A recent review of norovirus outbreaks in nursing homes found a correlation between outbreaks and higher rates of both hospitalizations and mortality among residents. While the correlation does not necessarily mean that the norovirus directly causes a greater number of hospitalizations or deaths, the data obtained by the study could prove useful in identifying risks faced by nursing home residents during outbreaks of communicable disease. This can in turn help nursing home administrators enact policies to protect and preserve their residents’ health and safety.
The norovirus is a highly contagious virus commonly associated with the stomach flu. It can affect anyone, regardless of age or general health condition, with symptoms ranging from stomach pain and nausea to acute gastroenteritis. People can contract an infection from other infected people, contact with contaminated surfaces, or ingestion of contaminated food or water. According to the Centers for Disease Control and Prevention (CDC), the norovirus sickens around 21 million people in the U.S. annually, and it is responsible for as many as seventy thousand hospitalizations and eight hundred fatalities per year.
The study, “Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010,” was published in the October 24/31, 2012 online edition of the Journal of the American Medical Association. The researchers reviewed records from Medicare and the CDC for a period from January 2009 through December 2010 from three states: Oregon, Pennsylvania, and Wisconsin. Their review covered 308 nursing homes, with a combined total of 407 reported outbreaks of norovirus. The norovirus outbreaks lasted a median of thirteen days. Twenty-nine percent of the total number of reported hospitalizations and seven percent of the reported deaths occurred during reported outbreaks.
Comparing hospitalization rates during outbreaks and at all other times, the researchers found that the rate increased from 109.5 hospitalizations per nursing home per year (“nursing home-year”) to 124 hospitalizations during norovirus outbreaks. The mortality rate increased from 41.9 to 53.7 nursing home-years during outbreaks. A greater availability of registered nursing care correlated with reduced mortality rates, although hospitalization rates were unaffected.
The study’s authors cautioned that they did not necessarily confirm causes of hospitalization or death during norovirus outbreaks, so the apparent increased risk of both does not in any way imply causation. While it is certainly plausible that the virus itself causes some of the additional hospital admissions and fatalities, they propose some alternative explanations. A norovirus outbreak causes significant disruption to a nursing home’s routine, with both residents and staff member suffering illness. This disruption could itself contribute to a greater incidence of both hospitalizations and deaths, as some residents may require additional care. Another possibility is that the disruption among nursing home staff could deprive residents of care they might otherwise receive, leading to the worsening of a resident’s condition even in the absence of direct infection with the norovirus.
The benefit for nursing home residents from this study may be a greater understanding of the impact of an outbreak of a single disease on all aspects of nursing home life. The disruptions caused by any sort of outbreak can affect not only those who directly fall ill, but those whose needs may be unwittingly neglected as a result. At Lebowitz and Mzhen, we defend the rights of Maryland seniors who have suffered injury because of nursing home abuse or neglect. To schedule a free and confidential consultation, contact us today online or at (800) 654-1949.
More Blog Posts:
New Methods Available to Help Nursing Home Staff Track Life-Threatening Infections, Maryland Nursing Home Lawyer Blog, October 17, 2012
Flu Vaccination of Nursing Home Staff Linked to Decline in Patient Flu Outbreaks, Maryland Nursing Home Lawyer Blog, September 14, 2011
Nursing Home Sued for Wrongful Death After Resident Dies from Sepsis, Dehydration, Maryland Nursing Home Lawyer Blog, February 7, 2011
Photo credit: ‘Norovirus 4’ by GrahamColm at en.wikipedia [GFDL or CC-BY-3.0], from Wikimedia Commons.