Control of norovirus outbreak on a pediatric oncology unit Journal Article


Authors: Sheahan, A.; Copeland, G.; Richardson, L.; McKay, S.; Chou, A.; Babady, N. E.; Tang, Y. W.; Boulad, F.; Eagan, J.; Sepkowitz, K.; Kamboj, M.
Article Title: Control of norovirus outbreak on a pediatric oncology unit
Abstract: Background Patients undergoing treatment for cancer with chemotherapy and hematopoietic stem cell recipients are at risk for severe morbidity caused by norovirus (NV). Methods We describe a NV outbreak on the Memorial Sloan Kettering Cancer Center's pediatric oncology unit. Stool testing for diagnosis of NV was performed by real-time polymerase chain reaction (PCR). Results Twelve NV cases occurred; 7 were hospital acquired. Twenty-five health care workers reported NV compatible illness. Patient-to-patient transmission occurred once. The practices of the Centers for Disease Control and Prevention were supplemented with electronic surveillance, surrogate screening for NV, and heightened cleaning. Two additional cases occurred after implementation of interventions. Long-term shedding was detected in 2 patients. Conclusion We describe interventions for controlling NV on a pediatric oncology unit. High-risk chronic shedders pose ongoing transmission risks. PCR is a valuable diagnostic tool but may be overly sensitive. Surrogate markers to assess NV burden in stool and studies on NV screening are needed to develop guidelines for high-risk chronic shedders. © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Keywords: child; clinical article; disease marker; gene amplification; childhood cancer; high risk patient; pediatric; health care personnel; real time polymerase chain reaction; screening test; infection control; virus detection; feces analysis; disease transmission; epidemic; disease surveillance; norovirus; outbreak; molecular diagnostics; immunocompromised; norovirus infection; human; male; female; article
Journal Title: American Journal of Infection Control
Volume: 43
Issue: 10
ISSN: 0196-6553
Publisher: Elsevier Inc.  
Date Published: 2015-10-01
Start Page: 1066
End Page: 1069
Language: English
DOI: 10.1016/j.ajic.2015.05.032
PROVIDER: scopus
PUBMED: 26164767
PMCID: PMC4988230
DOI/URL:
Notes: Export Date: 2 November 2015 -- Source: Scopus
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MSK Authors
  1. Ngolela Esther Babady
    121 Babady
  2. Farid Boulad
    315 Boulad
  3. Kent A Sepkowitz
    270 Sepkowitz
  4. Alexander Ja-Ho Chou
    57 Chou
  5. Mini Kamboj
    113 Kamboj
  6. Janet A Eagan
    38 Eagan
  7. Yi-Wei Tang
    173 Tang
  8. Shelley W McKay
    2 McKay