The Role of Contaminated Surfaces in the Transmission of Nosocomial Pathogens - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 43

Fig. 3.3 Comparing the role of the prior room occupant for non-fermenting Gram-negative
bacteria and Enterobacteriaceae
Odds ratio ( circles ) with 95 % confidence intervals ( lines ) comparing the rate of acquisition for
patients admitted to rooms where the prior room occupant had the pathogen of interest vs. patients
admitted to rooms were the prior room occupant did not have the pathogen of interest; from studies
by Nseir et al. [ 93 ] and Ajao et al. [ 115 ]
Fig. 3.4 Norovirus attack
rate among staff on
subsequent flights following
an episode of vomiting in
the economy cabin
3.7.5 Norovirus
Compelling evidence for the role of surface contamination in the transmission of
norovirus comes from outbreaks affecting epidemiologically distinct cohorts of
passengers on boat and plane trips [ 119 - 122 ]. For example, an outbreak affected
74 % of guests on three consecutive houseboat trips [ 120 ]. An environmental
investigation identified norovirus on 71 % of surfaces in bathrooms, kitchens and
door handles and fomite contamination appeared to contribute to continuation of
the outbreak over the three trips. Similarly, there was a sequentially decreasing
attack rate of norovirus among distinct cohorts of cabin crew following an episode
of vomiting on an airplane (Fig. 3.4 )[ 119 ].
Several investigations have identified surface contamination with norovirus
in the absence of other potential reservoirs during continuing outbreaks [ 45 , 47 ].