C. difficile outbreak at RVH declared over

The four-month-long outbreak of C. difficile at Royal Victoria Hospital has been declared over by the hospital, in collaboration with the Simcoe Muskoka District Health Unit (SMDHU).

"A steady and dramatic reduction in the number of new cases, combined with the effectiveness of our 50- point action plan has permitted us to officially call an end to the outbreak," says Dr. Michael Murray, RVH's Chief of Staff. "Thanks to the exceptional efforts of hospital staff and physicians, we have been able to gain control of the outbreak very quickly and effectively."

The outbreak was declared on February 23rd following a spike of 28 new C. difficile cases in January. The hospital immediately took aggressive action to contain the outbreak.

It requested the assistance of a team of infectious disease experts from University Health Network, while implementing a comprehensive 50-point action plan of control measures including double cleaning of inpatient rooms, a review of antibiotic usage and extensive education and training for staff, physicians and volunteers.

"RVH took this outbreak very seriously. We mobilized staff and resources to ensure everything was being done to minimize the number of cases and the possibility of transmission," remarks Janice Skot, RVH President and Chief Executive Officer.

"The safety of our patients, staff, volunteers, physicians and visitors was always our top priority, and by acting swiftly and aggressively, RVH was able to protect that safety."

The number of C. difficile cases has dropped dramatically since the action plan was introduced.

In May there were just three new cases, while in June there was only one new case.

So far in July, just one new case has been identified.

"The hospital's willingness to implement recommendations for enhanced outbreak management was critical to its success," said Dr. Charles Gardner, Simcoe Muskoka Medical Officer of Health.

"The response involved many experts, including the panel from University Health Network. This assembled expertise helped focus the control measures where they were most needed, and the results today are an indication of how effective the measures were."

In the event of a communicable disease outbreak at a hospital or institution, the health unit's role is as a partner in the team effort to ensure that the monitoring, investigation and response are conducted effectively in accordance with best accepted practices.

According to the expert team lead Dr. Michael Gardam, director of infection prevention and control at University Health Network,

"RVH has made phenomenal progress. I never would've imagined that the hospital's C. difficile rates would be brought so low, so quickly. RVH is committed to staying on top of it, so I believe the chance of a future outbreak is minimal."

RVH has developed a sustainability plan to ensure control measures remain in place.

However implementing and sustaining those control measures has required an enormous investment of human and financial resources.

Ongoing efforts to control the bacterium cost the hospital approximately $60,000 a week.

Royal Victoria Hospital has requested $3.2 million in annual funding assistance from the North Simcoe Muskoka Local Health Integration Network to assist with the ongoing costs of ensuring control measures are maintained at this elevated, but essential level.