OUTBREAK AND CONTROL OF A ROTAVIRAL INFECTION IN A NURSERY

Neonatal rotaviral infection generally causes and asymptomatic or mild illness. Once introduced into a nursery, it is very difficult to erad icate. We prospectively studied an outbreak of rotavirus infection in a normal newborn nursery from October 1994 through May 1995. Stool sam ples from infants more than 24 hours old were tested for rotaviral inf ection, either weekly, biweekly, or monthly. Rotavirus was identified in 164 (16%) of 1,037 tested neonates. Nintey-four (57%) rotavirus-pos itive neonates became symptomatic: 56 had diarrhea, 26 developed fever (rectal temperature > 38 degrees C), 25 experience vomiting, 17 showe d poor feeding, and 14 had an elevated core temperature. In total, 24 neonates were evaluated for suspected sepsis. RNA electropherotyping o f samples from 91 neonates revealed infection by the same rotavirus st rain in all cases. This strain differed from that isolated from 64 rot avirus-infected infants and toddlers in the pediatric ward during the same period. Infection control procedures (hand washing, isolation of infected neonates, and careful management of diapers) and early discha rge of uninfected neonates were instituted and the outbreak was eradic ated 8 months after the onset. Our findings indicate that many rotavir us-infected term neonates become symptomatic and have signs suggestive of sepsis. Extended hospital stay may be an important factor in promo ting rotaviral transmission. Thus, early discharge may be and addition al effective method of controlling rotavirus outbreaks in a nursery.