national guidelines on the management of outbreaks of norovirus ...
national guidelines on the management of outbreaks of norovirus ...
national guidelines on the management of outbreaks of norovirus ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Nati<strong>on</strong>al Guidelines <strong>on</strong> <strong>the</strong> Management <strong>of</strong> Outbreaks <strong>of</strong> Norovirus Infecti<strong>on</strong> in Healthcare Settings NDSC<br />
A combinati<strong>on</strong> <strong>of</strong> <strong>the</strong> following criteria (Box 1) are a warning that an outbreak <strong>of</strong> illness might be due to<br />
<strong>norovirus</strong> and that immediate c<strong>on</strong>trol measures need to be put in place.<br />
Virological c<strong>on</strong>firmati<strong>on</strong> should <strong>the</strong>n be sought.<br />
3.4 Outbreak C<strong>on</strong>trol Team<br />
C<strong>on</strong>trolling suspected or established <strong>outbreaks</strong> <strong>of</strong> illness due to <strong>norovirus</strong> in hospital requires <strong>the</strong> rapid<br />
establishment <strong>of</strong> an OCT as so<strong>on</strong> as an outbreak is suspected or recognised.<br />
In any healthcare setting gastrointestinal symptoms are comm<strong>on</strong>. Determining whe<strong>the</strong>r an outbreak is<br />
occurring will involve local judgement, but <strong>the</strong> Working Group suggest that <strong>the</strong> trigger to call an outbreak<br />
should be if at least 2 or more people (patients or staff) have symptoms suggestive <strong>of</strong> <strong>norovirus</strong><br />
infecti<strong>on</strong> in a unit, ward or o<strong>the</strong>r defined area, within a period <strong>of</strong> 48 hours.<br />
In healthcare settings <strong>the</strong> c<strong>on</strong>sultant microbiologist or designated clinician or specialist in public health<br />
medicine (SPHM) should c<strong>on</strong>vene an outbreak c<strong>on</strong>trol team when:<br />
• <strong>the</strong>re are a significant number <strong>of</strong> cases or<br />
• <strong>the</strong> disease is severe or<br />
• <strong>the</strong>re is potential for spread or<br />
• <strong>the</strong> cases are in high-risk areas e.g. ICU.<br />
3.4.1 Membership <strong>of</strong> <strong>the</strong> Outbreak C<strong>on</strong>trol Team<br />
Members <strong>of</strong> this team should be invited at <strong>the</strong> outset. The compositi<strong>on</strong> <strong>of</strong> <strong>the</strong> team may vary depending <strong>on</strong><br />
<strong>the</strong> setting and <strong>the</strong> extent <strong>of</strong> <strong>the</strong> outbreak. Senior pr<strong>of</strong>essi<strong>on</strong>als from relevant disciplines/ senior decisi<strong>on</strong><br />
makers should be represented. Suggested members could include: a c<strong>on</strong>sultant microbiologist (or o<strong>the</strong>r<br />
senior medical staff member with relevant expertise in <strong>the</strong> absence <strong>of</strong> a microbiologist), an infecti<strong>on</strong> c<strong>on</strong>trol<br />
nurse, a specialist in public health medicine, a CEO/ representative, representati<strong>on</strong> <strong>of</strong> <strong>the</strong> c<strong>on</strong>sultant medical<br />
staff and n<strong>on</strong>-c<strong>on</strong>sultant hospital doctors, an envir<strong>on</strong>mental health <strong>of</strong>ficer, an occupati<strong>on</strong>al health physician, a<br />
clinical nurse manager, a domestic services manager, a communicati<strong>on</strong>s/ press <strong>of</strong>ficer and o<strong>the</strong>r relevant<br />
staff c<strong>on</strong>sidered necessary.<br />
3.4.2 Role <strong>of</strong> <strong>the</strong> Outbreak C<strong>on</strong>trol Team<br />
The role <strong>of</strong> <strong>the</strong> OCT is that <strong>of</strong> an advisory body working closely with relevant<br />
staff members to advise <strong>on</strong> and co-ordinate in <strong>the</strong> following areas:<br />
- Page 7 -<br />
Key Message<br />
The OCT should be made<br />
up <strong>of</strong> senior pr<strong>of</strong>essi<strong>on</strong>als<br />
• C<strong>on</strong>trolling <strong>the</strong> spread <strong>of</strong> infecti<strong>on</strong>.<br />
and decisi<strong>on</strong> makers<br />
• Co-ordinating <strong>the</strong> investigati<strong>on</strong> <strong>of</strong> and resp<strong>on</strong>ses to an outbreak.<br />
• Declaring an outbreak and assigning a unique outbreak code (this is<br />
generally an alpha-numeric code which identifies regi<strong>on</strong>/ hospital, year and specific outbreak).<br />
• Designating a senior member <strong>of</strong> <strong>the</strong> OCT as nominated spokespers<strong>on</strong> for <strong>the</strong> team, in communicati<strong>on</strong>s with<br />
staff and patients.<br />
• Co-ordinating how cohorting and isolati<strong>on</strong> <strong>of</strong> patients will take place.<br />
• Recommending appropriate facilities and equipment for cleaning and dec<strong>on</strong>taminati<strong>on</strong>.<br />
• Advising <strong>on</strong> ways to minimise <strong>the</strong> movement <strong>of</strong> staff into and out <strong>of</strong> <strong>the</strong> affected areas.<br />
• Undertaking epidemiological investigati<strong>on</strong> <strong>of</strong> <strong>the</strong> outbreak.<br />
• Co-ordinating investigati<strong>on</strong> <strong>of</strong> illness through effective sampling and ensuring adequate support for<br />
laboratory services.<br />
• Alerting <strong>the</strong> Nati<strong>on</strong>al Virus Reference Laboratory and NDSC <strong>of</strong> <strong>the</strong> outbreak.<br />
• Provisi<strong>on</strong> <strong>of</strong> informati<strong>on</strong> for staff, patients, visitors, media <strong>of</strong> <strong>the</strong> outbreak with alert notices/posters around<br />
<strong>the</strong> hospital, staff guidance and updates, visitor informati<strong>on</strong>.<br />
• Press releases / media briefings (via <strong>the</strong> Communicati<strong>on</strong>s Department).<br />
• Declaring <strong>the</strong> outbreak at an end.<br />
• Agreeing an Outbreak Report.