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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Institutional risk factors for norovirus outbreaks in Hong Kong elderly homes: a retrospective cohort study

Authors: Hualiang Lin, Sammy Ng, Shelley Chan, Wai Man Chan, Krystal CK Lee, Suzanne C Ho, Linwei Tian

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Most of the institutional outbreaks of norovirus in Hong Kong occur in elderly homes, the proportion being 69% in 2006. Residents in elderly homes are a special population seriously affected by norovirus infections, it is necessary to investigate the risk factors of the norovirus outbreaks in Hong Kong elderly homes at the facility level.

Methods

A cohort of 748 elderly homes was followed up from January 2005 to December 2007; each elderly home was treated as one observation unit and the outcome event was the norovirus outbreak. Cox regression models were fitted to estimate the rate ratio (RR) and 95% confidence interval (CI) for the potential risk factors.

Results

A total of 276 norovirus outbreaks were confirmed during the study period; the outbreak rate was 12.2 (95% CI: 9.9-14.6) per 100 home-years; elderly homes with a larger capacity (RR = 1.4, 95% CI: 1.3-1.5 (per 30-resident increment)), a higher staff-to-resident ratio (RR = 1.2, 95% CI: 1.1-1.3 (per 1/30 increment) and better wheelchair accessibility (RR = 2.0, 95% CI: 1.3-3.2) were found to have an elevated norovirus outbreak rate in Hong Kong elderly homes; Elderly homes with partitions between beds had a lower rate of norovirus outbreaks (RR = 0.6, 95% CI: 0.4-0.8).

Conclusions

Elderly home capacity, staff-to-resident ratio and wheelchair accessibility were risk factors for norovirus outbreaks in Hong Kong elderly homes. Partitions between beds were a protective factor of norovirus outbreaks. These results should be considered in the infection control in Hong Kong elderly homes.
Appendix
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Metadata
Title
Institutional risk factors for norovirus outbreaks in Hong Kong elderly homes: a retrospective cohort study
Authors
Hualiang Lin
Sammy Ng
Shelley Chan
Wai Man Chan
Krystal CK Lee
Suzanne C Ho
Linwei Tian
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-297

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