1 / 18

Viral Gastroenteritis: Prevention and Control in Long-Term Care Facilities

Viral Gastroenteritis: Prevention and Control in Long-Term Care Facilities. Daniel Golson, MPH Epidemiologist daniel.golson@nashville.gov 615-340-5651. Practical Guidance for LTCFs. www.health.nashville.gov/healthdata. Development of Document. early 2009 – 4 confirmed norovirus outbreaks

taite
Download Presentation

Viral Gastroenteritis: Prevention and Control in Long-Term Care Facilities

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Viral Gastroenteritis:Prevention and Control in Long-Term Care Facilities Daniel Golson, MPHEpidemiologistdaniel.golson@nashville.gov615-340-5651

  2. Practical Guidance for LTCFs www.health.nashville.gov/healthdata

  3. Development of Document • early 2009 – 4 confirmed norovirus outbreaks • LTCF, retirement community, restaurant, social gathering • only one was determined to be foodborne • internal work group formed • internal communication, outbreak response, guidance for public facilities (e.g. hotels and LTCFs) • CDIs, environmentalists, & epidemiologists • Food Division, Public Facilities, Epidemiology

  4. And Then.... • Swine flu!

  5. Next Thing You Know...Fall 2009 Viral Gastroenteritis Outbreaks in Davidson County • 5* Assisted Living facilities • 2** Retirement communities • 2 Social gatherings • wedding (confirmed norovirus G2 etiology) • work environment (confirmed norovirus G2 etiology) *1 confirmed etiology – norovirus G2 **1 confirmed etiology – norovirus G2

  6. Lessons Learned • Some large institutions have very clear control protocols • Many do not • Many HCWs lackadasical about viral gastroenteritis – “it’s going around” • Closed communities must be prepared

  7. Guidance Needed for LTCFs • Prepare for eventuality of a viral gastroenteritis outbreak • When to suspect an outbreak • Control measures • Info to collect for CDIs, epi’s • Notification the LHD • Examples of info to hand out to residents & signs to discourage visitors

  8. Guidance Needed for LTCFs • Isolation practices • Dining facilities & community activities • Ill staff • Home-health workers • Transfers, EMS transports • New admissions • Environmental cleaning & disinfection • Flexible step by step guide

  9. Outbreaks • ≥2 residents or staff with new onset of V and/or D w/n 48 hrs of each other  suspect norovirus • early recognition critical to control • aggressive implementation of control measures

  10. Preparation is Critical! • Review guidance & share with staff • Think about what info your audience will want during an outbreak – be transparent in your communications • Prepare for specific audiences: • residents • residents’ families/friends • staff (food, maintenance, volunteers, home-health workers, etc) • the media?

  11. You suspect an outbreak, now what? Notification– Everyone plays a role • Residents, Staff – Report SxS to Mgmt • Mgmt or ICP • Consult with MPHD (615-340-5632) • Log cases daily using line list • Alert “sister” facilities, hospitals, hospice, EMS • Provide staff, residents, family, visitors with fact sheet on norovirus

  12. Isolation and Case Management • 48 hrs rule • isolate those with SxS until 48 hrs SxS-free • send ill staff home until 48 hrs SxS-free • discontinue communal activities until 48 hrs after last case ID’d • close dining facility until 48 hrs after last case • Limit staff to one area of assignment • Postpone transfers & new admissions • Discourage visitors

  13. Managing the Environment • Norovirus resistant to most disinfectants • Clean & disinfect (C&D) contaminated areas promptly • Step up C&D and continue enhanced C&D ≥72 hrs after last case ID’d • Chlorine bleach is best Lysol® 409® Pinesol®

  14. Managing the Environment • Do Not bring non-essential equip into contaminated areas • Do Not vacuum until after steam cleaning (carpets, rugs, furnishings) • Segregate clean & soiled linens/laundry • Wear PPE when handling soiled laundry

  15. Viral Gastroenteritis Outbreaks in Davidson County since Fall 2009 • Over 175 illnesses in total • At least 8 hospitalizations, many ED visits • No fatalities • Attack rates among residents ranged from 16% to 73%

  16. Propagated Outbreak in 3 phases?

  17. Questions? www.health.nashville.gov/healthdata

More Related