Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results

Abstract

ObjectivesTo estimate the incidence of gastroenteritis in individuals in care homes.DesignProspective cohort study.SettingFive participating care homes in North West England, UK.ParticipantsResidents and staff present at the five study care homes between 15 August 2017 and 30 May 2019 (n=268).Outcome measuresWe calculated incidence rates for all gastroenteritis cases per 1000 person-years at risk and per 1000 bed-days at risk. We also calculated the incidence rate of gastroenteritis outbreaks per 100 care homes per year.ResultsIn total 45 cases were reported during the surveillance period, equating to 133.7 cases per 1000 person-years at risk. In residents the incidence rate was 0.62 cases per 1000 bed-days. We observed seven outbreaks in all care homes included in surveillance, a rate of 76.4 outbreaks per 100 care homes per year. 15 stool samples were tested; three were positive for norovirus, no other pathogens were detected.ConclusionsWe found that surveillance of infectious gastroenteritis disease in care homes based on outbreaks, the current general approach, detected a majority of cases of gastroenteritis. However, if policymakers are to estimate the burden of infectious gastroenteritis in this setting using only routine outbreak surveillance data and not accounting for non-outbreak cases, this study implies that the total burden will be underestimated.

Incidence and risk factors for norovirus‐related diarrhea in Japanese geriatric intermediate care facilities: A prospective cohort study

“…The incidence rate of norovirus-related diarrhea in the present study subjects was much lower than that previously reported in a prospective cohort study at care homes in England, which found an incidence rate of 225.2 per 1000 person-years. 20 Although the incidences vary according to the study season, location and population, the difference between studies can partly be explained by the following three reasons. First, epidemics of infectious gastroenteritis in the community were low during the study seasons, 21 which would have affected our results.…”