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

Inns, Thomas, Pulawska-Czub, Anna, Harris, John P, Vivancos, Roberto, Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791, Iturriza-Gomara, Miren and O'Brien, Sarah J (2019) 'Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results'. BMJ Open, Vol 9, Issue 12, e033239.

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Abstract

Objectives To estimate the incidence of gastroenteritis in individuals in care homes.

Design Prospective cohort study.

Setting Five participating care homes in North West England, UK.

Participants Residents and staff present at the five study care homes between 15 August 2017 and 30 May 2019 (n=268).

Outcome measures We 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.

Results In 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.

Conclusions We 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.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WA Public Health > WA 4 Works on general hygiene WI Digestive System > WI 100 General works WT Geriatrics. Chronic Disease > Geriatrics > WT 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2019-033239
Depositing User:	Stacy Murtagh
Date Deposited:	15 Jan 2020 12:27
Last Modified:	15 Jan 2020 12:27
URI:	https://archive.lstmed.ac.uk/id/eprint/13531

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