Curran, Evonne T., Wilson, Jennie ORCID: https://orcid.org/0000-0002-4713-9662, Haig, Caroline E., McCowan, Colin, Leonard, Alistair and Loveday, Heather ORCID: https://orcid.org/0000-0003-2259-8149 (2016) The Where is Norovirus Control Lost (WINCL) study: an enhanced surveillance project to identify norovirus index cases in care settings in the UK and Ireland. Journal of Infection Prevention, 17 (1). pp. 8-14. ISSN 1757-1774

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Abstract

Background: Norovirus outbreaks have a significant impact on all care settings; little is known about the index cases
from whom these outbreaks initiate.
Aim: To identify and categorise norovirus outbreak index cases in care settings.
Methods: A mixed-methods, multi-centre, prospective, enhanced surveillance study identified and categorised index
cases in acute and non-acute care settings.
Results: From 54 participating centres, 537 outbreaks were reported (November 2013 to April 2014): 383 (71.3%) in
acute care facilities (ACF); 115 (21.4%) in residential or care homes (RCH) and 39 (7.3%) in other care settings (OCS).
Index cases were identified in 424 (79%) outbreaks. Of the 245 index cases who were asymptomatic on admission and not
transferred within/into the care setting, 123 (50%) had been an inpatient/resident for 4 days. Four themes emerged: missing
the diagnosis, care service under pressure, delay in outbreak control measures and patient/resident location and proximity.
Conclusion: The true index case is commonly not identified as the cause of a norovirus outbreak with at least 50%
of index cases being misclassified. Unrecognised norovirus cross-transmission occurs frequently suggesting that either
Standard Infection Control Precautions (SICPs) are being insufficiently well applied, and or SICPs are themselves are
insufficient to prevent outbreaks.

Item Type:	Article
Identifier:	10.1177/1757177415613133
Subjects:	Medicine and health > Microbiology Medicine and health > Nursing
Related URLs:	Organisation
Date Deposited:	02 Jun 2016
URI:	https://repository.uwl.ac.uk/id/eprint/1704

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