An Outbreak of Acute Gastroenteritis Associated with Group A Rotavirus in Long-term Care Facility in Slovenia

Background: In April 2013, an outbreak of acute gastroenteritis was reported in a residential long-term care facility (LTCF) in Ljubljana. We carried out an outbreak investigation to describe the outbreak, identify factors associated with contracting infection and to recommend control measures.

Methods: We conducted descriptive epidemiology of the outbreak and a case-control study among residents; a case was a resident or staff member of the LTCF with acute diarrhoea and at least one of the following symptoms: fever, vomiting, nausea, fatigue, headache and abdominal pain between 11 and 23 April 2013. Controls had no gastrointestinal symptoms during the outbreak period. Stool specimens were tested for enteric pathogens, including Rotavirus.

Results: Of 244, 33 (13.5 %) and 4 of 106 staff (3.8 %) were affected. Twenty-eight (84.8 %; median age 85 years; range 71-95 years) among affected residents and four (100 %; median age 35 years; range 30-45 years) among affected staff were women. The main symptoms besides acute diarrhoea were fatigue (54.1 %) and nausea (45.9 %). The average duration of gastroenteritis symptoms was 3.6 days in residents and 1.3 days in staff. None of the affected persons was hospitalized. Rotavirus group A was detected in a single stool specimen. In the multivariable analysis, being ambulant (aOR = 12.3; 95 % CI: 1.14-133.1), and having more than two comorbidities (aOR = 4.7; 95 % CI: 1.14-19.0) were significantly associated with acute gastroenterocolitis.

Conclusions: Contact precautions of affected persons and controlled staff interactions between outbreak ward and unaffected ward are recommended in times of outbreak, with additional effort in targeting mobile residents and those with comorbidities.