Healthcare-Associated Gastroenteritis: Outbreak Report and Systematic Review of the Literature

Healthcare-associated gastroenteritis continues to be associated with significant pediatric morbidity and mortality despite the introduction of rotavirus vaccines. Infection prevention (IP) measures are critical in mitigating outbreaks. We describe an outbreak of norovirus and effective IP strategies utilized and calculated the costs associated with the outbreak. To demonstrate the burden of these events, we conducted a systematic review of pediatric healthcare-associated gastroenteritis outbreaks since 1973 to describe changing epidemiologic trends. Twenty-four publications describing 27 outbreaks were included in the final analysis with 293 healthcare-associated cases. Rotavirus (14) and norovirus (7) outbreaks were most commonly described. Limitations include the retrospective nature of included reports, nonuniform data ascertainment and reporting among publications. Norovirus has replaced rotavirus as the most common etiology of healthcare-associated gastroenteritis outbreaks in North America, Europe, and Australia and New Zealand, since the introduction of rotavirus vaccines.