations for uses of antimicrobial agents.US Environmental Protection Agency, Washington, DC2012
United States Environmental Protection Agency. Antimicrobial pesticide products. Available from: http://www.epa.gov/opp00001/factsheets/antimic.htm. Accessed June 22, 2015.
- The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet.J Appl Microbiol. 2005; 99: 339-347
- Effects of cleaning and disinfection in reducing the spread of norovirus contamination via environmental surfaces.J Hosp Infect. 2004; 58: 42-49
- Norovirus disease in the United States.Emerg Infect Dis. 2013; 19: 1198-1205
- Hierarchy of susceptibility of viruses to environmental surface disinfectants: a predictor of activity against new and emerging viral pathogens.J AOAC Int. 2007; 90: 1655-1658
- Guideline for disinfection and sterilization in healthcare facilities, 2008.The Centers for Disease Control and Prevention, Atlanta [GA]2009
US Environmental Protection Agency, Office of Pesticide Programs. List G: EPA registered hospital disinfectants effective against norovirus (Norwalk-like virus). Available from: http://www.epa.gov/oppad001/list_g_norovirus.pdf. Accessed June 22, 2015.
- Occupational Safety and Health Standards 29 CFR 1910.151(c).1998 (Available from: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=9806. Accessed July 30, 2015.)
International Programme on Chemical Safety. Main risk and target organs. Available from: http://www.inchem.org/documents/pims/chemical/pimg022.htm#SectionTitle:2.1. Accessed March 2, 2015.
- Widespread environmental contamination with Norwalk-like viruses (NLV) detected in a prolonged hotel outbreak of gastroenteritis.Epidemiol Infect. 2000; 125: 93-98
- An outbreak of norovirus infection affecting an Austrian nursing home and a hospital.Wien Klin Wochenschr. 2005; 117: 802-808
- Vomiting Larry: a simulated vomiting system for assessing environmental contamination from projectile vomiting related to norovirus infection.J Infect Prev. 2014; 15: 176-180
- An outbreak of acute gastroenteritis in a geriatric long-term-care facility: Combined application of epidemiological and molecular diagnostic methods.Infect Control Hosp Epidemiol. 1999; 20: 306-311
- Hand hygiene practices among nursing staff in public secondary care hospitals in Kuwait: self-report and direct observation.Med Princ Pract. 2011; 20: 326-331
Article info
Footnotes
Funding/Support: This material is based on work supported by the Cooperative State Research, Education and Extension Service, U.S. Department of Agriculture, under agreement no. 2009-51110-05858.
Disclaimer: Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the U.S. Department of Agriculture.
Conflicts of interest: None to report.
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© 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
