333154
Houston's January 2015 Norovirus Outbreaks
Stephen Long, MD, MPH; Alan Timme, MPH; Okey Akwari, MPH; Brenda Thorne, MS; Marcia Wolverton, MPH; Raouf Arafat, MD, MPH
Houston Department of Health and Human Services (HDHHS)
Background: In January 2015, the Houston Department of Health and Human Services (HDHHS), Bureau of Epidemiology (BOE) investigated three norovirus outbreaks reported within a 24 hour period at different locations affecting diverse groups of individuals. Norovirus is a contagious virus and can spread through contaminated food or water, or by touching contaminated surfaces. The most common symptoms are abdominal pain, nausea, vomiting and diarrhea.
Methods: In addition to routine case investigations the HDHHS investigates Bureau of Consumer Health (BCH) complaints and BOE phone complaints. To obtain a composite picture of an outbreak situation and to identify the cause of the disease epidemiologists conduct site visits and interview key personnel at the facilities. To understand the cause of the outbreak, stool specimens from affected individuals are tested. Data is compiled to determine the demographics, hospitalizations status and severity of the outbreak. Preventive measures are emphasized to contain an outbreak situation.
Results: The three norovirus outbreak results by sites, age, gender and symptoms are:
1) Assisted living facility: 7% were 24-49 years old, 7% were 50-64 years old and 86% were 65+ years old. The gender distribution was 93% females; 7% males. 86% had diarrheal symptoms.
2) Movie theatre: 73% were 20-49 years old and 22% were 50-74 years old; 5% were unknown. Gender distribution was 51% were females and 47% were males. Fifty-two percent had diarrheal symptoms.
3) Children’s birthday party venue: 29% belonged to the age group 1-4 years old, 21% to 5-9 years old, 4% to 10-19 years old. Among adults 32% were 20-49 years old, 7% were 50-74 years old and 7% were unknown. Gender distribution was 61% were females and 39% males. Fifty-seven percent had diarrheal symptoms.
Stool specimens from individuals affected at the three locations were positive for norovirus G II.
Conclusions: Currently there are no vaccines or drugs to treat norovirus. Seniors at assisted living silently endure the brunt of norovirus outbreaks, a call for enhanced preventive measures are essential with the era of baby boomers.
Limitations: Numerous norovirus cases may remain undetected among the population; its accurate incidence may remain unknown.
Learning Areas:
EpidemiologyImplementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Learning Objectives:
Demonstrate the need for the treatment of norovirus.
Explain how norovirus affects a wide range of population in various settings. Discuss the methods to investigate and contain norovirus outbreaks in various settings.
Keyword(s): Epidemiology, Surveillance
Qualified on the content I am responsible for because: I am an epidemiologist at the Houston department of health and human services and I investigated the outbreaks. The proposal is my venture.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.