Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis. Issue 2 (1st February 2022)

• Record Type: Journal Article
• Authors: Adams, Carly; Peterson, Shenita R; Hall, Aron J; Parashar, Umesh; Lopman, Benjamin A
• Is Part Of: Expert review of anti-infective therapy. Volume 20:Issue 2(2022)
• Page Start: 279
• Page End: 290
• Publication Date: 2022-02-01
• Subjects: Control measures -- gastrointestinal infection -- healthcare -- hospitals -- infection control -- long-term care facilities -- meta-analysis -- norovirus -- outbreaks -- systematic review; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2021.1949985
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Background: Although most norovirus outbreaks in high-income countries occur in healthcare facilities, information on associations between control measures and outbreak outcomes in these settings is lacking. Methods: We conducted a systematic review/meta-analysis to assess associations between norovirus outbreak control measures and outcomes in hospitals and long-term care facilities (LTCFs), globally. Using regression analyses stratified by setting (hospital/LTCF), we compared durations, attack rates, and case counts for outbreaks in which control measures were reportedly implemented to those in which they were not. Results: We identified 102 papers describing 162 norovirus outbreaks. Control measures were reportedly implemented in 118 (73%) outbreaks and were associated with 0.6 (95% CI: 0.3–1.1) times smaller patient case counts and 0.7 (95% CI: 0.4, 1.0) times shorter durations in hospitals but 1.5 (95% CI: 1.1-2.2), 1.5 (95% CI: 1.0–2.1) and 1.6 (95% CI: 1.0–2.6) times larger overall, resident and staff case counts, respectively, and 1.4 (95% CI: 1.0–2.0) times longer durations in LTCFs. Conclusions: Reported implementation of control measures was associated with smaller/shorter outbreaks in hospitals but larger/longer outbreaks in LTCFs. Control measures were likely implemented in response to larger/longer outbreaks in LTCFs, rather than causing them. Prospective observational or intervention studies are needed to determine effectiveness.