Sapovirus Outbreaks in Long-Term Care Facilities

Sapovirus Outbreaks in Long-Term Care Facilities

[Announcer] This program is presented by the Centers for Disease Control and Prevention.

[Maureen Marshall] Hi, I’m Maureen Marshall, and today I’m speaking with Lore Elizabeth Lee, clinical epidemiologist at the Oregon Public Health Division. Our conversation is based on her study about sapovirus outbreaks in long-term care facilities, which appears in CDC’s journal, Emerging Infectious Diseases. Welcome, Lore.

[Lore Lee] Hi.

[Maureen Marshall] Lore, when you began your investigation, what were you looking for?

[Lore Lee] We had a group of gastroenteritis outbreaks from a variety of settings and we didn’t know what caused them. So we undertook our study to identify the agents that caused these outbreaks.

[Maureen Marshall] And what did you find?

[Lore Lee] We discovered that sapovirus caused 23 percent of these outbreaks and that sapovirus infection could also occur along with enteric adenoviruses and norovirus infections.

[Maureen Marshall] Was this a surprise?

[Lore Lee] Yes. We are always surprised--and delighted--to find the cause of an outbreak.

[Maureen Marshall] What time period were you looking at and why did you choose this timeframe?

[Lore Lee] We studied outbreaks that occurred from 2002 through 2009 because we still had stool specimens that were collected while these outbreaks were being investigated.

[Maureen Marshall] What are noro and sapoviruses?

[Lore Lee] Norovirus and sapovirus are both members of the virus family Caliciviridae. They are highly infectious and easy to spread in settings where people have close contact with each other-- schools, child care centers, long-term care facilities. They cause vomiting and diarrhea that lasts from two to three days, but usually not fevers, and leaves their victims feeling ill for several days after the vomiting and diarrhea stop.

[Maureen Marshall] We hear a lot about norovirus but not about sapovirus. Why is that?

[Lore Lee] Advanced tests for norovirus have been available for a long time. An advanced test for sapovirus has only been available since 2006 and we’ve just started to look for sapovirus.

[Maureen Marshall] Is there an easy way for health care providers to tell the difference between them?

[Lore Lee] No. The clinical symptoms produced by these viruses make them close enough to be indistinguishable without testing.

[Maureen Marshall] Is this an infection that only affects older people who live in care facilities?

[Lore Lee] No, this infection affects people of all ages. We found high rates of sapovirus infection among older people who live in care facilities because gastroenteritis outbreaks in health care facilities are reportable to public health authorities and we were, therefore, more likely to test such people.

[Maureen Marshall] Is sapovirus becoming more prevalent?

[Lore Lee] It is difficult to say whether sapovirus is actually occurring more often or whether we’re finding it more often because we are now looking for it. Before this determination can be made, routine laboratory testing for both sapovirus and norovirus needs to be carried out for several years. This will establish the baseline level of occurrence against which changes can be compared.

[Maureen Marshall] Are the treatments different for noro and sapovirus and if not, does it really matter which virus a person has?

[Lore Lee] Because both viruses cause severe vomiting and diarrhea, treatments are aimed at preventing dehydration and treating it if it does occur. At the individual patient level, it doesn’t matter which virus a person has.

[Maureen Marshall] Are there any ways to prevent the spread of sapovirus?

[Lore Lee] Individuals with sapovirus symptoms can prevent spread to others by scrupulous personal hygiene and by remaining apart from others while having vomiting and diarrhea, by staying home from work, for example. Hospital and long-term care facility patients with sapovirus symptoms should be placed in contact isolation.

[Maureen Marshall] Thank you, Lore. I’ve been talking to Lore Elizabeth Lee about her study, Sapovirus Outbreaks in Long-Term Care Facilities, Oregon and Minnesota, USA, 2002–2009, which appears in the May 2012 issue of CDC’s journal, Emerging Infectious Diseases. You can see the entire article online at www.cdc.gov/eid.

If you’d like to comment on this podcast, send an email to eideditor@cdc.gov. I’m Maureen Marshall, for Emerging Infectious Diseases.