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Review
. 2009 Feb;137(2):145-55.
doi: 10.1017/S0950268808000757. Epub 2008 May 12.

Enteric outbreaks in long-term care facilities and recommendations for prevention: a review

J D Greig  1 , M B Lee
Affiliations
Review

Enteric outbreaks in long-term care facilities and recommendations for prevention: a review

J D Greig et al. Epidemiol Infect. 2009 Feb.

Abstract

Outbreaks of enteric illness in long-term care facilities (LTCFs) were reviewed to identify preventative recommendations. Systematic review methodology identified outbreak reports of gastrointestinal illness in LTCFs either published or that occurred from January 1997 to June 2007. The inclusion criteria captured 75 outbreaks; 23 (31%) associated with bacterial agents and 52 (69%) with viral agents. Transmission was mainly foodborne (52%) for those of bacterial origin and person-to-person (71%) for viral outbreaks. Norovirus infection was associated with 58% of hospitalizations. Sixty deaths were reported, about half from Salmonella infections. Recommendations for foodborne outbreaks emphasized appropriate sourcing and preparation of eggs, staff training, and temperature control during food preparation. Recommendations from outbreaks transmitted person-to-person centred on controlling residents' movements, effective environmental cleaning and disinfection, cancelling social events and restricting visitors, excluding ill staff, encouraging effective hand hygiene, and preventing cross-contamination through gloving and gowning. In none of the 75 published outbreak reports were the suggested recommendations evaluated for effectiveness in controlling the outbreak. Applied research of this type could greatly help in the acceptance of prevention and control strategies.

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