Risk groups for clinical complications of norovirus infections: an outbreak investigation.

2.50
Hdl Handle:
http://hdl.handle.net/10029/8371
Title:
Risk groups for clinical complications of norovirus infections: an outbreak investigation.
Authors:
Mattner, F; Sohr, D; Heim, A; Gastmeier, P; Vennema, H; Koopmans, M
Abstract:
Norovirus infections have been described as self-limiting diseases of short duration. An investigation of a norovirus outbreak in a university hospital provided evidence for severe clinical features in patients with several underlying diseases. Clinical outcomes of norovirus infection were defined. Risk-factor analysis targeting underlying diseases and medication was performed using multivariate analyses. In five outbreak wards, 84 patients and 60 nurses were infected (an overall attack rate of 32% in patients, and 76% in nurses). The causative agent was the new variant Grimsby virus. Severe clinical features, including acute renal failure, arrhythmia and signs of acute graft organ rejection in renal transplant patients, were observed in seven (8.3%) patients. In multivariate analyses, cardiovascular disease (OR 17.1, 95% CI 2.17-403) and renal transplant (OR 13.0, 95% CI 1.63-281) were risk-factors for a potassium decrease of >20%. Age >65 years (OR 11.6, 95% CI 1.89-224) was a risk-factor for diarrhoea lasting >2 days. Immunosuppression (OR 5.7, 95% CI 1.78-20.1) was a risk-factor for a creatinine increase of >10%. Norovirus infections in patients with underlying conditions such as cardiovascular disease, renal transplant and immunosuppressive therapy may lead to severe consequences typified by decreased potassium levels, increased levels of C-reactive protein and creatine phosphokinase. In the elderly, norovirus infection may lead to an increased duration of diarrhoea. Therefore patients at risk should be hospitalised early and monitored frequently. Strict preventional measures should be implemented as early as possible to minimise the risk of nosocomial outbreaks.
Citation:
Clin. Microbiol. Infect. 2006, 12(1):69-74
Issue Date:
1-Jan-2006
URI:
http://hdl.handle.net/10029/8371
DOI:
10.1111/j.1469-0691.2005.01299.x
PubMed ID:
16460549
Type:
Article
Language:
en
ISSN:
1198-743X
Appears in Collections:
Infectious Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorMattner, F-
dc.contributor.authorSohr, D-
dc.contributor.authorHeim, A-
dc.contributor.authorGastmeier, P-
dc.contributor.authorVennema, H-
dc.contributor.authorKoopmans, M-
dc.date.accessioned2007-02-14T09:53:29Z-
dc.date.available2007-02-14T09:53:29Z-
dc.date.issued2006-01-01-
dc.identifier.citationClin. Microbiol. Infect. 2006, 12(1):69-74en
dc.identifier.issn1198-743X-
dc.identifier.pmid16460549-
dc.identifier.doi10.1111/j.1469-0691.2005.01299.x-
dc.identifier.urihttp://hdl.handle.net/10029/8371-
dc.description.abstractNorovirus infections have been described as self-limiting diseases of short duration. An investigation of a norovirus outbreak in a university hospital provided evidence for severe clinical features in patients with several underlying diseases. Clinical outcomes of norovirus infection were defined. Risk-factor analysis targeting underlying diseases and medication was performed using multivariate analyses. In five outbreak wards, 84 patients and 60 nurses were infected (an overall attack rate of 32% in patients, and 76% in nurses). The causative agent was the new variant Grimsby virus. Severe clinical features, including acute renal failure, arrhythmia and signs of acute graft organ rejection in renal transplant patients, were observed in seven (8.3%) patients. In multivariate analyses, cardiovascular disease (OR 17.1, 95% CI 2.17-403) and renal transplant (OR 13.0, 95% CI 1.63-281) were risk-factors for a potassium decrease of >20%. Age >65 years (OR 11.6, 95% CI 1.89-224) was a risk-factor for diarrhoea lasting >2 days. Immunosuppression (OR 5.7, 95% CI 1.78-20.1) was a risk-factor for a creatinine increase of >10%. Norovirus infections in patients with underlying conditions such as cardiovascular disease, renal transplant and immunosuppressive therapy may lead to severe consequences typified by decreased potassium levels, increased levels of C-reactive protein and creatine phosphokinase. In the elderly, norovirus infection may lead to an increased duration of diarrhoea. Therefore patients at risk should be hospitalised early and monitored frequently. Strict preventional measures should be implemented as early as possible to minimise the risk of nosocomial outbreaks.en
dc.format.extent87945 bytes-
dc.format.mimetypeapplication/pdf-
dc.language.isoenen
dc.titleRisk groups for clinical complications of norovirus infections: an outbreak investigation.en
dc.typeArticleen
dc.format.digYES-

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