The principal cause of acute gastroenteritis (AGE) epidemics is the highly contagious norovirus. The Centers for Disease Control and Prevention attributes a 254% increase in AGE outbreaks nationwide from 2005 to 2006 to the emergence of two new norovirus strains. Norovirus-like illness is a common cause of healthcare facility outbreaks and emergency department visits. It can be fatal among vulnerable populations (e.g., very young, elderly, immunocompromised). The reports of non-Clostridium difficile (non-C. diff) AGE cases in Pennsylvania nursing homes increased from 634 cases in the third quarter of 2009 to 813 cases in the fourth quarter of 2009 and then surged to 4,090 cases in the first quarter of 2010. Pennsylvania hospitals also reported an increase in non-C. diff AGE in the first quarter of 2010. Recurring, annual attacks of norovirus affect resident/patient and staff safety, disrupt healthcare facility operations, and may result in financial and operational burden to facilities. Published health department guidelines suggest that the best method to reduce the risk or mitigate the impact of a norovirus outbreak is to develop preseason preparation measures and to have a rapid response plan in place. Interviews with Pennsylvania healthcare facilities revealed successful strategies for controlling noroviral outbreaks. Key components of an outbreak prevention/containment program include addressing risk factors that increase the potential for norovirus infection and applying best practices to identify and control an AGE outbreak.
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