Acute gastroenteritis outbreaks in closed and semi-closed facilities during 2017 in Catalonia, Spain
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BRIEF REPORT
Acute gastroenteritis outbreaks in closed and semi-closed facilities during 2017 in Catalonia, Spain Nuria Torner 1,2 & Conchita Izquierdo 3 & Lorena Coronas 3 & Ana Martínez 1,3 & Ariadna Rovira 1,3 & Cristina Rius 1,4 & Maria Sabater 3 & Ignasi Parron 3 & Mònica Carol 3 & Ma Rosa Sala 3 & Sofia Minguell 3 & Pere Godoy 1,3 & Mireia Jané 1,3 & Ángela Domínguez 1,2 & The Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia Received: 7 July 2020 / Accepted: 5 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Acute gastroenteritis (AGE) is a leading cause of disease worldwide. The aim of this prospective observational study is to describe the epidemiology of AGE in closed and semi-closed institutions in Catalonia. In 2017, 151 outbreaks were reported; 30.5% occurred in closed and semi-closed institutions; 71.7% caused by norovirus (NoV) (1532) cases. Person-to-person transmission accounted for 75.8% of NoV outbreaks vs 46.1% in non-NoV outbreaks (p < 0.001). Attack rate for NoV outbreaks was 33.1% vs 14.3% for non-NoV outbreaks (RR = 2.3; 95%CI: 2.0–2.7). The high number of affected underscores prompt and intense preventive measures to avoid the extension and perpetuation of outbreaks in these settings. Keywords Norovirus . Closed setting . Semi-closed setting . Outbreak . Gastroenteritis
Introduction Individuals dwelling in nursing homes and long-term care facilities (LTCF) are at a high risk of acute gastroenteritis (AGE) where norovirus (NoV) is considered to be the most frequent cause [1–3]. The low infectious viral load and shedding for an extended period of time in stools and vomitus leads to a rapid spread of NoV in closed and semi-closed facilities [4, 5]. Early recognition of disease, contact precautions with strict adherence to hygiene measures, use of gloves and wearing facial masks, restriction of residents’ movements in affected areas, and exclusion of affected healthcare workers may reduce transmission [4]. Other semi-closed settings such as schools or holiday camp homes implementing control measures can also shorten the duration of outbreaks [6].
* Nuria Torner [email protected] 1
CIBER Epidemiology and Public Health (CIBERESP) PREVICET Barcelona, Institute of Health Carlos III, Madrid, Spain
2
Department of Medicine, University of Barcelona, Casanova 143, 08036 Barcelona, Spain
3
Public Health Agency of Catalonia, Barcelona, Spain
4
Public Health Agency of Barcelona, Barcelona, Spain
The environmental persistence and resistance of to common disinfectants is well known. The importance of environmental transmission of NoV has not been fully assessed, but it is a relevant feature that makes outbreak control more difficult and costly [7–9]. Improvements in NoV detection and research have made it possible to provide knowledge of its epidemiology. The aim of this study is to describe AGE in closed and semi-closed institutions, assessing differential traits between NoV and other aetiologies.
Methods A prospective observatio
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