Determining the Economic Value of Nosocomial Norovirus Outbreak Control Measures

Background: Norovirus is highly infectious and can spread rapidly in health care settings, consuming resources and resulting in longer hospital stays. The economic value of hospital outbreak containment measures following identification of a norovirus case is currently unknown although it is a significant cause of nosocomial viral gastroenteritis.

Objective: To determine the potential cost-benefit of norovirus outbreak control interventions.

Methods: We developed stochastic computer simulation models to explore the cost-benefit of norovirus outbreak control interventions. The following interventions were explored: (1) Patient Isolation (2) Increased Hand Hygiene Measures (3) Use of Protective Apparel (4) Enhanced Disinfection Practices (5) Ward Staff Exclusion Policies (6) Ward Closure. Sensitivity analyses explored the impact of varying each intervention's efficacy, initial number of norovirus cases, s reproductive rate (R) of norovirus, and room and ward size and occupancy.
Results: Increased hand hygiene, use of protective apparel, enhanced disinfection practices, or staff exclusion policies provided net cost-savings, even when the intervention was only 10% effective in preventing norovirus transmission.  Only when transmission prevent efficacy was very high (≥90%) were patient isolation or ward closure cost-saving. Economic value decreased as the number of beds per room and the number of empty beds per ward increased.     

Conclusions: The most cost-saving interventions for the control and containment of a norovirus outbreak are increased hand hygiene, use of protective apparel, enhanced disinfection practices, or staff exclusion policies.