Norovirus is the Leading Cause of Infection Outbreaks in U.S. Hospitals

Washington, DC, January 31, 2012 –Norovirus, a pathogen that often causes food poisoning and gastroenteritis, was responsible for 18.2 percent of all infection outbreaks and 65 percent of ward closures in U.S. hospitals during a two-year period, according to a new study published in the February issue of the American Journal of Infection Control (AJIC), the official publication of APIC - the Association for Professionals in Infection Control and Epidemiology.

A team of researchers from Chartis, Main Line Health System, Lexington Insurance Company, and APIC Consulting Services collected survey responses from 822 APIC members who work in U.S. hospitals regarding outbreak investigations at their institutions during 2008 and 2009. The study was conducted to determine how often outbreak investigations are initiated in U.S. hospitals, as well as the triggers for investigations, types of organisms, and control measures including unit closures.

Thirty-five percent of the 822 hospitals responding had investigated at least one outbreak in the previous two years. Four organisms caused nearly 60 percent of the outbreaks: norovirus (18.2 percent), Staphylococcus aureus (17.5 percent), Acinetobacter spp (13.7 percent), and Clostridium difficile (10.3 percent). These results reflect 386 outbreak investigations reported by 289 hospitals over a 24-month period.

Medical/surgical units were the most common location of outbreak investigations (25.7 percent), followed by surgical units (13.9 percent). Nearly one-third (29.2 percent) of outbreaks were reported in a category that included emergency departments, rehabilitation units, long-term acute care hospitals, psychiatric/behavioral health units, and skilled nursing facilities. According to the results, the average number of confirmed cases per outbreak was 10.1 and the average duration was 58.4 days. Unit closures were reported in 22.6 percent of the cases, causing an average 16.7 bed closures for 8.3 days.

Of reported outbreaks, only 132 (52.2 percent) of investigations were reported to an external agency, with just 71 (28.4 percent) involving assistance in the investigation by an external resource. In most states, reporting to the state health department is required and can provide hospitals with expertise to expedite and expand their outbreak investigations.

“It is clear that outbreaks of healthcare-associated infections occur with some frequency in hospitals as well as nonacute settings,” state the authors. “An infection prevention and control program and its staff should be prepared for all aspects of an outbreak investigation through written policies and procedures as well as communication with internal and external partners.”

The Centers for Disease Control and Prevention (CDC) recently released updated guidelines for the prevention and control of norovirus outbreaks in healthcare settings.

Full text of the AJIC article is available to journalists upon request; contact Liz Garman, APIC, +1 202 454 2604, egarman@apic.org to obtain copies.

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Notes for editors
“Frequency of outbreak investigations in U.S. hospitals: Results of a national survey of infection preventionists,” by Emily Rhinehart, Scott Walker, Denise Murphy, Karen O’Reilly, and Patty Leeman, appears in the American Journal of Infection Control, Volume 40, Issue 1 (February 2012).

Authors

Emily Rhinehart, RN, MPH, CIC (Corresponding Author)
Global Loss Prevention, Chartis, Atlanta, Ga.

Scott Walker, BBA
Global Loss Prevention, Chartis, Atlanta, Ga.

Denise Murphy, RN, MPH, CIC
Department of Quality and Patient Safety, Main Line Health Systems, Bryn Mawr, Pa.

Karen O’Reilly, BS, MBA
Lexington Insurance Company, Boston, Mass.

Patty Leeman, MCE, MBA, CAE
APIC Consulting Services, Washington, DC

About AJIC: American Journal of Infection Control
AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

About APIC
APIC’s mission is to create a safer world through prevention of infection. The association’s more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Follow APIC on Twitter: http://twitter.com/apic.


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Media contact
Liz Garman
+1 202 454 2604
egarman@apic.org