CDC Releases Guidelines for Controlling Norovirus Gastroenteritis Outbreaks

The Centers for Disease Control and Prevention has released "Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings."

The authors studied the scientific literature on norovirus gastroenteritis to develop recommendations for implementation, performance measurement and surveillance for initiatives to prevent and control norovirus gastroenteritis in healthcare settings.

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The document includes 51 recommendations organized into 12 categories:

1. Patient cohorting and isolation precautions.
2. Hand hygiene.
3. Patient transfer and ward closure.
4. Indirect patient care staff-food handlers in healthcare
5. Diagnostics.
6. Personal protective equipment.
7. Environmental cleaning.
8. Staff leave and policy.
9. Visitors.
10. Education.
11. Active case-finding.
12. Communication and notification.

Recommendations were also categorized by the strength of the recommendation and its supporting evidence. Category IA recommendations are strong recommendations supported by high- to moderate- quality evidence suggesting net clinical benefits or harms. For example, the CDC makes a category IA recommendation that in the absence of clinical laboratory diagnostics on in the case of a delay in obtaining lab results, use Kaplan's clinical and epidemiologic criteria to identify a norovirus gastroenteritis outbreak.   

Category IB recommendations are strong recommendations supported by low-quality evidence suggesting net clinical benefits or harms, or accepted practices supported by low- to very low-quality evidence. Category IC recommendations include strong recommendations required by state or federal regulations and Category II recommendations include weak recommendations supported by any quality evidence suggesting a tradeoff between clinical benefits and harms. The authors also recommend areas for further research, encompassing unresolved issues that have very low-quality evidence with uncertain tradeoffs between benefits and harms.

Read the CDC's "Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings" (pdf).

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