Guidelines for investigating gastroenteritis outbreaks in long-term care facilities and hospitals
Mandatory Outbreak Reporting
Long term care facilities (LTCFs) and hospitals are required
to report gastroenteritis outbreaks to the local health authority under OAR 333-018.0000
. Local health authorities are empowered to investigate such outbreaks under OAR 333-019.0000.
Local health authorities need to report gastroenteritis outbreaks to the state communicable disease epidemiology program (971-673-1111) within 24 hours of receiving an outbreak report (Outbreak Investigation Expectations, 2012).
- Acute gastroenteritis (AGE): acute-onset vomiting, diarrhea, or both without another apparent cause.
- AGE outbreaks in LTCFs and hospitals:
- general definition: an "unusual" number of patients, residents or employees with AGE clustered by time and place
- working definition: two or more patients, residents or employees in the same LTCF or on the same hospital unit with AGE onset dates within 96 hours of each other (two incubation periods of most gastroenteritis agents) of each other
- lab-confirmed AGE outbreak: 2+ stool samples that test positive for the same pathogen
- "unexplained" AGE outbreak: 4+ stool samples that test negative for any pathogen (all unexplained AGE outbreaks will now be tested for sapovirus, a Calicivirus similar to norovirus)
- Collect up to 5 stool samples until the etiologic agent is laboratory-confirmed with >2 positive samples or until >4 samples are negative. Stool samples collected by LTCFs and hospitals and tested at commercial laboratories count toward the five-stool target.
- Follow: The Stool Sample Kit: Instructions for [Local Health] Staff.
- Order "Enteric Outbreak Stool Sample Kits" (AKA "It Kits") from the state public health lab. Consider arranging for LTCFs and hospitals to stock up on "It Kits" before they have outbreaks.
Data Collection and Basic Descriptive Epidemiology