February 17, 2004

To All Staff:

An increase in gastrointestinal illness (new onset nausea, vomiting and diarrhea) has been noted in the Baltimore region. One healthcare facility has restricted access to new admissions as a consequence.

In an effort to protect our patients, visitors and staff, JHH is increasing its vigilance to prevent transmission of this infection. Staff with new onset of nausea, vomiting and diarrhea should not report to the workplace and should call their supervisor to report the illness. Staff at work with new onset of these symptoms should be sent home. The illness lasts approximately 24-48 hours. Staff should contact their primary care physician for medical concerns.

Gastrointestinal Illness

· SYMPTOMS: NAUSEA, VOMITING, DIARRHEA, FEVER
· INCUBATION PERIOD: 24-48 HOURS
· DURATION: 1 - 3 DAYS

· HEALTHCARE WORKERS WHO HAVE THESE SYMPTOMS SHOULD:

o NOT REPORT TO WORK AND SHOULD CALL THEIR SUPERVISOR IMMEDIATELY
o BE SENT HOME IF THEY REPORT TO WORK
o NOT COME TO WORK UNTIL THEY HAVE BEEN SYMPTOM FREE FOR 72 HOURS PER HEALTH DEPARTMENT REGULATIONS

· PATIENTS WITH THESE SYMPTOMS:

o MUST BE PLACED IN CONTACT ISOLATION UNTIL THEY ARE SYMPTOM FREE FOR 72 HOURS
o SHOULD BE PLACED IN A SINGLE ROOM IF POSSIBLE AND MAY BE COHORTED (GROUPED) WITH OTHER PATIENTS WHO HAVE THE SAME SYMPTOMS
o SHOULD HAVE STOOL SENT TO MICROBIOLOGY LAB FOR VIRAL CULTURE WITH SPECIMENS LABELED "R/O NORWALK VIRUS"

· SUPERVISORS SHOULD REPORT PATIENTS AND HEALTHCARE WORKERS WITH NEW ONSET GI SYMPTOMS TO HOSPITAL EPIDEMIOLOGY AND INFECTION CONTROL (5-8384)