General outbreaks of infectious intestinal disease (IID) in hospitals, England and Wales, 1992-2000

Between 1992 and 2000, 26.6% (1396/5257) of all general outbreaks of infectious intestinal disease (IID) reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC) occurred in hospitals. Over 29 000 patients and staff were affected and the mortality risk was higher than for outbreaks in other settings [relative risk 2.00 (95% CI: 1.52-2.63) P < 0.001]. Person-to-person spread was the predominant mode of transmission. The mortality risk was highest in foodborne disease outbreaks [relative risk 3.22 (95% CI: 1.41-7.36); P = 0.003]. Most-outbreaks occurred between November and April. The pathogens most frequently reported were Norwalk-like virus (NLV) (54%) and Clostridium difficile (12.6%). These findings emphasize the public health importance of outbreaks of IID in hospitals, especially during the winter when pressures on hospitals are at their height. (C) 2003 The Hospital Infection Society.