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

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).Ou...

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Main Authors: Roberto Vivancos, Miren Iturriza-Gómara, Thomas Inns, Anna Pulawska-Czub, John P Harris, Nicholas J Beeching, Sarah J O'Brien
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e033239.full
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author Roberto Vivancos
Miren Iturriza-Gómara
Thomas Inns
Anna Pulawska-Czub
John P Harris
Nicholas J Beeching
Sarah J O'Brien
author_facet Roberto Vivancos
Miren Iturriza-Gómara
Thomas Inns
Anna Pulawska-Czub
John P Harris
Nicholas J Beeching
Sarah J O'Brien
author_sort Roberto Vivancos
collection DOAJ
description 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.
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spelling doaj-art-a49138605ec0469eb4345967bc86daed2025-08-20T02:38:35ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-033239Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological resultsRoberto Vivancos0Miren Iturriza-Gómara1Thomas Inns2Anna Pulawska-Czub3John P Harris4Nicholas J Beeching5Sarah J O'Brien6Health Protection Unit in Emerging and Zoonotic Infections & in GI Infections, NIHR, London, UKNIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK1 Institute of Population Health Sciences, University of Liverpool, Liverpool, UK2 NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK1 Institute of Population Health Sciences, University of Liverpool, Liverpool, UK2 NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK2 NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UKObjectives 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.https://bmjopen.bmj.com/content/9/12/e033239.full
spellingShingle Roberto Vivancos
Miren Iturriza-Gómara
Thomas Inns
Anna Pulawska-Czub
John P Harris
Nicholas J Beeching
Sarah J O'Brien
Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
BMJ Open
title Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
title_full Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
title_fullStr Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
title_full_unstemmed Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
title_short Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results
title_sort prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes epidemiological results
url https://bmjopen.bmj.com/content/9/12/e033239.full
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