Gastroenteritis outbreaks, 86% of which are caused by norovirus, are common in nursing homes. Norovirus infection is thought to be associated with substantial morbidity and mortality in nursing home residents, but the exact risk is undefined.
In this retrospective cohort study, researchers used linked databases of infection outbreaks and Medicare nursing homes to assess the incidences of hospitalizations and deaths during norovirus outbreaks in 308 nursing homes in Oregon, Wisconsin, and Pennsylvania. Four hundred seven outbreaks were reported during 2009 and 2010, with a median of 26 cases per outbreak. In analyses adjusted for seasonal differences, risk for hospitalization was 9% higher and risk for death was 11% higher during outbreaks than at other times.
Comment: These results put some hard numbers to the trends that are observed clinically: Risks for hospitalization and death rise during norovirus outbreaks in nursing homes. The authors estimate that about 100 excess hospitalizations and 45 excess deaths occurred in these homes during the study period, which translates to 500 to 600 excess deaths in nursing home residents nationwide during 2 years. Norovirus vaccine development (now under way) and more aggressive infection control strategies are warranted.
Source: Journal Watch General Medicine