Stomach Flu Can Be Fatal in Nursing Homes

Norovirus leads to hospitalization and death in nursing homes

(RxWiki News) An outbreak of stomach flu can spread quickly in nursing homes, where older adults live in close quarters. It's an illness to be taken seriously, but how dangerous is it?

According to a new study, a substantial number of nursing home residents are hospitalized and die during outbreaks of norovirus gastroenteritis, the medical name for a type of stomach flu.

These outbreaks are relatively common, and might be avoided with more attentive care for residents.

"Stomach flu is dangerous - seek help."

The study was led by Tarak K. Trivedi, a fourth year medical student at the University of Chicago Pritzker School of Medicine. Along with his colleagues, he investigated over 300 Medicare-certified nursing homes for data on outbreaks of norovirus gastroenteritis.

The illness is a big concern in nursing homes. Elderly people are more likely to develop a severe and possibly life-threatening illness, compared to younger adults.

The virus is extremely contagious, and spreads easily from person to person. There are many possible sources for the virus: Contaminated food, beverages, or surfaces could be ground zero for an outbreak.

Anyone can get infected. You'll probably experience norovirus gastroenteritis several times in your life, but the symptoms can be more severe and even fatal for young children and older adults.

Norovirus inflames the stomach and intestines. It causes diarrhea, vomiting, stomach pain and cramps, and you can easily become dehydrated.

Most people get better within one to three days. But when the illness turns violent you might require hospitalization.

In Trivedi's study, data on resident hospitalizations and mortality during norovirus outbreaks were compared to non-outbreak periods, when residents might have been hospitalized or died for different reasons.

They found that the rates of hospitalizations and deaths were significantly increased during norovirus outbreaks. Most of the hospitalizations occurred within the first two weeks of the outbreak's start.

The study authors wrote, “Overall, we estimated 101 excess hospitalizations and 45 excess deaths during norovirus outbreaks annually in these 3 states, which account for only 8% of the 15,884 homes nationwide.”

That means that they think those excess hospitalizations and deaths can be attributed to the spread of norovirus during that time.

But the number of hours that registered nurses (RNs) were staffed made a difference from nursing home to nursing home.

Nursing homes with a low number of daily RN hours per resident (less than an hour a day) had more hospitalizations and deaths during norovirus outbreaks than non-outbreak periods, while homes with a high number of daily RN hours showed no significant increase of deaths by the same measure.

Right now, the only way to prevent becoming infected norovirus is through handwashing and avoiding contact with infected people. A vaccine may be on the horizon, which would be a welcome development for vulnerable people in nursing homes.

The authors conclude that “the 20% to 30% increase in risk of death and hospitalization during outbreaks among individuals who are older than 90 years suggests that this is a particularly high-risk population that warrants closer attention during outbreaks, possibly requiring earlier transport to the hospital.”

The study was presented at IDWeek, a conference on infectious diseases, and published online by the Journal of the American Medical Association in October 2012.

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Review Date: 
October 21, 2012