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Nosocomial rotavirus infections in neonates: means of prevention and control
Insights
A nosocomial epidemic of human rotavirus (HRV) infected 63% of at-risk neonates and 46% of healthy neonates in a Zürich hospital. Prompt implementation of hygiene measures was crucial for controlling the outbreak.
Area of Science:
- Neonatology
- Infectious Diseases
- Epidemiology
Background:
- Nosocomial outbreaks of human rotavirus (HRV) pose a significant threat to vulnerable infant populations in hospital settings.
- Neonates, particularly those in premature baby wards, are at increased risk of severe outcomes from HRV infections.
Purpose of the Study:
- To describe the epidemiology of a nosocomial human rotavirus outbreak in a hospital setting.
- To evaluate the effectiveness of implemented control measures in containing the outbreak.
Main Methods:
- Retrospective analysis of HRV infections in neonates admitted to a Zürich hospital over a 29-day period.
- Monitoring of infection rates in both at-risk neonates (premature ward) and healthy neonates (infant nursery).
- Documentation of implemented countermeasures, including hand hygiene, individual nursing sets, and cohorting.
Main Results:
- During the 29-day outbreak, 63% of at-risk neonates (15/24) and 46% of healthy neonates (36/79) were infected with HRV.
- Rotavirus was detected in infected at-risk neonates an average of five days post-admission.
- 11 out of 15 at-risk neonates were infected within 10 days of the index case's admission.
- 82% of all HRV-infected infants (42/51) presented with clinical symptoms, though not all were attributable to HRV.
Conclusions:
- Early detection and rapid implementation of strict hygiene protocols, including hand disinfection and cohorting, are critical for controlling nosocomial rotavirus outbreaks in neonatal units.
- Effective communication and adherence to infection control measures among all healthcare personnel are essential for preventing further transmission.
Abstract:
Fifteen out of 24 risk neonates from the premature baby ward (= 63%) and 36 of 79 healthy neonates from the infant nursery (= 46%) at a Zürich hospital were infected within a period of 29 days during a nosocomial epidemic human rotavirus (HRV) outbreak. Forty-two out of 51 of all HRV-infected babies (=82%) manifested clinical symptoms, but these could not all be attributed to an HRV infection. On average, rotavirus could be detected in infected risk neonates five days after their admission to the premature baby ward. Eleven of the 15 risk neonates were infected within 10 days after the admission of the index case. Immediately after detection of the epidemic process, specific detailed countermeasures were instituted, including hand protection and hand disinfection, individual nursing set and cohorting of already infected babies. Early institution of such measures and information of all persons responsible for treatment and care of the babies concerned are crucial for success.