Challenging and Costly to Hospitals -- MEDICA - World Forum for Medicine
Picture: Norovirus 
Noroviruses in a hospital can
be a costly thing; © PHIL

A review of measures taken to address the outbreak of the highly infectious Norwalk virus at The Johns Hopkins Hospital has provided the first solid documentation of expenses and efforts in the United States to stop the infection from spreading among patients, staff and visitors. The costs for the three-month outbreak included extra cleaning supplies, staff sick leave, diagnostic tests, replacement staff, and salaries and lost revenue from closed beds

Norwalk virus is highly contagious because only small amounts, as few as ten to 100 viral particles, can lead to infection. It is spread or passed from person to person through faecal matter and when people touch or share handling of the same objects, such as doorknobs.

“Outbreaks need to be identified quickly and dealt with immediately, and relying on standard infection control procedures is not adequate,” says Cecilia Johnston, M.D., an instructor at Hopkins in infectious diseases who led the investigation. “It may be necessary to close the infected units, isolate the infection source, get strict on hand hygiene, conduct a thorough washing down of units, and keep repeating these steps until the outbreak is stopped. Health care workers especially need to be vigilant about these steps because they are the group primarily affected by outbreaks.”

Johnston and her team of Hopkins patient safety experts describe in the review how an outbreak spread among 265 health care workers and 90 patients between February and May 2004. No one at Hopkins died from their infection, but 13 afflicted hospital staff either visited the emergency room for treatment or required hospitalization after becoming severely dehydrated.

“Health care workers really do need to be on the lookout for norovirus infections, and if there is an outbreak, hospitals need to address it very aggressively,” says senior hospital epidemiologist Trish Perl, M.D., a professor of medicine and pathology at The Johns Hopkins University School of Medicine. “Our experience shows that people can get very sick and that it costs a lot to fix the problem and address disruptions to staffing.”

Further information to this review can be found here.; Source: Johns Hopkins Medical Institutions