Elderly residents with gastroenteritis must be tested as soon as possible to minimise the effects of outbreaks in aged care facilities (ACFs), say senior government medical advisors in the latest issue of the Medical Journal of Australia (MJA).
A single case of gastroenteritis in an elderly resident of an ACF may signal the beginning of an outbreak, say Mr Martyn Kirk and colleagues of the Department of Health and Ageing.
It is important for clinicians to have a low threshold for testing faecal specimens in elderly residents, they say.
"Early recognition of the pathogen can guide public health investigations and infection control measures in the facility to minimise the spread and consequences of a potential outbreak", says Mr Kirk.
Gastroenteritis may be spread through food or person-to-person contact, or a combination of both.
"If a foodborne pathogen … is isolated from the faeces of an elderly resident of an ACF, there is an urgent need for public health authorities to search for other related cases and investigate food sources," says Mr Kirk.
"If norovirus is identified, the focus should be on strict and heightened infection control within the facility."
Gastroenteritis normally has a mild clinical course, but hospitalisation and death as a result of gastroenteritis are more common among elderly people.
In Australia, recorded outbreaks in ACFs comprise about half of all outbreaks of gastroenteritis.
Most of these are due to norovirus spread from person-to-person, which is a common cause of outbreaks where people are in close contact, such as schools, hospitals, and cruise ships.
However, the authors assure us that Australia has a robust aged care system with a safe food supply.
"Of the reported gastroenteritis outbreaks in these facilities, only a very small number are the result of contaminated food," they say.