Role of the Hospital Environment in Norovirus Containment

Norovirus is an important cause of gastroenteritis in healthcare settings; these infections occur frequently, are highly contagious, and can be difficult to control. Norovirus outbreaks were investigated during a 3-month enhanced surveillance period from 1 February to 30 April 2015 in 6 London, United Kingdom, hospitals (coded A-E). During this surveillance period, 1379 stool samples were tested for the presence of norovirus. Of these, 129 (9.4%) demonstrated the presence of norovirus RNA. Two of these hospitals (A and D) reported 0 outbreaks, 2 (hospitals C and F) reported 1 outbreak, 1 hospital (B) reported 2 outbreaks, and hospital E reported 16 norovirus outbreaks during this period. The hospital with a newer infrastructure (B), which reported 2 norovirus outbreaks, demonstrated that 7 bed-days had been lost over the 3-month period, compared with 512 bed-days lost by the hospital with an older, Nightingale-style infrastructure (E). Control measures included isolation, hand hygiene, environmental cleaning, and rapid diagnostic testing. Our data suggest that outbreak control is more difficult to achieve in a hospital with Nightingale-style wards and limited isolation facilities.