Abstract
BackgroundOutbreaks of norovirus infection can have detrimental impacts on long-term care facilities. This study investigated the incidence, clinical picture, treatment and resource use of norovirus gastroenteritis in long-term care facilities.MethodsNineteen facilities in Osaka and Kyoto, Japan participated in questionnaire surveys conducted between 2009 and 2011 regarding the incidence of norovirus gastroenteritis. From clinical charts, the characteristics, symptoms, and treatment of infected residents were analyzed. Total drug cost per infected resident was calculated by multiplying the unit price for each drug by the daily dose and the number of days administered and summing the costs for each drug (USD 1 = JPY 100).ResultsOver the 3-year period, 8 outbreaks of norovirus gastroenteritis occurred in 6 facilities. The mean clinical course of 107 infected residents in five facilities that granted permission to examine patients’ medical records was 4 days, with all but one resident presenting with vomiting and/or diarrhea, and 84 (79%) also presenting with associated symptoms. Of 107 infected residents, 72 (67%) were isolated. The proportion of infected residents isolated varied from 50 to 100% depending on the facility. Of the infected residents, 81 (76%) received some type of medication, the most common being infusion (67 patients, 63%) and antibiotics (30 patients, 28%). The median total cost of all drugs administered was USD 4.4, and the median drug cost per infected resident per day was USD 2.0. Total drug cost over the entire treatment period was the highest for antibiotics, at USD 8.6.ConclusionClinical course was similar to those of norovirus cases examined at other long-term care facilities. The majority of infected residents received some type of medication. Although the economic burden was not large, not a few infected residents were given antibiotics, which are ineffective for norovirus.
Highlights
Outbreaks of norovirus infection can have detrimental impacts on long-term care facilities
This study aimed to clarify the incidence, clinical picture, treatment, and medical resource useassociated with Norovirus gastroenteritis (NG) in longterm care facilities (LTCFs) in Japan
For Survey I, letters were written in October, 2011 to facilities belonging to the Osaka and Kyoto branches of the Japan Association of Geriatric Health Service Facilities (JAGHSF) requesting their participation in this study
Summary
Outbreaks of norovirus infection can have detrimental impacts on long-term care facilities. This study investigated the incidence, clinical picture, treatment and resource use of norovirus gastroenteritis in long-term care facilities. Norovirus gastroenteritis (NG) is one of the infectious diseases of greatest concern for elderly residents of longterm care facilities (LTCFs). The majority of infected individuals recover within 3 days, NG can be fatal in elderly persons. In the United States, there are approximately 20 million cases of acute gastroenteritis each year, with the majority occurring in LTCFs [1, 3]. In Japan, the number of patients infected with NG each year ranges between 10,000 and 15,000. Cases first appear and start to increase in number in October, peaking in January of the following year and decreasing in March [4]. In Japan, NG outbreaks occur most frequently in nurseries, restaurants, and facilities [5]
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