Download PDF
Der Klinikarzt 2009; 38(4): 182-186
DOI: 10.1055/s-0029-1223263
Schwerpunkt

© Georg Thieme Verlag Stuttgart · New York

Prävention und Ausbruchmanagement bei Auftreten von Norovirusinfektionen – Hygienemaßnahmen zur Infektionskontrolle im Krankenhaus

Prevention and outbreak management of norovirus infections – Implementation of hygiene in hospitals to control the infectionsAxel Kramer1 , Nils–Olaf Hübner1 , Jochen Steinmann1 , Claus Bartels1 , Markus Lerch1
  • 1Institut für Hygiene und Umweltmedizin, Ernst–Moritz–Arndt–Universität Greifswald (Leitung: Prof. Dr. med. Axel Kramer)
Further Information

Publication History

Publication Date:
30 April 2009 (online)

Also available at
    Permissions and Reprints

Das humane Norovirus, früher Norwalk–like–Virus genannt, ist die häufigste Ursache für infektiöse Durchfallerkrankungen in vielen westlichen Ländern. Im Zusammenwirken von innerbetrieblichen Sofortmeldesystemen und strenger Kontaktisolierung, Umstellung der Hände– und Flächendesinfektion auf Desinfektionsmittel mit nachgewiesener Wirksamkeit gegen Noroviren sowie konsequentem Verhalten von Personal und Patienten (Schwarz–Weiß–Trennung) ist es möglich, Ausbrüche, die vor allem über die Hand (direkt und via Flächen) mit hoch dynamischer Ausbreitungstendenz ablaufen, nach Auftreten erster Verdachtsfälle zu verhindern.

Human norovirus, previously named Norwalk–like virus, is the most common cause of infectious diarrhea in many Western countries. Co–ordination of an in–house early warning system with strict contact isolation of affected patients, the use of disinfectants with definite activiry against norovirus, as well as training of personnel, must be implemented. Only these co–ordinated measures can prevent outbreaks via hand and surface contamination after a patient with suspected norovirus infection has been admitted. Without these measures a rapid spread to staff and other patients is bound to occur.

Key words

norovirus infection - epidemiology - prevention - outbreak management - disinfection - isolation

Literatur

  • 1 Armbrust S, Kramer A, Olbertz D. et al. .Norovirus infections in preterm infants: wide variety of clinical courses. BMC Research Notes, accepted
    Google Scholar
  • 2 Belliot G, Lavaux A, Souihel D. et al. . Use of murine norovirus as a surrogate to evaluate resistance of human norovirus to disinfectants.  Appl Environ Microbiol. 2008;  74 3315-3318
    CrossrefPubMedGoogle Scholar
  • 3 Chadwick PR, Beards G, Brown D. et al. . Management of hospital outbreaks of gastro–enteritis due to small roundstructured viruses.  J Hosp Inf. 2000;  45 1-10
    PubMedGoogle Scholar
  • 4 Cheng FW, Leung TF, Lai RW. et al. . Rapid control of norovirus gastroenteritis outbreak in an acute paediatric ward.  Acta Paediatr. 2006;  95 581-586
    CrossrefPubMedGoogle Scholar
  • 5 Doultree JC, Druce JD, Birch CJ. et al. . Inactivation of feline calicivirus, a Norwalk virus surrogate.  J Hosp Inf. 1999;  41 51-57
    CrossrefPubMedGoogle Scholar
  • 6 Gehrke C, Steinmann J, Goroncy–Bermes P.. Inactivation of feline calicivirus, a surrogate of norovirus (formerly Norwalk–like viruses), by different types of alcohol in vitro and in vivo.  J Hosp Inf. 2004;  56 49-55
    PubMedGoogle Scholar
  • 7 Hewitt J, Bell D, Simmons GC. et al. . Gastroenteritis outbreak caused by waterborne norovirus at a New Zealand ski resort.  Appl Environ Microbiol. 2007;  73 7853-7857
    CrossrefPubMedGoogle Scholar
  • 8 Jiang X, Wang M, Wang K, Estes MK.. Sequence and genomic organization of Norwalk virus.  Virology. 1993;  195 51-61
    CrossrefPubMedGoogle Scholar
  • 9 Kampf G, Grotheer D, Steinmann J.. Efficacy of three ethanol–based hand rubs against feline calicivirus, a surrogate virus for norovirus.  J Hosp Infect. 2005;  60 144-149
    CrossrefPubMedGoogle Scholar
  • 10 Karst SM, Wobus CE, Lay M. et al. . STAT1–dependent innate immunity to a Norwalk–like virus.  Science. 2003;  299 1575-1578
    CrossrefPubMedGoogle Scholar
  • 11 Khanna N, Goldenberger D, Graber P. et al. . Gastroenteritis outbreak with norovirus in a Swiss university hospital with a newly identified virus strain.  J Hosp Inf. 2003;  55 131-136
    CrossrefPubMedGoogle Scholar
  • 12 Kramer A, Galabov AS, Sattar SA. et al. . Virucidal activity of a new hand disinfectant with reduced ethanol content: comparison with other alcohol–based formulations.  J Hosp Infect. 2006;  62 98-106
    CrossrefPubMedGoogle Scholar
  • 13 Lages SLS, Ramakrishnan MA, Goyal SM.. In–vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus.  J Hosp Inf. 2008;  68 159-163
    CrossrefPubMedGoogle Scholar
  • 14 Marks PJ, Vipond IB, Carlisle D. et al. . Evidence for airborne transmission of Norwalk–like virus (NLV) in a hotel restaurant.  Epidemiol Infect. 2000;  124 481-487
    CrossrefPubMedGoogle Scholar
  • 15 Mattison K, Shukla A, Cook A. et al. . Human noroviruses in swine and cattle.  Emerg Infect Dis. 2007;  13 1184-1188
    PubMedGoogle Scholar
  • 16 Mattison K, Karthikeyan K, Abebe M. et al. .Survival of calicivirus in foods and on surfaces: experiments with feline calicivirus as a surrogate for norovirus. J Food Prot 2007a 70: 500-503
    Google Scholar
  • 17 Pang XL, Joensuu J, Vesikari T.. Human calicivirus–associated sporadic gastroenteritis in Finnish children less than two years of age followed prospectively during a rotavirus vaccine trial.  Paediatr Infect Dis J. 1999;  18 420-426
    PubMedGoogle Scholar
  • 18 Poschetto LF, Ike A, Papp T. et al. . Comparison of the sensitivities of noroviruses and feline calicivirus to chemical disinfection under field–like conditions.  Appl Environ Microbiol. 2007;  73 5494-5500
    CrossrefPubMedGoogle Scholar
  • 19 RKI. . Information zum Management von Ausbrüchen durch Norwalk–like Viren.  Epidemiol Bull. 2002;  47 396-397
    PubMedGoogle Scholar
  • 20 RKI. .Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2007.  www.rki.de/DE/Content/Infekt/Jahrbuch/Jahrbuch2007.html
    Google Scholar
  • 21 Steinmann J.. Expert's investigation report: FCV efficacy of Desderman N. Mikrolab GmbH Bremen, 16.8. FCV efficacy of Terralin.  Bremen. 09;  09 2002
    PubMedGoogle Scholar
  • 22 Steinmann J, Becker B, Bischoff B. et al. . Das murine Norovirus – ein neues Surrogatvirus für die humanen Noroviren.  Hyg Med. 2008;  33 136-140
    PubMedGoogle Scholar
  • 23 Turcios–Ruiz RM, Axelrod P, St K John. et al. . Outbreak of necrotizing enterocolitis caused by norovirus in a neonatal intensive care unit.  J Pediatr. 2008;  153 339-344
    PubMedGoogle Scholar
  • 24 Wunderle W, Vogel C.. Bericht über einen Ausbruch durch Norwalk–like–Viren in einem Altenheim in Bremen. Epidemiol Bull 2001: 81-82
    Google Scholar

Korrespondenz

Prof. Dr. med. Axel Kramer

Institut für Hygiene und Umweltmedizin Ernst–Moritz–Arndt–Universität Greifswald

Walter–Rathenau–Straße 49A

17487 Greifswald

Fax: 03834/515541

Email: kramer@uni-greifswald.de

      >