Norovirus Outbreak Report 2011/12 - The Royal Wolverhampton ...

The Royal Wolverhampton Hospitals NHS TrustHousekeeping, institutions, care homes, Public Health, Environmental Health and theAmbulance Trust to ensure effective communication and management.METHODOLOGY:The Infection Prevention Team (IPT) is responsible for the daily intelligence and datacollection of symptomatic patients/residents, their locations and patient status and foradvising on closure of bays or wards. IPT are required to report to the Health ProtectionAgency West Midlands if outbreaks occur on a weekly or daily report depending onoutbreak activity to enable a regional surveillance system to operate. Occupational Healthand Wellbeing collect staff sickness data. Housekeeping are responsible for coordinatingthe environmental cleaning and environmental decontamination response liaising with theIPT.The Outbreak Management Committee meets daily to review the overall situation, risks andcoordinate the actions. Preventing admissions to the Acute Trust from community carehomes requires the community outbreak notification and management plan anddehydration clinical pathway for care homes to be operational and managed by the IPT.Communication for the Acute Trust is through a daily press bulletin.GP’s are communicated to via a Public Health cascade system.Care homes with confirmed or suspected outbreaks use an outbreak notification systemand an outbreak management plan/pack which includes an oral hydration plan with 15minute oral fluids being offered to prevent dehydration. This has proved effective with sipspreventing drips. The outbreak management plan is supported by IPT and includes analert for possible admissions to hospital.RESULTS:As of June 2012 there were four Norovirus outbreaks in the acute Trust, two of which werecontained to individual wards. The outbreaks affected 380 people (219 patients, 161 staff)and lasted for 76 days, on average wards were closed for 6 days. This resulted in a loss of361 bed days for the Trust.Norovirus activity in care homes was observed to be slightly higher than in the previousyear. In total there were 24 outbreaks in 20 care homes between 11 th October 2011 and16 th March 2012. The average length of each outbreak was 10 days.In eleven outbreaks there were either insufficient samples or none were sent to be testedfor Norovirus. However the symptoms met the case definition and so these were managedas Norovirus and cases subsequently included in this report. Norovirus was confirmed in 7of the reported outbreaks. 254 residents and 107 staff were symptomatic over the period,and 827 bed days were lost. There were no admissions reported of residents fromWolverhampton care homes being admitted due to dehydration secondary to Norovirusactivity. Any resident admitted for another condition was isolated at the receivingemergency portal thus reducing significantly the risk of spread.The improvement in caring for the residents locally during outbreaks was due to aneducation and training plan/pack for care home staff cascaded out in 2011-12. Educationand guidance in Norovirus Management was delivered via the Care Managers Link Groupbefore the start of the winter season and a copy of the Norovirus Toolkit was circulated tothe Wolverhampton care homes. The introduction of a revised outbreak notification and