Hospital acts quickly to stop "stomach flu" spread

By Nelson Sigelman
Published: January 8, 2009

A highly infectious and very unpleasant intestinal viral infection struck Martha's Vineyard like a winter blizzard over Christmas. The prevalence of the infection was severe enough that Martha's Vineyard Hospital officials, concerned about elderly patients who might come to the hospital for treatment of unrelated illnesses, made plans to divert such incoming patients to mainland hospitals to avoid any infection risk.

Some hospital patients and more than a dozen hospital employees suffered from the viral gastroenteritis, which describes an infection caused by a variety of viruses. The illness causes vomiting or diarrhea and is often called the "stomach flu," although it is not caused by the influenza viruses.

While the emergency room remained open, the hospital put a hold on non-critical admissions just before Christmas and implemented strict procedures to halt the spread of the virus.

How it strikes you

The following information is provided by the Centers for Disease Control and the Massachusetts Department of Public Health:

* The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. The affected person may also have headache, fever, and abdominal cramps. In general, the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days, depending on which virus causes the illness.

* People who get viral gastroenteritis almost always recover completely without any long-term problems. Gastroenteritis is a serious illness, however, for persons who are unable to drink enough fluids to replace what they lose through vomiting or diarrhea. Infants, young children, and persons who are unable to care for themselves, such as the disabled or elderly, are at risk for dehydration from loss of fluids.

* The viruses that cause gastroenteritis are spread through close contact with infected persons (for example, by sharing food, water, or eating utensils).
The most important point in treating viral gastroenteritis in children and adults is to prevent severe loss of fluids. This treatment should begin at home. Families with infants and young children are advised to keep a supply of oral rehydration solution at home at all times and use the solution when diarrhea first occurs in the child.

* The simplest and most effective preventive measure is frequent hand washing with soap and warm water. It is the soap combined with the scrubbing action that helps dislodge and remove germs. Antibacterial soap is not necessary. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers are suitable.

Tim Walsh, hospital chief executive officer, said the infection generally runs its course in two days and is not usually dangerous. However, those most at risk of more serious complications are the elderly and the very young, he said.

When it became evident that the infection had found a foothold during the Tuesday and Wednesday prior to Christmas, the hospital redoubled its infection control efforts, said Mr. Walsh. Visitors were restricted, doors closed and signs placed to remind everyone entering and leaving the patient care portions of the hospital to thoroughly wash their hands.

Nurses, rather than food service personnel, delivered daily meals to patient rooms to minimize the risk of wider infection.

Mr. Walsh said the hospital notified the Oak Bluffs board of health and the Massachusetts Department of Public Health (DPH), which recommended that for a 24-hour period the hospital not admit anyone who did not require immediate treatment, for example someone coming in for an elective procedure.

Mr. Walsh said, according to DPH, 12 hospitals located in Southeastern Massachusetts saw similar spikes.

Mr. Walsh said although the hospital made plans to send those most at risk to the mainland, that option was not required.

One report circulating on the Island was that the hospital had been closed. "We didn't close," said Mr. Walsh. "We were just being very careful."

Donna Enos, hospital infection control nurse, said the hospital "pulled out all the stops" and the procedures were successful in restricting the spread of the infection. "Within 24 hours, we stopped seeing any new cases," she said.

Ms. Enos said viral gastroenteritis covers a number of possible viral infections. In this case, she said, it was likely a norovirus of the type that is sometimes reported on cruise ships. Viral gastroenteritis is not unusual, but Martha's Vineyard has generally been spared, she said.

Ms. Enos said the most effective preventive measure and the one used at the hospital is strict and proper hand washing. "Twenty seconds of friction, warm water, dry your hands, don't touch the faucets with your hands, use a paper towel," Ms. Enos explained.

Alerted by Ms. Enos, on Monday Edgartown School nurse Donna Joyce reminded teachers to have students wash their hands thoroughly prior to snack and lunch time.