Incidence of Hospital Norovirus Outbreaks and Infections Using 2 Surveillance Methods in Sweden
(2017) In Infection Control & Hospital Epidemiology 38(1). p.96-102- Abstract
OBJECTIVE To evaluate 2 different methods of surveillance and to estimate the incidence of norovirus (NoV) outbreaks in hospitals. DESIGN Prospective observational study. SETTING All 194 hospital wards in southern Sweden during 2 winter seasons (2010-2012). METHODS Clinical surveillance based on outbreak reports of 2 or more clinical cases, with symptom onset within 5 days, was compared with laboratory surveillance based on positive NoV results among inpatients. At least 2 NoV positive patients sampled within 5 days at a ward defined a cluster. Outbreak reports including at least 1 NoV positive case and clusters including at least 1 NoV positive patient with 5 or more days from ward admission to sampling were defined as NoV outbreaks.... (More)
OBJECTIVE To evaluate 2 different methods of surveillance and to estimate the incidence of norovirus (NoV) outbreaks in hospitals. DESIGN Prospective observational study. SETTING All 194 hospital wards in southern Sweden during 2 winter seasons (2010-2012). METHODS Clinical surveillance based on outbreak reports of 2 or more clinical cases, with symptom onset within 5 days, was compared with laboratory surveillance based on positive NoV results among inpatients. At least 2 NoV positive patients sampled within 5 days at a ward defined a cluster. Outbreak reports including at least 1 NoV positive case and clusters including at least 1 NoV positive patient with 5 or more days from ward admission to sampling were defined as NoV outbreaks. RESULTS During the study periods 135 NoV outbreaks were identified; 74 were identified by both clinical and laboratory surveillance, 18 were identified only by outbreak reports, and 43 were identified only by laboratory surveillance. The outbreak incidence was 1.0 (95% CI, 0.8-1.2) and 0.5 (95% CI, 0.3-0.6) per 1,000 admissions for the 2 different seasons, respectively. To correctly identify NoV outbreaks, the sensitivity and positive predictive value of the clinical surveillance were 68% and 88% and of the laboratory surveillance were 86% and 81%, respectively. CONCLUSION The addition of laboratory surveillance significantly improves outbreak surveillance and provides a more complete estimate of NoV outbreaks in hospitals. Laboratory surveillance can be recommended for evaluation of clinical surveillance.
(Less)
- author
- Fraenkel, Carl Johan LU ; Inghammar, Malin LU ; Johansson, Hugo LU and Böttiger, Blenda LU
- organization
- publishing date
- 2017-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Infection Control & Hospital Epidemiology
- volume
- 38
- issue
- 1
- pages
- 7 pages
- publisher
- University of Chicago Press
- external identifiers
-
- pmid:27841102
- wos:000391243000015
- scopus:85008707901
- ISSN
- 0899-823X
- DOI
- 10.1017/ice.2016.237
- language
- English
- LU publication?
- yes
- id
- 9b72d65e-9b2a-4d23-af18-759a0f5f6d91
- date added to LUP
- 2017-02-01 15:00:37
- date last changed
- 2024-03-07 21:25:32
@article{9b72d65e-9b2a-4d23-af18-759a0f5f6d91,
abstract = {{<p>OBJECTIVE To evaluate 2 different methods of surveillance and to estimate the incidence of norovirus (NoV) outbreaks in hospitals. DESIGN Prospective observational study. SETTING All 194 hospital wards in southern Sweden during 2 winter seasons (2010-2012). METHODS Clinical surveillance based on outbreak reports of 2 or more clinical cases, with symptom onset within 5 days, was compared with laboratory surveillance based on positive NoV results among inpatients. At least 2 NoV positive patients sampled within 5 days at a ward defined a cluster. Outbreak reports including at least 1 NoV positive case and clusters including at least 1 NoV positive patient with 5 or more days from ward admission to sampling were defined as NoV outbreaks. RESULTS During the study periods 135 NoV outbreaks were identified; 74 were identified by both clinical and laboratory surveillance, 18 were identified only by outbreak reports, and 43 were identified only by laboratory surveillance. The outbreak incidence was 1.0 (95% CI, 0.8-1.2) and 0.5 (95% CI, 0.3-0.6) per 1,000 admissions for the 2 different seasons, respectively. To correctly identify NoV outbreaks, the sensitivity and positive predictive value of the clinical surveillance were 68% and 88% and of the laboratory surveillance were 86% and 81%, respectively. CONCLUSION The addition of laboratory surveillance significantly improves outbreak surveillance and provides a more complete estimate of NoV outbreaks in hospitals. Laboratory surveillance can be recommended for evaluation of clinical surveillance.</p>}},
author = {{Fraenkel, Carl Johan and Inghammar, Malin and Johansson, Hugo and Böttiger, Blenda}},
issn = {{0899-823X}},
language = {{eng}},
month = {{01}},
number = {{1}},
pages = {{96--102}},
publisher = {{University of Chicago Press}},
series = {{Infection Control & Hospital Epidemiology}},
title = {{Incidence of Hospital Norovirus Outbreaks and Infections Using 2 Surveillance Methods in Sweden}},
url = {{https://lup.lub.lu.se/search/files/31009195/20762078.pdf}},
doi = {{10.1017/ice.2016.237}},
volume = {{38}},
year = {{2017}},
}