Epidemiology and Infection



A large-scale gastroenteritis outbreak associated with Norovirus in nursing homes


R. CALDERON-MARGALIT a1c1, R. SHEFFER a2, T. HALPERIN a3, N. ORR a3, D. COHEN a3a4 and T. SHOHAT a2a4
a1 Hadassah Braun School of Public Health, Hebrew University, Jerusalem, Israel
a2 Tel-Aviv District Authority, Israel Ministry of Health, Israel
a3 Center for Vaccine Development and Evaluation, Israel Defense Forces, Israel
a4 Department of Epidemiology and Biostatistics, Tel-Aviv University, Israel

Article author query
calderon-margalit r   [PubMed][Google Scholar] 
sheffer r   [PubMed][Google Scholar] 
halperin t   [PubMed][Google Scholar] 
orr n   [PubMed][Google Scholar] 
cohen d   [PubMed][Google Scholar] 
shohat t   [PubMed][Google Scholar] 

Abstract

An increase in gastroenteritis outbreaks due to Norovirus has been reported worldwide. We investigated a large-scale outbreak affecting 246 residents and 33 staff members in six nursing homes in the Tel-Aviv district, Israel, during 3 weeks in 2002. Person-to-person spread was noticed in all nursing homes. The spread of disease could not be attributed to social interactions. Among the elderly residents, the hospitalization rate was 10·2% and the case-fatality rate was 2·0%. Bacteriological cultures were negative. Overall, 7 out of 15 stool specimens were positive for Norovirus by RT–PCR. All were sequenced and found to be 90% identical. The characteristics of this outbreak and the RT–PCR results suggest that illness was caused by Norovirus. Due to the high case-fatality rate of Norovirus gastroenteritis, there should be a high index of suspicion when encountering a gastroenteritis outbreak among the elderly. This will enable prompt action to stop the spread of illness.

(Accepted August 14 2004)


Correspondence:
c1 Dr R. Calderon-Margalit, Hebrew University–Hadassah Braun School of Public Health, PO Box 12272, Jerusalem, 91120, Israel. (Email: ronitca@hadassah.org.il)


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