An outbreak of norovirus infection in a long-term care facility in Brazil

Objective: To describe a norovirus outbreak in a Brazilian longtermcare facility from July 8 to 29, 2005. Methods: In thefirst 48 to 72 hours after onset of symptoms in inpatients andemployees, the main infection control strategies were staffeducation, emphasis on hand washing, implementing contactprecautions up to 48-72 hours after resolution of symptoms,complete cleaning of the rooms and exclusion of symptomaticemployees from work until 48-72 hours after resolution of theirsymptoms. Epidemiological and clinical characteristics of thenorovirus infections were described based on chart review.Results: The incidence among inpatients and employees was41.3% and 16.25%, respectively. The main symptom was diarrhea,affecting 100% of inpatients and employees. Forty-four percent ofspecimens were positive by RIDASCREEN Norovirus analyses,and identified as norovirus genogroup GII. Seventy percent ofinpatients were women and their age range was 51-98 years.Inpatients had in average two comorbid conditions – 87.3% withcardiovascular or chronic pulmonary condition and 47.6% withdementia. There was not relapse or death. Conclusions: The earlyinfection-control measures associated to surveillance are requiredto keep long-term care facilities free of noroviruses and to protectthose who are most vulnerable.