Abstract:
:Norovirus (NV) infections are a frequent cause of gastroenteritis (GE), but data on this disease in immunocompromised patients are limited. We analyzed an NV outbreak, which affected immunosuppressed patients in the context of chemotherapy or HSCT. On recognition, 7 days after admission of the index patient, preventive measures were implemented. Attack rates were only 3% (11/334) and 10% (11/105) among patients and staff members, respectively. The median duration of symptoms was 7 days in patients compared with only 3 days in staff members (P = .02). Three patients died of the NV infection. Commonly used clinical diagnostic criteria (Kaplan-criteria) were unsuitable because they applied to 11 patients with proven NV-GE but also to 15 patients without NV-GE. With respect to the therapeutic management, it is important to differentiate intestinal GVHD from NV-GE. Therefore, we analyzed the histopathologic patterns in duodenal biopsies, which were distinctive in both conditions. Stool specimens in patients remained positive for NV-RNA for a median of 30 days, but no transmission was observed beyond an asymptomatic interval of 48 hours. NV-GE is a major threat to patients with chemotherapy or HSCT, and meticulous measures are warranted to prevent transmission of NV to these patients.
journal_name
Bloodjournal_title
Bloodauthors
Schwartz S,Vergoulidou M,Schreier E,Loddenkemper C,Reinwald M,Schmidt-Hieber M,Flegel WA,Thiel E,Schneider Tdoi
10.1182/blood-2010-12-325886subject
Has Abstractpub_date
2011-06-02 00:00:00pages
5850-6issue
22eissn
0006-4971issn
1528-0020pii
blood-2010-12-325886journal_volume
117pub_type
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