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To close or not to close? Analysis of 4 year's data from national surveillance of norovirus outbreaks in hospitals in England

Lookup NU author(s): Professor Sarah O'Brien



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Objective: To assess the impact of ward or bay closures, specifically, whether prompt closure of an affected ward shortens the duration of norovirus outbreaks and the resulting disruption in hospitals. Design: Analysis of summary data from hospitals on outbreaks of norovirus from 2009 to 2012. Methods: Using a large outbreak surveillance dataset, we examined the duration of outbreaks, duration of disruption, ward closures, the number of patients and staff affected and the number of lost bed-days, as functions of the timing of closure. We conducted Quasi-Poisson regression analyses to assess the effect of ward closure (timing of closure) on outcome measures, controlling for time of year (winter or summer), ward size and ward type (elderly care wards). Results: Regression analysis indicates that after controlling for season ward size and type, the duration of outbreak and duration of disruption were shorter, fewer patients were affected by the time of closure and fewer patients were affected overall, when closure occurred promptly (within 3 days of the first case becoming ill) compared with non-prompt closure groups. However, in outbreaks where wards were not closed, the length of outbreaks were similar to the prompt closure group and also had fewer patients and staff affected and fewer cases per day of outbreak compared with prompt closure. Conclusions: Closing a bay or ward promptly in an outbreak of norovirus leads to a shorter duration of outbreaks, a shorter duration of disruption and fewer patients being affected compared with outbreaks where wards were not promptly closed. However, the interpretation of these results is not straightforward. The outbreaks where the ward was not closed at all have similar characteristics in terms of the duration of outbreak and fewer people were affected compared with the baseline prompt closure group.

Publication metadata

Author(s): Harris JP, Adak GK, O'Brien SJ

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2014

Volume: 4

Issue: 1

Online publication date: 09/01/2014

Acceptance date: 06/12/2013

Date deposited: 22/08/2019

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2013-003919

PubMed id: 24413345


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