Norwalk virus: 'Cruise ship' illness challenging and costly to hosp...( A review of measures taken to addre...),Health

A review of measures taken to address a 2004 outbreak of the highly infectious Norwalk virus at The Johns Hopkins Hospital has provided the first solid documentation of expenses and efforts in the United States to stop the infection from spreading among patients, staff and visitors. Total hospital costs for the three-month outbreak - including extra cleaning supplies, staff sick leave, diagnostic tests, replacement staff, and salaries and lost revenue from closed beds - were estimated at more than $650,000.

The outbreak at The Johns Hopkins Hospital (JHH) was one of at least 24 at Maryland hospitals during the first half of 2004. Norwalk virus is highly contagious because only small amounts, as few as 10 to 100 viral particles, can lead to infection. It is spread or passed from person to person through fecal matter when people fail to wash their hands properly after using the bathroom and when people touch or share handling of the same objects, such as doorknobs.

We hope our approach will help other hospitals prepare for or manage an outbreak, says Cecilia Johnston, M.D., an instructor at Hopkins in infectious diseases who led the investigation.

Outbreaks need to be identified quickly and dealt with immediately, and relying on standard infection control procedures is not adequate, she adds. It may be necessary to close the infected units, isolate the infection source, get strict on hand hygiene, conduct a thorough washing down of units, and keep repeating these steps until the outbreak is stopped. Health care workers especially need to be vigilant about these steps because they are the group primarily affected by outbreaks.

Reporting in the Sept. 1 edition of the journal Clinical Infectious Disease, Johnston and her team of Hopkins patient safety experts describe how an outbreak spread among 265 health care workers and 90 patients between February and May 2004.

No one at Hopkins died from their infect
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