We have provided a baseline rate for SSIs after CABG procedures in Norway. The results show the importance of post-hospital discharge follow-up. The NNIS risk index did not adequately stratify CABG patients. We recommend that more potential risk variables should be included in the surveillance, such as the European System for Cardiac Operative Risk Evaluation (EuroSCORE), height, weight, and diabetes.
In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.
The aim of this study was, for the first time, to describe in detail the epidemiology and impact of norovirus outbreaks in healthcare institituions (HCIs) in Norway to identify areas which may improve outbreak response. Methods: An analysis of all reported norovirus outbreaks in hospitals and long-term-care facilities (LTCFs) was carried out from week 34, 2005 to week 33, 2018. Seasonality, symptoms and number of cases among personnel and patients were described. Findings: A total of 20,544 cases, including 7044 healthcare personnel were reported in 965 outbreaks; 740 from LTCFs and 225 from hospitals. Median number of cases per outbreak was 15, interquartile range (IQR) 8e25 in LTCF; and 17, IQR 10e28 in hospitals. All regions reported outbreaks, with one-third of the municipalities having at least one outbreak in LTCFs during the study period. The start of the outbreak season happened almost four weeks earlier in hospitals than in LTCFs. The estimated average number of working days lost for healthcare personnel per year ranged from 1590 to 1944. Conclusions: Norovirus outbreaks in Norwegian HCIs appears to have a substantial impact on both hospital and LTCFs all over Norway, especially during the winter months. That up to half of all cases were healthcare professionals emphasizes a need for further focus on infection control. Our results suggest that hospitals, affected first, could alert LTCFs in the area in order to prevent further outbreaks.
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