Norovirus outbreaks in nursing homes: the evaluation of infection control measures.

Effective infection control measures during norovirus outbreaks are urgently needed in places where vulnerable individuals gather. In the present study, the effect of a number of measures was investigated in daily practice. Forty-nine Dutch nursing homes were monitored prospectively for norovirus outbreaks during two winter seasons. A total of 37 norovirus outbreaks were registered. Control measures were most effective when implemented within 3 days after onset of disease of the first patient. Measures targeted at reduced transmission between persons, via aerosols, and via contaminated surfaces reduced illness in staff and in residents. Reducing illness in staff results in fewer costs for sick leave and substitution of staff and less disruption in the care of residents. The effect of control measures on outbreak duration was limited. This is the first intervention study examining the effect of control measures. Further research is needed to extend and refine the conclusions.

[Not more symptoms with mefloquine use than with other drugs in malaria prophylaxis]. / Niet meer klachten bij mefloquinegebruik dan bij malariaprofylaxe met andere middelen.

OBJECTIVE: To investigate the prevalence of health problems and compliance with respect to malaria prophylaxis of travellers to the (sub)tropics. SETTING: Travel department of the Public Health Care Centre Groningen, the Netherlands. DESIGN: Retrospective follow-up study. METHODS: A questionnaire was sent out to 450 visitors to the Public Health Care Centre. They had stayed in the (sub)tropics for at most three months. Two subgroups used malaria prophylaxis (mefloquine or proguanil/proguanil-chloroquine): the control group used no prophylaxis. RESULTS: 40% of the 321 responders reported health problems during their stay in the (sub)tropics. Users of proguanil (with or without concurrent chloroquine prophylaxis) reported significantly more health problems (55%). Symptoms reported most frequently were vomiting and diarrhoea. Insomnia and neuropsychiatric disorders were reported only rarely (1%) and these complaints were equally distributed over the prophylaxis subgroups. The reported compliance with chemoprophylaxis was 77%. CONCLUSIONS: The frequently reported psychiatric complaints during use of mefloquine were not confirmed by this study. The compliance with malaria prophylaxis in this study was similar to that in other studies.