SHN169 - Gastrointestinal infections
Gastrointestinal infections
Aim
Discuss the key characteristics and IPC precautions for epidemiologically important
gastro pathogens
Norovirus (Viral Gastroenteritis)
Often known as:
o SRSV
o Norwalk like virus (NLV)
o Winter vomiting virus no longer referred to this as it can occur at anytime
of the year
Most common cause of outbreaks of gastroenteritis in hospitals, schools, cruise ships
Outbreaks often lead to massive disruption
Attack both patients and staff (50% attack rate)
According to the Norovirus Working Party (2011)1:
o Norovirus is estimated to cost the NHS in excess of £100 million per annum
(2002-2003 figures) in years of high incidence.
o Approximately 3000 people a year are admitted to hospital with norovirus in
England
o The incidence in the community is thought to be about 16.5% of the 17
million cases of Infectious intestinal disease in England per year and there is
evidence that this burden has increased over the past decade.
Mode of transmission
o Faecal-oral route (poor hygiene, food and water contamination)
i.e. something from the gut has gotten into the mouth (microscopic
viral particles)
o Contact
o Vomiting (aerosol dissemination)
Norovirus and the faecal oral route
Norovirus-Clinical Features
1
The most up to date information we have to date on Norovirus
1
, SHN169 - Gastrointestinal infections
o Stomach cramps
o Nausea
o Fever and chills
o Vomiting
o Diarrhoea
o Symptoms last 1-3 days
o Symptoms can present within 12 hours of exposure
o Infection confers up to 14 weeks immunity
o No specific treatment – analgesia, rehydration
Rehydration is vital (small sips of water)
Outbreak management
o Criteria for suspecting a norovirus outbreak:
o Outbreaks can be diagnosed on clinical grounds. Explosive in onset.
o Vomiting (often projectile) in > 50% of cases
o Duration of illness 12-60 hours
Younger people tend to recover more quickly
o Incubation period of 15-48 hours
o Both staff and patients affected
o The aim is to contain the outbreak to the ward involved and limit the number
of affected patients, staff and visitors
Important to prevent transmission however often difficult to achieve
o Institute control measures immediately
o Contact the Infection control team immediately
o Outbreak Management Guidelines
2
Gastrointestinal infections
Aim
Discuss the key characteristics and IPC precautions for epidemiologically important
gastro pathogens
Norovirus (Viral Gastroenteritis)
Often known as:
o SRSV
o Norwalk like virus (NLV)
o Winter vomiting virus no longer referred to this as it can occur at anytime
of the year
Most common cause of outbreaks of gastroenteritis in hospitals, schools, cruise ships
Outbreaks often lead to massive disruption
Attack both patients and staff (50% attack rate)
According to the Norovirus Working Party (2011)1:
o Norovirus is estimated to cost the NHS in excess of £100 million per annum
(2002-2003 figures) in years of high incidence.
o Approximately 3000 people a year are admitted to hospital with norovirus in
England
o The incidence in the community is thought to be about 16.5% of the 17
million cases of Infectious intestinal disease in England per year and there is
evidence that this burden has increased over the past decade.
Mode of transmission
o Faecal-oral route (poor hygiene, food and water contamination)
i.e. something from the gut has gotten into the mouth (microscopic
viral particles)
o Contact
o Vomiting (aerosol dissemination)
Norovirus and the faecal oral route
Norovirus-Clinical Features
1
The most up to date information we have to date on Norovirus
1
, SHN169 - Gastrointestinal infections
o Stomach cramps
o Nausea
o Fever and chills
o Vomiting
o Diarrhoea
o Symptoms last 1-3 days
o Symptoms can present within 12 hours of exposure
o Infection confers up to 14 weeks immunity
o No specific treatment – analgesia, rehydration
Rehydration is vital (small sips of water)
Outbreak management
o Criteria for suspecting a norovirus outbreak:
o Outbreaks can be diagnosed on clinical grounds. Explosive in onset.
o Vomiting (often projectile) in > 50% of cases
o Duration of illness 12-60 hours
Younger people tend to recover more quickly
o Incubation period of 15-48 hours
o Both staff and patients affected
o The aim is to contain the outbreak to the ward involved and limit the number
of affected patients, staff and visitors
Important to prevent transmission however often difficult to achieve
o Institute control measures immediately
o Contact the Infection control team immediately
o Outbreak Management Guidelines
2
