A VIRAL GASTROENTERITIS OUTBREAK ASSOCIATED WITH PERSON-TO-PERSON SPREAD AMONG HOSPITAL STAFF

OBJECTIVE: To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis. SETTING: A regional referral hospital in upstate South Carolina. METHODS: We reviewed pat ient charts, surveyed staff, and tested stool from acutely ill persons . A case was defined as diarrhea and vomiting in a staff member or pat ient from January 5 to 13, 1996. RESULTS: The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the w ard and visited by many staff colleagues. The staff were at a signific antly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI9 5], 1.55.5). All 10 case-patients had been exposed to case-nurses (ass igned nurses who were primary caretakers), and eight had documented ex posure to case-nurses 1 to 2 days before their illness. Patients expos ed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples. CONCLUSION: This nosoco mial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from a nd among staff. The potential for spread of SRSV-associated gastroente ritis from and among staff should be considered in developing strategi es to prevent similar outbreaks in hospital settings (Infect Control H osp Epidemiol 1998;19:162-167).