ABSTRACT
BACKGROUND: Environmental surfaces are a potential vehicle for the transmission of norovirus outbreaks in closed and semi-closed settings. Testing of environmental samples may help control outbreaks. AIM: To assess the level of environmental contamination by norovirus in acute gastroenteritis outbreaks in closed or semi-closed settings (nursing homes, schools, kindergartens, youth accommodations, hospitals and social health centres) in the Barcelona region between January 2017 and March 2019. METHODS: A prospective surveillance study was carried out. Environmental samples (529) were collected in 46 of the 50 outbreaks of acute norovirus gastroenteritis from environmental surfaces of common areas, bathrooms and kitchens in closed and semi-closed settings when the outbreak was notified and 10 days later. Instructions for taking environmental samples were distributed to public health inspectors. Norovirus was detected by reverse transcription polymerase chain reaction. FINDINGS: Environmental samples were positive for norovirus in 31 (67.4%) outbreaks. Norovirus was most frequently detected on elevator buttons (4/17, 24%), toilet handles (16/66, 24%) and handrail bars (7/34, 21%). Positive samples from the first sampling were mainly found in bathrooms and greater viral persistence in the second sampling was found on elevator buttons and TV remote controls. Nursing homes were the setting with the most types of environmental surfaces contaminated (82% in first samples and 55% in second samples). CONCLUSION: The probability of virus detection is independent of the time between notification of the outbreak or symptom onset and sample collection. Our results suggest possible defects in cleaning protocols and disinfection in closed and semi-closed settings.
Subject(s)
Disease Outbreaks/prevention & control , Environmental Monitoring , Equipment Contamination/statistics & numerical data , Feces/virology , Norovirus/isolation & purification , Caliciviridae Infections/transmission , Equipment Contamination/prevention & control , Gastroenteritis/epidemiology , Gastroenteritis/virology , Hospitals , Humans , Norovirus/genetics , Nursing Homes , Prospective Studies , Schools , Spain/epidemiologyABSTRACT
On 16 March 2018, a nursing home notified a possible acute gastroenteritis outbreak that affected 11 people. Descriptive and case-control studies and analysis of clinical and environmental samples were carried out to determine the characteristics of the outbreak, its aetiology, the transmission mechanism and the causal food. The extent of the outbreak in and outside the nursing home was determined and the staff factors influencing propagation were studied by multivariate analysis. A turkey dinner on March 14 was associated with the outbreak (OR 4.22, 95% CI 1.11-16.01). Norovirus genogroups I and II were identified in stool samples. The attack rates in residents, staff and household contacts of staff were 23.49%, 46.22% and 22.87%, respectively. Care assistants and cleaning staff were the staff most frequently affected. Cohabitation with an affected care assistant was the most important factor in the occurrence of cases in the home (adjusted OR 6.37, 95% CI 1.13-36.02). Our results show that staff in close contact with residents and their household contacts had a higher risk of infection during the norovirus outbreak.
Subject(s)
Caliciviridae Infections/epidemiology , Contact Tracing/methods , Disease Outbreaks , Gastroenteritis/epidemiology , Norovirus/isolation & purification , Nursing Homes , Adult , Aged , Analysis of Variance , Caliciviridae Infections/etiology , Case-Control Studies , Female , Foodborne Diseases/diagnosis , Foodborne Diseases/epidemiology , Gastroenteritis/etiology , Gastroenteritis/physiopathology , Humans , Infection Control/methods , Logistic Models , Male , Middle Aged , Multivariate Analysis , Nursing Staff/statistics & numerical data , Prevalence , Retrospective Studies , Risk Assessment , Severity of Illness Index , Spain/epidemiologySubject(s)
Humans , Female , Personal Satisfaction , Patient Satisfaction/statistics & numerical data , Family Development Planning , Self-Assessment , Self-Evaluation Programs/methods , Self-Evaluation Programs/trends , Patient Acceptance of Health Care/statistics & numerical data , Rural Population/statistics & numerical dataSubject(s)
Family Planning Services/standards , Patient Satisfaction , Cross-Sectional Studies , Female , Humans , Rural Population , SpainABSTRACT
Photosynthetic and respiratory activities at low light intensities (300 &mgr;E m-2 s-1) in the microbial mats of the Ebro Delta were measured by the oxygen exchange method in the laboratory. The response to H2S concentration, a significant factor in the dynamics of that ecosystem, was assessed. Total photosynthesis reached 23. 78-28.17 &mgr;g O2 cm-2 h-1. Photosynthetic activity was not significantly different at the two temperatures tested. Respiratory activity reached a consumption of 6.95-8.56 &mgr;g O2 cm-2 h-1 at 25 degreesC and 11.42-11.70 &mgr;g O2 cm-2 h-1 at 35 degreesC. The Q10 value for respiration was 1.37-1.64. Oxygen production in Microcoleus chthonoplastes, the most abundant cyanobacterium in those microbial mats, was highly resistant to sulfide inhibition. Concentrations less than 0.02 mM sulfide did not affect the rate of photosynthesis. Concentrations up to 0.1 mM sulfide caused different degrees of partially reversible inhibition, with a maximum of 67% at 0.78 mM sulfide. Primary production (g C assimilated/m2/year) in those microbial mats was also assessed and compared with data from other ecosystems.