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Published on: January 28, 2019
Rotavirus Gastroenteritis Outbreaks in a neonate intermediate care unit: Direct detection of rotavirus from a
Hsing-Chen Tsai1, Meng-Tsen Tsai2, Wang-Huei Sheng3
1Division of Pediatric Infectious Diseases, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, New Taipei City Hospital, Taipei, Taiwan.
Insights
A rotavirus outbreak in a neonatal unit was investigated. Enhanced infection control, focusing on hand hygiene and isolation, successfully stopped the spread of gastroenteritis in neonates.
Area of Science:
- Neonatal care
- Infectious disease epidemiology
- Public health
Background:
- A rotavirus gastroenteritis outbreak occurred in a tertiary teaching children's hospital's neonatal intermediate care unit.
- The outbreak began with an index case, followed by two additional cases within one week.
- An investigation was initiated to identify the source and contain the infection.
Observation:
- Cohort care and environmental disinfection were implemented immediately.
- Stool and environmental samples were collected from neonates and the unit.
- Healthcare provider practices regarding hand hygiene and isolation gowns were reassessed.
Findings:
- A total of 39 contacts were identified, including neonates, family members, and healthcare providers.
- Rotavirus was detected in one additional neonate and on a computer keyboard and mouse.
- Inadequate hygiene precautions and isolation gown use by healthcare workers were noted.
Implications:
- Intensified infection control measures, including strict hand hygiene and isolation protocols, are crucial.
- Preventing healthcare-associated viral gastroenteritis outbreaks in neonatal units requires diligent adherence to infection control.
- Environmental contamination, such as on keyboards, may play a role in rotavirus transmission.
Background:
During one week in September, one index case, followed by two cases of rotavirus gastroenteritis infection, was identified in a neonate intermediate care unit of a tertiary teaching children's hospital. An outbreak investigation was launched to clarify the possible infection source and to stop the spread of infection.
Methods:
Cohort care and environmental disinfection were immediately implemented. We screened rotavirus in all the unit neonates' stool samples as well as environmental swab samples. The precautionary measures with regard to hand hygiene and contact isolation taken by healthcare providers and family members were re-examined.
Results:
The fourth case was identified 5 days after commencement of the outbreak investigation. There were total 39 contacts, including 6 neonates, 8 family members, and 25 healthcare providers. Nineteen stool samples collected from other neonates in the units revealed one positive case (the fourth case). However, one sample taken from the computer keyboard and mouse in the ward was also positive. The observation of hygiene precautions and the use of isolation gowns by healthcare workers were found to be inadequate. Following the intensification of infection control measures, no further cases of infection were reported.
Conclusions:
Hand hygiene and an intensive isolation strategy remained the most critical precautions for preventing an outbreak of healthcare-associated viral gastroenteritis in the neonate care unit.
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