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It certainly can be if you are a young child, pregnant, elderly or immunocompromised. Viral gastroenteritis can affect everyone. That impact can multiply at a significant rate if you operate with a ‘high foot flow’ of visitors, such as a food business, medical practitioner, childcare or aged care facility and you have a gastroenteritis outbreak.
Transmission
We’ve all been there. It starts with a gurgle. Maybe a bit of a headache and tummy cramp, and you feel generally unwell. Suddenly there’s the onset of nausea, followed by vomiting, diarrhoea, or both!
Was it something I ate? Have I been around someone sick?
Viral gastroenteritis, or ‘gastro’, is highly infectious and is spread by the vomit or faeces of an infected person through:
- contaminated food or drink,
- contaminated surfaces, or
- person-to-person contact with someone who has been sick and has the virus or spread through aerosolised particles.
Gastro is triggered by infection that causes inflammation of the lining of the digestive system. It can cause vomiting, diarrhoea, stomach pain and nausea that can last up to two weeks. Many different viruses can cause gastroenteritis, including rotavirus and norovirus.
Gastro is not usually serious, but it can lead to dehydration. Milder forms can be managed at home by drinking fluids. However, older people, young children and those with a weakened immune system are at risk of developing more serious illnesses.
Gastroenteritis is contagious. According to Queensland Health[1];
in Australia there are at least 4.1 million cases of gastro each year. On average, there are more than 230,000 cases of Campylobacter and 55,000 cases of Salmonella each year. The total annual cost to society for foodborne illness is $1.249 billion.
Hospital patients and aged care residents are more susceptible to gastroenteritis because of weaker immune systems, potential poor hand hygiene practices and a greater use of antibiotics which can strip the gastric system. Close living arrangements in these types of facilities, along with close contact with staff and visitors make them an ideal place for gastroenteritis to spread.
Managing an outbreak
It is important to be alert to a possible gastroenteritis outbreak. It is recommended that all Health Care Workers (HCWs) report all episodes of unexplained diarrhoea and/or vomiting in patients and/or HCWs to their manager promptly. This is so that cases can be appropriately monitored and managed, and an outbreak identified as early as possible.
When an outbreak is suspected, additional infection prevention control (IPC) measures should be implemented immediately to:
- limit the spread of infection
- reduce HCW absenteeism
- reduce other adverse effects or costs to the facility, patients and the community.
If you have an outbreak you need to implement your outbreak management plan as soon as possible. In the event of a gastroenteritis outbreak there are a number of precautions that will prevent the spread of infection and control the outbreak, such as [2]:
· Form an outbreak team to enable decisions, communication and development of strategies to manage the outbreak.
· Hand hygiene is the most effective way of controlling gastroenteritis pathogens. Hand hygiene must be performed before and after all patient contact. Hand hygiene should occur following contact with the affected patient’s immediate environment and following all specimen contact, regardless of whether hands are visibly soiled. If hands are visibly soiled, hand washing with soap and water is recommended.
· Standard precautions shouldbe used for ALL patients.
· Contact precautions includes wearing gloves and a plastic apron or impervious gown when having contact with the patient or the patient’s environment, especially when attending to patient toileting and hygiene. Protective eyewear and mask must beworn when there is the potential of vomit or faecal splashing. A mask should also be worn when there is the potential for aerosol dissemination.
· It is important that staff arecompetent in the correct wearing and removal of PPE to avoid inadvertently contaminating themselves. PPE should be donned before entering the affected isolation area.
· Affected (suspected orconfirmed) patients should be nursed in isolation with designated toilet/bathroom facilities, or cohorted with other affected patients. Caution is required when cohorting patients because gastroenteritis may be caused by different infectious agents.
· Once an outbreak has been identified, the cleaning of the affected area should be increased to twice daily. Particular attention should be given to environmental surfaces frequently touched such as door handles and taps.
· Used linen, whether visibly soiled or not, should not be agitated to cause the spread ofthe virus through aerosols. The laundering of linen must be consistent with Australian Standard AS/NZS 4146: LaundryPractice.
· Minimise as much as possible the circulation of staff between affected and unaffected areas. Where possible designated staff should care for affected patients.
· Staff with gastro intestinal symptoms should leave work immediately andnot return to work until 48 hours after their last episode of vomiting or diarrhoea.
· Visiting should be minimised and patients informed of the required precautions.
· Temporary closure of an affected facility or ward may be necessary to allow for adequate cleaningand disinfection after the last affected patient has recovered.
· Eating utensils, such as crockery, cutlery and food trays, should be washed and cleaned in the normal manner using hot water and detergent. No special requirements are necessary. Staff delivering or collecting food trays should wash their hands with liquid soap and running water or use alcohol based rub on leaving the patient area.
There should be regular communication of the criteria to determine the end of the outbreak. Usually the requirement is that the last affected person has been symptom free for 48 hours. Ongoing vigilance should be maintained in the event that further cases occur. If they do occur the practices outlined in this section should be recommenced. Ongoing vigilance should be maintained in the event that further cases occur. If they do occur the practices outlined in this section should be recommenced.
Educate, educate, educate
Your people need a safe and compliant place to work. Learning and compliance are fundamental to your organisation’s success. We can support you to train, induct and develop your most important asset – your people.
Achieve increased engagement and compliance by your learners, with high quality design and delivery, allowing them to learn in a way that’s tailored to them, any time, any place and on any internet enabled device, and work across all your learning and performance systems you currently use.
We provide workplace online training designed to drive behavioural change and deliver measurable impact for your business. Designed and developed in Australia our Courses offer an engaging, interactive learning experience that can help you instil the right knowledge and behaviours to manage infection control. For example:
· Hand hygiene for Healthcare Workers
· Infection Prevention and Control - The Basics
· Infection Prevention and Control - Standard Precautions
· Infection Prevention and Control - Transmission Based Precautions
· Gastroenteritis Outbreak IPC Management
Get in touch if you would like to know more.
[1] https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/foodborne/outbreaks
[2] https://www.health.nsw.gov.au/Infectious/gastroenteritis/Documents/hospital-gastro-pack.pdf
