How timely closure can reduce outbreak duration

Infectious gastroenteritis is a common cause of illness in care homes, which provide an environment well suited for the spread of infectious disease. Norovirus is the most common cause of gastroenteritis outbreaks in care homes and is associated with excess mortality in the elderly. The majority of norovirus infections are transmitted person-to-person.

During this study data on outbreaks of infectious gastroenteritis in care homes has been collected using an internet-based surveillance system in North West England since 2012. The HPRU GI team, including colleagues from University of Lancaster, Public Health England and the University of Liverpool, have analysed the burden and characteristics of care home outbreaks to inform future public health decision-making.

They recorded 795 outbreaks from 379 care homes (37.1 outbreaks per 100 care homes per year). In total 11,568 cases, 75 hospitalisations and 29 deaths were reported. Closure within three days of the first case (IRR = 0.442, 95%CI 0.366–0.534) was significantly associated with reduced duration of closure. The total size of the home (IRR = 1.426, 95%CI = 1.275–1.595) and the total attack rate (IRR = 1.434, 95%CI = 1.257–1.595) were significantly associated with increased duration of closure.

Care homes that closed promptly had outbreaks of shorter duration. Care home providers, and those advising them on infection control, should aim to close homes quickly to prevent lengthy disruption to services.

For the full article, entitled: 'How timely closure can reduce outbreak duration: gastroenteritis in care homes in North West England, 2012–2016', see the April issue of: BMC Public Health.