Control of the spread of viruses in a long-term care facility using hygiene protocols

Abstract

Background: Approximately 50% of norovirus cases in the United States occur in long-term care facilities; many incidences of rotavirus, sapovirus, and adenovirus also occur. The primary objectives of this study were to demonstrate movement of pathogenic viruses through a long-term care facility and to determine the impact of a hygiene intervention on viral transmission.

Methods: The coliphage MS-2 was seeded onto a staff member's hands, and samples were collected after 4 hours from fomites and hands. After 3 consecutive days of sample collection, a 14-day hygiene intervention was implemented. Hand sanitizers, hand and face wipes, antiviral tissues, and a disinfectant spray were distributed to employees and residents. Seeding and sampling were repeated postintervention.

Results: Analysis of the pre- and postintervention data was performed using a Wilcoxon signed-rank test. Significant reductions in the spread of MS-2 on hands (P = .0002) and fomites (P = .04) were observed postintervention, with a >99% average reduction of virus recovered from both hands and fomites.

Conclusion: Although MS-2 spread readily from hands to fomites and vice versa, the intervention reduced average MS-2 concentrations recovered from hands and fomites by up to 4 logs and also reduced the incidence of MS-2 recovery.

Keywords: Hygiene protocol; Long-term care; Virus spread.