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Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results

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



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


Objectives: To estimate the incidence of gastroenteritis in individuals in care homes. Design: Prospective cohort study. Setting: Five participating care homes in North West England, UK. Participants: Residents and staff present at the five study care homes between 15 August 2017 and 30 May 2019 (n=268). Outcome measures: We calculated incidence rates for all gastroenteritis cases per 1000 person-years at risk and per 1000 bed-days at risk. We also calculated the incidence rate of gastroenteritis outbreaks per 100 care homes per year. Results: In total 45 cases were reported during the surveillance period, equating to 133.7 cases per 1000 person-years at risk. In residents the incidence rate was 0.62 cases per 1000 bed-days. We observed seven outbreaks in all care homes included in surveillance, a rate of 76.4 outbreaks per 100 care homes per year. 15 stool samples were tested; three were positive for norovirus, no other pathogens were detected. Conclusions: We found that surveillance of infectious gastroenteritis disease in care homes based on outbreaks, the current general approach, detected a majority of cases of gastroenteritis. However, if policymakers are to estimate the burden of infectious gastroenteritis in this setting using only routine outbreak surveillance data and not accounting for non-outbreak cases, this study implies that the total burden will be underestimated.

Publication metadata

Author(s): Inns T, Pulawska-Czub A, Harris JP, Vivancos R, Beeching NJ, Iturriza-Gomara M, O'Brien SJ

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2019

Volume: 9

Issue: 12

Online publication date: 08/12/2019

Acceptance date: 21/11/2019

Date deposited: 25/06/2021

ISSN (electronic): 2044-6055

Publisher: BMJ Group


DOI: 10.1136/bmjopen-2019-033239

PubMed id: 31818842


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