Norovirus Outbreak Spurs Probe
Health Officials Question Management's Response Time

By Leef Smith
Washington Post Staff Writer
Tuesday, April 3, 2007

An assisted living facility in Arlington County is under investigation by state and county health officials after a highly contagious norovirus outbreak that sickened 61 percent of the home's 140 residents last month before it was brought under control.

Officials with the Virginia Department of Social Services said yesterday that they are looking into an outbreak that apparently began in late February at Brighton Gardens of Arlington, a facility for assisted and independent living managed by Sunrise Senior Living, and whether management responded to the virus in a timely manner.

The findings of the investigation will determine whether a penalty is warranted, state officials said. The most severe penalty facing the facility is closure.

The norovirus, a gastrointestinal malady that is particularly dangerous to the young and elderly, has struck the state with a vengeance this year, shuttering nursing homes and hotels.

Since November, there have been 211 confirmed norovirus outbreaks in Virginia, according to officials with the Virginia Department of Health. Of those, 27 have been in Northern Virginia.

Statewide, 76 percent of the reported outbreaks have been in facilities that provide long-term care, officials said.

Arlington health officials said they have visited Brighton Gardens at least a half-dozen times since the virus was first brought to their attention March 4, making a host of recommendations on how to eradicate the bug.

Although Sunrise officials said yesterday afternoon that only one resident had reported symptoms of the virus in the past 48 hours, the facility suffered a major hit that lingered for more than a month and caused 85 of the 140 residents to become ill, county health officials said.

Officials said at least 13 sickened residents suffered a second episode. Ten of the 85 victims were hospitalized, and a hospice resident died, although county health officials said there is no way to know whether the death was caused by the virus.

Additionally, 28 Sunrise employees have developed symptoms since the outbreak was reported, health officials said.

Reuben Varghese, Arlington's public health director, said facility managers are "working very hard" to implement the county's recommendations for wiping out the virus, which include discontinuing new admissions, isolating residents with symptoms, cleaning the entire facility and bringing in additional care staff. But he said that the managers at Brighton Gardens should have acted sooner to hire extra employees.

"Putting in staff sooner obviously would have been helpful," Varghese said. "It would have slowed the virus down faster. . . . Their response could have been more timely."

Officials with Sunrise said they added staff March 10 and have been fighting the virus "very aggressively." Sunrise is "confident that we have followed and in some cases exceeded the department's recommendations for managing the situation," spokeswoman Meghan K. Lublin said.

First identified in 1972 but made part of routine tests only in the past decade, the norovirus is known to cause dramatic outbreaks in crowded settings. Death from the infection is uncommon, but it can occur in the disabled and elderly.

Norovirus is almost always passed through vomit or feces, and it has an incubation period of a day or more.

Three-quarters of people with the virus report vomiting and diarrhea, and one-third have a fever. Symptoms usually last about five days.