Nosocomial infections and norovirus Kawasaki variant: a review on emergency management in hospitals

Nosocomial infections, also known as health-care-associated infections (HAIs), are infections acquired during the process of receiving healthcare that were not present at the time of admission. They can occur in many areas of healthcare delivery, such as hospitals, long-term care facilities, and outpatient clinics, and can also occur after discharge. Among HAIs, nosocomial enteritis appears to be an important risk factor. However, there has been a great effort by infection prevention and control programs to develop surveillance systems and infection control methods. Viruses are the main cause of nosocomial enteritis in neonates, and rotavirus species A (RVA) and norovirus (NoV) are considered the main etiologic agents responsible for acute gastroenteritis (AGE) in hospitalized children, excluding that caused by C. difficile. Since October 2024, there has been a significant increase in cases of gastroenteritis due to a highly infectious NoV (genotype GII.17), known as the Kawasaki variant, especially in the United Kingdom, but cases are being reported throughout Europe. The hospitalization of many individuals, in a short time, due to NoV Kawasaki, in combination with the increase in hospitalizations due to typical seasonal flu, could trigger a chain reaction with a strong increase in HAIs. The aim of this work is to evaluate the current situation regarding nosocomial enteritis in the face of the new extremely infectious variant of NoV. as well as to analyze the possibility to contain the spread of a possible epidemic using a Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNe) approch.