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Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study

BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A...

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Autores principales: Eriksen, Hanne M, Guerin, Philippe J, Nygård, Karin, Hjertqvist, Marika, de Jong, Birgitta, Rose, Angela MC, Kuusi, Markku, Durr, Ulrike, Rojas, AG, Mør, Cato, Aavitsland, Preben
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC529448/
https://www.ncbi.nlm.nih.gov/pubmed/15511300
http://dx.doi.org/10.1186/1471-2334-4-45
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author Eriksen, Hanne M
Guerin, Philippe J
Nygård, Karin
Hjertqvist, Marika
de Jong, Birgitta
Rose, Angela MC
Kuusi, Markku
Durr, Ulrike
Rojas, AG
Mør, Cato
Aavitsland, Preben
author_facet Eriksen, Hanne M
Guerin, Philippe J
Nygård, Karin
Hjertqvist, Marika
de Jong, Birgitta
Rose, Angela MC
Kuusi, Markku
Durr, Ulrike
Rojas, AG
Mør, Cato
Aavitsland, Preben
author_sort Eriksen, Hanne M
collection PubMed
description BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms.
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spelling pubmed-5294482004-11-21 Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study Eriksen, Hanne M Guerin, Philippe J Nygård, Karin Hjertqvist, Marika de Jong, Birgitta Rose, Angela MC Kuusi, Markku Durr, Ulrike Rojas, AG Mør, Cato Aavitsland, Preben BMC Infect Dis Research Article BACKGROUND: Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. METHODS: A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. RESULTS: Altogether 41% (48/116) of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids). During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1) and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1) than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. CONCLUSIONS: We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last symptoms. BioMed Central 2004-10-29 /pmc/articles/PMC529448/ /pubmed/15511300 http://dx.doi.org/10.1186/1471-2334-4-45 Text en Copyright © 2004 Eriksen et al; licensee BioMed Central Ltd.
spellingShingle Research Article
Eriksen, Hanne M
Guerin, Philippe J
Nygård, Karin
Hjertqvist, Marika
de Jong, Birgitta
Rose, Angela MC
Kuusi, Markku
Durr, Ulrike
Rojas, AG
Mør, Cato
Aavitsland, Preben
Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title_full Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title_fullStr Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title_full_unstemmed Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title_short Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study
title_sort gastro-enteritis outbreak among nordic patients with psoriasis in a health centre in gran canaria, spain: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC529448/
https://www.ncbi.nlm.nih.gov/pubmed/15511300
http://dx.doi.org/10.1186/1471-2334-4-45
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