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Rotavirus outbreak on a pediatric oncology floor: possible association with toys
M Rogers1, D M Weinstock, J Eagan
1Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Insights
Communal toys may have spread rotavirus during a pediatric oncology unit outbreak. Enhanced cleaning protocols are crucial for preventing hospital-acquired rotavirus gastroenteritis in vulnerable patient populations.
Area of Science:
- Infectious Diseases
- Pediatric Oncology
- Hospital Epidemiology
Background:
- Rotavirus gastroenteritis outbreaks are a known risk in healthcare settings.
- A rotavirus outbreak occurred on a pediatric unit in the spring of 1997.
- Infection control measures were implemented and assessed during the outbreak.
Purpose of the Study:
- To investigate a rotavirus outbreak on a pediatric oncology unit.
- To identify potential sources and transmission routes of nosocomial rotavirus.
- To evaluate the effectiveness of infection control interventions.
Main Methods:
- The study was conducted at Memorial Sloan-Kettering Cancer Center, a 434-bed cancer hospital.
- Nosocomial rotavirus was defined by specific clinical symptoms and laboratory confirmation (enzyme immunoassay).
- Infection control measures included cohorting patients and implementing contact precautions.
Main Results:
- Eight pediatric patients acquired rotavirus nosocomially between February 24 and April 4, 1997.
- An investigation identified lapses in the cleaning protocol for communal toys in the playroom.
- Shared toys were suspected as fomites contributing to rotavirus transmission.
Conclusions:
- An outbreak of nosocomial rotavirus occurred on the pediatric oncology unit.
- Communal toys may have played a role in the transmission of rotavirus.
- Adherence to cleaning protocols is essential for preventing rotavirus spread in hospitals.
Background:
Several outbreaks of rotavirus gastroenteritis have occurred in hospitals and day care centers. In the spring of 1997, an outbreak of rotavirus occurred on our pediatric unit. Aggressive infection control measures were instituted, and potential lapses in infection control were assessed.
Methods:
Memorial Sloan-Kettering Cancer Center is a 434-bed cancer hospital in New York City. The pediatric unit is a 42-bed ward with both bone marrow transplant patients and non-bone marrow transplant oncology patients. Nosocomially acquired rotavirus was defined as diarrhea, vomiting, or gastrointestinal upset with onset 48 hours or more after hospital admission, accompanied by a positive enzyme immunoassay for rotavirus antigen.
Results:
Between February 24 and April 4, 1997, 8 patients on the pediatric unit had nosocomial rotavirus. Aggressive infection control measures were instituted. Patients with rotavirus were cohorted and placed on contact precautions (strict handwashing, gloves, and gown). Investigation by the infection control team revealed that communal toys in the playroom were not being cleaned according to the weekly protocol.
Conclusions:
An outbreak of nosocomial rotavirus occurred on our pediatric oncology unit. Shared toys may have served as fomites in the transmission of rotavirus.