Norovirus Case Study

On reflection I have learned by being with the IPCT the importance of sending samples off when the first episode of diarrhoea and vomiting occurs leasing with team members. The IPCT emphasises prompt screening of suspecting patients for a norovirus as early detection of the signs can prevent an outbreak on the ward. I have become aware that the mode of transmission of norovirus means it is not always possible to avoid becoming infected (Nursing Times 2011). The trust provides mandatory training to inform nursing staff on the most recent infection control measures in practice. Hence, good hygiene and the isolation of infected individuals can limit the spread. Good communication is important with all visitors and staff, including cleaners.

The prototype of norovirus was identified in 1968 by electron microscopy as a cause of Gastroenteritis in Norwalk, Ohio. Human noroviruses are a major cause of Epidemic Gastroenteritis, and Epidemic Gastroenteritis is a major cause of foodborne illness. Outbreaks occur throughout the year, but it is most common in the winter. Causes 19-21 million cases of acute gastroenteritis, and contributes to 56,000-71,000 hospitalizations and 570-800 deaths, mostly among young children and older adults. Responsible for 58% of domestically-acquired foodborne illnesses, and about 50% of foodborne disease outbreaks due to known agents.

As we know, older residents are susceptible to infections because of multi-morbidity, greater severity of illness, functional impairment, cognitive impairment, incontinence, and the presence of frequent short-term and long-term indwelling device use such as urinary catheters and feeding tubes. For infection prevention control program, an effective infection prevention program includes a method of surveillance for infections and antimicrobial-resistant pathogens, an outbreak control plan for epidemics, isolation and standard precautions, hand hygiene, staff education, an employee health program, a resident health program, policy formation and periodic review with audits, and a policy

4.2: The potential risks of infection within the workplace can be very high in a care home as you are constantly coming into contact with people who may have infections, handling waste material which could be contaminated and working in an environment and with equipment which could be contaminated. This is why it is extremely important to wear the correct PPE and use the correct hand washing procedure and use the correct cleaning products.

In addition, risk assessments should be undertaken for example; each person who has a catheter; PEG feed; pressure sore; or other factor which makes them more susceptible to the risk of infection. Ultimately anyone within the home who can cause infection are subject to risk assessment under the COSHH Regulations and Management of Health and Safety at Work Regulation 1992. It is important that infected residents are isolated and infected staff excluded from work, until 48 hours after the symptoms have settled. Management of cases should be planned following a risk assessment, which should consider continence, personal hygiene, overall health, likelihood of physical contact with other residents or their food, the facilities available and the vulnerability of other residents. The local HPU can advise on this process. Infected residents should, if possible, have sole use of a designated toilet or commode as long as their symptoms persist. In the case of a likely norovirus infection, they should keep a designated toilet facility for 48 hours after their symptoms have settled.

Viruses such as colds and the flu can spread rapidly in the social care settings

To prevent and control the infection and the measures that are to be taken by the facility to limit the spread of norovirus is that the organisation should have signs saying that there are some infected patients. Making sure of having a proper hand hygiene and wash the laundry thoroughly and make sure to disinfect the clothes. Usage of proper Personal Protection Equipment and sterilize the suspected

A mother of a young child called the Vermont Department on February 5 to report the possibility of a foodborne disease outbreak after her child aged 5 years and two other children of her neighbor aged 7 and 10 years became ill with a lot of vomiting and diarrhea that took place within an interval of 12 hours. The child’s sickness became severe that the mother took her to a local hospital where she was kept at the emergency department.

Everyone listen up, it is now time to take caution. A virus has re-emerged and is spreading fast. We first saw a case like this in 1994 where well-known horse trainer, Vic Rail died after 6 days and experienced severe lung inflammation, interstitial pneumonia and respiratory failure (Grant,2013). 14 of his horses also died when it broke out not far from here, in fact Hendra and now it has come back to haunt us with its lethality (Betterhealth.vic.gov.au, 2015).The emergence in humans was unprecedented and shocking.

During the fall of 2008, three outbreaks of norovirus on college campuses in California, Michigan, and Wisconsin were reported to the CDC (Roberts, et al., 2015). Based on the approximately one-thousand reported cases, including ten hospitalizations, and closure of one of the campuses, public health investigations were led by the respective states and local health departments to characterize the extent of the outbreaks and implement control measures (Roberts, et al., 2015).

Viruses affect us in our everyday life and they have become something that is not an abnormal phenomenon or a fatal occurrence like it was in olden times. (Alic and Longe , 2015) Likewise, the viruses that affect us have much impact of what the actual disease is. Norovirus being an example of a virus that affects our daily lives and can be fatal. (Longe, 2015) This disease is highly contagious and is very often overlooked by the public eye, however it can have much impact on our daily lives and how we live. This virus can be seen throughout all of your lifetime and can affect anybody at any age, it is harder to treat as it can withstand high temperatures and can live in almost any environment making it difficult to damage and control. (Alic and Longe , 2015) Norovirus outbreaks are very common

Mattner, Mattner, Borck, and Gastmeier (2005) found patient-indexed outbreaks of norovirus in a hospital involved more patients than staff-indexed outbreaks, contradicting the assumption HCPs are mainly responsible for person-to-person spread of norovirus. Larson et al. (2009) found inpatients are more likely to have MDROs as part of their normal flora compared with outpatients. Istenes (2011) found 39% of patients had at least one hospital-associated pathogen on their hands within 48 hours of admission. Banfield, Kerr, Jones, and Snelling (2007) demonstrated after seven days, 62% of all patients had enterococcal hand contamination, compared with 10.7% of non-hospitalized

The incubation period is for an average of two days, implying that norovirus takes two days from the mouth to the small intestine to cause the adverse effect with biologically active dose. The illness is typically acute onset because extremely short-term, only minute dose of the exposure with usually one contact can cause the infection to humans indiscriminately. A specific fraction of the population such as elderly people, children and pregnant women are susceptible, due to the incomplete immunity, showing severe illness with extra symptoms such as dehydration and the fever, which indicates that the human body response may not be limited in the small intestine but extended to the entire body. Children are at risk of exposure because of the frequent non-dietary ingestion with random hand-to-mouth activities. (Atmar et al., 2008; Division of Viral Diseases, 2011; Hall, 2012)With a low infectious dose and high levels of shedding, a norovirus outbreak can occur in this environment, accompanied with the poor infrastructure destructed by the disaster and the weather in the affected area, therefore it is important to take public health

An outbreak of infection or foodborne illness may be defined either as two or more linked cases of the same illness, or as the situation when the observed number of cases unaccountably exceeds the expected number (Food standard Agency, 2006). However, the World Health Organisation (WHO) defines it as, any disease of an infectious or toxic nature caused by or thought to be caused by the consumption of food or water Norovirus is the most common known cause of infectious intestinal disease in Western Europe and North America [1–3] and one of the leading causes of foodborne outbreaks of acute gastroenteritis [4–9]. It has been estimated that there are over 600,000 cases of norovirus infection in England each year [10], with infection rates peaking during the winter months that lend the disease the initial description “winter vomiting disease” (Mounts et al., 2000 EFSA).

The following is a literature review of the Norovirus. According to Prasad, Hardy, Dokland, Bella, Rossmann and Estes, Norovirus is classified as a virus belonging to the Caliciviridae family. The genus Norovirus has only one species known as the Norwalk Virus (NV) and a number of serotypes. These strains of Norovirus are classified genetically into five genogroups, namely GI, GII, GIII, GIV and GV. Only viruses in the GI and GII genotypes affect humans. Noroviruses under GI genotype include the Southampton Virus and the Norwalk Virus. Noroviruses under GII genotype include the Lordsdale Virus, Hawaii Virus, Mexico Virus, Bristol Virus and the Snow Mountain Virus. The rest of this paper covers the characteristics of the Norovirus, the diseases it causes, its diagnosis and treatment, its hosts and finally its prevalence in the United States.