Rotavirus outbreak on a pediatric oncology floor: Possible association with toys

Background: Several outbreaks of rotavirus gastroenteritis have occurred in hospitals and day care centers. In the spring of 1997, an outbreak of rota virus occurred on our pediatric unit. Aggressive infection control measures were instituted, and potential lapses in infection control were assessed. Methods: Memorial Sloan-Kettering Cancer Center is a 434-bed cancer hospita l in New York City. The pediatric unit is a 42-bed ward with both bone marr ow transplant patients and non-bone marrow transplant oncology patients. No socomially acquired rotavirus was defined as diarrhea, vomiting, or gastroi ntestinal upset with onset 48 hours or more after hospital admission, accom panied by a positive enzyme immunoassay for rotavirus antigen. Results: Between February 24 and April 4, 1997, 8 patients on the pediatric unit had nosocomial rotavirus. Aggressive infection control measures were instituted. Patients with rotavirus were cohorted and placed on contact pre cautions (strict handwashing, gloves, and gown). Investigation by the infec tion control team revealed that communal toys in the playroom were not bein g cleaned according to the weekly protocol. Conclusions: An outbreak of nosocomial rotavirus occurred on our pediatric oncology unit. Shared toys may have served as fomites in the transmission o f rotavirus.