Cohort study of an outbreak of viral gastroenteritis in a nursing home for elderly, Majorca, Spain, February 2008

M. A. Luque Fernandez, A. Galmes Truyols, D. Herrera Guibert, G. Arbona Cerda and F. Sancho Gaya

Working Paper from Harvard University OpenScholar

Abstract: An outbreak of acute gastroenteritis occurred in a nursing home for elderly in Majorca between 4 and 23 February 2008. To know its aetiology and mechanism of transmission a retrospective cohort study was conducted with a fixed cohort including 146 people (96 residents and 50 employees). The data were collected from clinical histories and through a survey by questionnaire. In total 71 cases were identified (53 residents, 18 employees), corresponding to an overall attack rate (AR) of 48.6%. The consumption of tap water, adjusted by age, sex and consumption of meals provided at the nursing home, presented a relative risk (RR) of 4.03 (95%CI, 1.4-11.4). The microbiological analyses confirmed the presence of norovirus and/or rotavirus in five of the seven stool samples submitted. The slow appearance of cases at the beginning of the outbreak is characteristic of a person to person transmission, while the sudden peak in the middle of the month suggests a common source such as the tap water. We therefore concluded that the outbreak likely originated from two sources: an infected employee of the nursing home and the tap water. The high number of dependent residents most probably facilitated the spread of the outbreak.

Keywords: *Population; Surveillance; Aged; Aged; 80 and over; Caliciviridae; Infections/*epidemiology; Cohort; Studies; Disease; Outbreaks/*statistics; &; numerical; data; Female; Gastroenteritis/*epidemiology; Humans; Incidence; Male; Nursing; Homes/*statistics; &; numerical; data; Risk; Assessment/*methods; Risk; Factors; Rotavirus; Infections/*epidemiology; Spain/epidemiology (search for similar items in EconPapers)
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