Outbreak of acute gastroenteritis among emergency department staff

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Abstract
Objectives: We attempted to examine an outbreak of acute gastroenteritis among the staff of the emergency department of Glasgow Royal Infirmary. We specifically looked at the pattern of spread among staff, the estimated hours of sick time and the practicalities of applying standard hospital guidelines for infection control within the emergency department. Methods: Anonymous questionnaires were filled in by all medical and nursing staff within the department. Results: The outbreak, considered to be caused by norovirus infection, affected 45% of staff over a 51-day period. The most commonly affected grades were staff/enrolled nurses (56%) and SHOs (58%), arguably the groups with greatest patient contact. The outbreak appeared to occur in three waves with affected staff at the start of each wave being more likely to recall contact with an infected patient than those towards the end. A total of 449.5 working hours were lost to the department through staff illness with further hours lost as staff took time to care for ill family members. Conclusion: We hypothesise that the infection was introduced from the community on several occasions and was subsequently passed among staff within the department. Infection control measures designed for the inpatient setting can be partially applied to the emergency department. We felt the most useful measures would be early identification and isolation of infectious patients, barrier nursing, escalation of cleaning of the department and early investment in replacement staff to allow ill staff members to remain isolated at home and to prevent understaffing.