Norovirus Outbreak in a Psychiatric Institution, New Taipei City, December 2015

DOI: 10.6525/TEB.20161108.32(21).002

Pei-Chen Chen, Hsin-Yi Wei, Yu-Fang Tsai, Hsiao-Ping Tung, Jer-Jea Yen

2016 Vol.32 NO.21

Correspondence Author: Pei-Chen Chen

  • Taipei Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


On December 28, 2015, the health department of New Taipei City was notified of a diarrhea outbreak in a psychiatric institution (total 653 residents and 306 staffs). During December 22–30, 2015, there were 33 diarrheal patients (attack rate 3.4%), including 32 residents and 1 healthcare giver who developed fever, vomiting, diarrhea or abdominal pain. Laboratory investigations indicated norovirus as the etiological agent. The outbreak took place across 6 buildings (11 ward-units), involving patients from acute psychiatric units, chronic psychiatric units, and nursing home residents. As the acute units were separated from the chronic, Taipei Regional Center of Taiwan Centers for Disease Control, together with New Taipei City Health Department, conducted an investigation on December 29. We found that a person with epidemiologic links to the two units was tested positive for norovirus. The patient was a resident of and had contact with index case in the chronic unit, and worked as a receptionist assisting patients in the acute units on using the toilet during routine occupational therapy time. The patient had poor hand-hygiene adherence during work, which might be associated with the transmission among different units. Because psychiatric patients were poorly compliant with washing hands after using toilets, 50 ppm chlorine-containing solutions were used for hand hygiene every two hours; however, not all residents had adequately clean their hands immediately after possible norovirus exposures. The experience of this investigation highlights the challenge and the importance of infection control in psychiatric institutions.

Keywords:Psychiatric institutions, Diarrhea, Outbreak, Norovirus, Hand hygiene