Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023

Khalid Khalfan Alnair; Shady Kamel; Abdulaziz S. Almeshal

doi:doi:10.11648/j.ijg.20230702.11

| Peer-Reviewed

Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023

Khalid Khalfan Alnair, Shady Kamel, Abdulaziz S. Almeshal

Published in International Journal of Gastroenterology (Volume 7, Issue 2)

Received: 20 June 2023 Accepted: 6 July 2023 Published: 27 July 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3^rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and 4 staff members. Objective: Investigate the outbreak, implemented infection control measures, and infection risk factors in a female (LTCF) in Riyadh. Methods: A laboratory, environmental investigation, and retrospective cohort study were conducted, including 54 residents and descriptive data on 27 employees. The data were collected from clinical histories and through a survey by questionnaire. Results: A total of 19 cases of which 15 (79%) female residents, 3 (16%) staff nurses, and one (5%) female worker at the kitchen had been ill with AGE, corresponding to an overall attack rate of 11% and 28% among the residents. And 3 (16%) being managed as outpatient and 1 (5%) being admitted. No deaths occurred among the affected cases. The Cases ranged from 51-91 years (median: 64 years). The main reported symptoms were vomiting (86.6%), diarrhea (60.0%). Living on the first floor and in unit 3 was associated with a higher risk of developing AGE (RR 3.7, 95% CI 1.2-11.7) and (RR 3.3, 95% CI 1.6 - 7.0) with a P value of 0.01, respectively. Stool analysis and culture for 4 resident cases were negative. Food and water samples were also negative. Conclusion: We concluded that the source of outbreak was not identified as no sample had taken from patients or the prepared food on same day. While it cannot be proven with certainty, this investigation suggests that the outbreak may have originated from food, highlighting the importance of implementing food safety protocols in institutional care facilities. Public health agencies should investigate these outbreaks to uncover any problems with food handling or other possible causes.

Published in	International Journal of Gastroenterology (Volume 7, Issue 2)
DOI	10.11648/j.ijg.20230702.11
Page(s)	40-48
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Gastrointestinal Illness, Long-Term Elderly Care Facility, Al-Riyadh

References

[1]	POP SEM2021A. pdf [Internet]. [cited 2023 Feb 7]. Available from: https://www.stats.gov.sa/sites/default/files/POP%20SEM2021A.pdf
[2]	azalghamdi01. Elderly Survey [Internet]. General Authority for Statistics. 2018 [cited 2023 Feb 7]. Available from: https://www.stats.gov.sa/ar/909
[3]	1Statistical-Yearbook-2021.pdf [Internet]. [cited 2023 Feb 7]. Available from: https://www.moh.gov.sa/Ministry/Statistics/book/Documents/1Statistical-Yearbook-2021.pdf
[4]	azalghamdi01. Chapter 08 \| Service & Social Development [Internet]. General Authority for Statistics. 2019 [cited 2023 Feb 7]. Available from: https://www.stats.gov.sa/en/1014
[5]	Clarkson P, Hays R, Tucker S, Paddock K, Challis D. Healthcare support to older residents of care homes: a systematic review of specialist services. Qual Ageing Older Adults. 2018 Mar 12; 19 (1): 54–84.
[6]	El Chakhtoura NG, Bonomo RA, Jump RLP. Influence of Aging and Environment on Presentation of Infection in Older Adults. Infect Dis Clin North Am. 2017 Dec; 31 (4): 593–608.
[7]	Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 17; 69 (15): 458–64.
[8]	Greig JD, Lee MB. Enteric outbreaks in long-term care facilities and recommendations for prevention: a review. Epidemiol Infect. 2009 Feb; 137 (2): 145–55.
[9]	Hasanpour AH, Sepidarkish M, Mollalo A, Ardekani A, Almukhtar M, Mechaal A, et al. The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2023 Jan 29; 12 (1): 4.
[10]	Norovirus \| CDC [Internet]. [cited 2023 May 9]. Available from: https://www.cdc.gov/norovirus
[11]	Karakusevic A, Devaney P, Enstone A, Kanibir N, Hartwig S, Carias CDS. The burden of rotavirus-associated acute gastroenteritis in the elderly: assessment of the epidemiology in the context of universal childhood vaccination programs. Expert Rev Vaccines. 2022 Jul 3; 21 (7): 929–40.
[12]	Lee MH, Lee GA, Lee SH, Park YH. A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control. PloS One. 2020; 15 (3): e0229911.
[13]	Chen D, Li Y, Lv J, Liu X, Gao P, Zhen G, et al. A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018: a retrospective cohort study. BMC Infect Dis. 2019 Oct 29; 19 (1): 910.
[14]	Ai J, Zhu Y, Fu J, Cheng X, Zhang X, Ji H, et al. Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018. Front Med. 2021; 8: 786096.
[15]	Brugha R, Vipond IB, Evans MR, Sandifer QD, Roberts RJ, Salmon RL, et al. A community outbreak of food-borne small round-structured virus gastroenteritis caused by a contaminated water supply. Epidemiol Infect. 1999 Feb; 122 (1): 145–54.

Cite This Article

Plain Text BibTeX RIS

APA Style

Khalid Khalfan Alnair, Shady Kamel, Abdulaziz S. Almeshal. (2023). Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. International Journal of Gastroenterology, 7(2), 40-48. https://doi.org/10.11648/j.ijg.20230702.11

Copy | Download

ACS Style

Khalid Khalfan Alnair; Shady Kamel; Abdulaziz S. Almeshal. Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. Int. J. Gastroenterol. 2023, 7(2), 40-48. doi: 10.11648/j.ijg.20230702.11

Copy | Download

AMA Style

Khalid Khalfan Alnair, Shady Kamel, Abdulaziz S. Almeshal. Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. Int J Gastroenterol. 2023;7(2):40-48. doi: 10.11648/j.ijg.20230702.11

Copy | Download

@article{10.11648/j.ijg.20230702.11,
  author = {Khalid Khalfan Alnair and Shady Kamel and Abdulaziz S. Almeshal},
  title = {Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023},
  journal = {International Journal of Gastroenterology},
  volume = {7},
  number = {2},
  pages = {40-48},
  doi = {10.11648/j.ijg.20230702.11},
  url = {https://doi.org/10.11648/j.ijg.20230702.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20230702.11},
  abstract = {Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and 4 staff members. Objective: Investigate the outbreak, implemented infection control measures, and infection risk factors in a female (LTCF) in Riyadh. Methods: A laboratory, environmental investigation, and retrospective cohort study were conducted, including 54 residents and descriptive data on 27 employees. The data were collected from clinical histories and through a survey by questionnaire. Results: A total of 19 cases of which 15 (79%) female residents, 3 (16%) staff nurses, and one (5%) female worker at the kitchen had been ill with AGE, corresponding to an overall attack rate of 11% and 28% among the residents. And 3 (16%) being managed as outpatient and 1 (5%) being admitted. No deaths occurred among the affected cases. The Cases ranged from 51-91 years (median: 64 years). The main reported symptoms were vomiting (86.6%), diarrhea (60.0%). Living on the first floor and in unit 3 was associated with a higher risk of developing AGE (RR 3.7, 95% CI 1.2-11.7) and (RR 3.3, 95% CI 1.6 - 7.0) with a P value of 0.01, respectively. Stool analysis and culture for 4 resident cases were negative. Food and water samples were also negative. Conclusion: We concluded that the source of outbreak was not identified as no sample had taken from patients or the prepared food on same day. While it cannot be proven with certainty, this investigation suggests that the outbreak may have originated from food, highlighting the importance of implementing food safety protocols in institutional care facilities. Public health agencies should investigate these outbreaks to uncover any problems with food handling or other possible causes.},
 year = {2023}
}

Copy | Download

TY - JOUR
T1 - Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023
AU - Khalid Khalfan Alnair
AU - Shady Kamel
AU - Abdulaziz S. Almeshal
Y1 - 2023/07/27
PY - 2023
N1 - https://doi.org/10.11648/j.ijg.20230702.11
DO - 10.11648/j.ijg.20230702.11
T2 - International Journal of Gastroenterology
JF - International Journal of Gastroenterology
JO - International Journal of Gastroenterology
SP - 40
EP - 48
PB - Science Publishing Group
SN - 2640-169X
UR - https://doi.org/10.11648/j.ijg.20230702.11
AB - Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and 4 staff members. Objective: Investigate the outbreak, implemented infection control measures, and infection risk factors in a female (LTCF) in Riyadh. Methods: A laboratory, environmental investigation, and retrospective cohort study were conducted, including 54 residents and descriptive data on 27 employees. The data were collected from clinical histories and through a survey by questionnaire. Results: A total of 19 cases of which 15 (79%) female residents, 3 (16%) staff nurses, and one (5%) female worker at the kitchen had been ill with AGE, corresponding to an overall attack rate of 11% and 28% among the residents. And 3 (16%) being managed as outpatient and 1 (5%) being admitted. No deaths occurred among the affected cases. The Cases ranged from 51-91 years (median: 64 years). The main reported symptoms were vomiting (86.6%), diarrhea (60.0%). Living on the first floor and in unit 3 was associated with a higher risk of developing AGE (RR 3.7, 95% CI 1.2-11.7) and (RR 3.3, 95% CI 1.6 - 7.0) with a P value of 0.01, respectively. Stool analysis and culture for 4 resident cases were negative. Food and water samples were also negative. Conclusion: We concluded that the source of outbreak was not identified as no sample had taken from patients or the prepared food on same day. While it cannot be proven with certainty, this investigation suggests that the outbreak may have originated from food, highlighting the importance of implementing food safety protocols in institutional care facilities. Public health agencies should investigate these outbreaks to uncover any problems with food handling or other possible causes.
VL - 7
IS - 2
ER -

Copy | Download

Author Information

Khalid Khalfan Alnair

Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Shady Kamel

Field Epidemiology Training Program, Saudi Ministry of Health, Riyadh, Saudi Arabia
Abdulaziz S. Almeshal

Field Epidemiology Training Program, Saudi Ministry of Health, Riyadh, Saudi Arabia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Khalid Khalfan Alnair, Shady Kamel, Abdulaziz S. Almeshal. (2023). Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. International Journal of Gastroenterology, 7(2), 40-48. https://doi.org/10.11648/j.ijg.20230702.11

Copy | Download

ACS Style

Khalid Khalfan Alnair; Shady Kamel; Abdulaziz S. Almeshal. Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. Int. J. Gastroenterol. 2023, 7(2), 40-48. doi: 10.11648/j.ijg.20230702.11

Copy | Download

AMA Style

Khalid Khalfan Alnair, Shady Kamel, Abdulaziz S. Almeshal. Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023. Int J Gastroenterol. 2023;7(2):40-48. doi: 10.11648/j.ijg.20230702.11

Copy | Download

@article{10.11648/j.ijg.20230702.11,
  author = {Khalid Khalfan Alnair and Shady Kamel and Abdulaziz S. Almeshal},
  title = {Outbreak of Gastroenteritis Among Riyadh Female Long-Term Elderly Care Facility Residents-Saudi Arabia, January 2023},
  journal = {International Journal of Gastroenterology},
  volume = {7},
  number = {2},
  pages = {40-48},
  doi = {10.11648/j.ijg.20230702.11},
  url = {https://doi.org/10.11648/j.ijg.20230702.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20230702.11},
  abstract = {Background: The female long-term elderly care facility in Al-Riyadh is affiliated with the Ministry of Human Resources and Social Development, with a maximum capacity of 60. Between January 29, and February 3rd, 2023, the local public health authorities were notified of a potential gastrointestinal illness (AGE) outbreak involving 15 residents and 4 staff members. Objective: Investigate the outbreak, implemented infection control measures, and infection risk factors in a female (LTCF) in Riyadh. Methods: A laboratory, environmental investigation, and retrospective cohort study were conducted, including 54 residents and descriptive data on 27 employees. The data were collected from clinical histories and through a survey by questionnaire. Results: A total of 19 cases of which 15 (79%) female residents, 3 (16%) staff nurses, and one (5%) female worker at the kitchen had been ill with AGE, corresponding to an overall attack rate of 11% and 28% among the residents. And 3 (16%) being managed as outpatient and 1 (5%) being admitted. No deaths occurred among the affected cases. The Cases ranged from 51-91 years (median: 64 years). The main reported symptoms were vomiting (86.6%), diarrhea (60.0%). Living on the first floor and in unit 3 was associated with a higher risk of developing AGE (RR 3.7, 95% CI 1.2-11.7) and (RR 3.3, 95% CI 1.6 - 7.0) with a P value of 0.01, respectively. Stool analysis and culture for 4 resident cases were negative. Food and water samples were also negative. Conclusion: We concluded that the source of outbreak was not identified as no sample had taken from patients or the prepared food on same day. While it cannot be proven with certainty, this investigation suggests that the outbreak may have originated from food, highlighting the importance of implementing food safety protocols in institutional care facilities. Public health agencies should investigate these outbreaks to uncover any problems with food handling or other possible causes.},
 year = {2023}
}

Copy | Download