Hidden Reservoir: An Outbreak of Tuberculosis in Hospital Employees with No Patient Contact

2016 ◽  
Vol 37 (9) ◽  
pp. 1111-1113
Author(s):  
Riley Hazard ◽  
Kyle B. Enfield ◽  
Darla J. Low ◽  
Eve T. Giannetta ◽  
Costi D. Sifri
Keyword(s):  
Infect Control Hosp ◽  
Food Preparation ◽  
Patient Contact ◽  
Hospital Employees ◽  
Healthcare Settings ◽  
Direct Patient Contact ◽  
Potential Risks

We describe an outbreak of tuberculosis (TB) in the food preparation area of a hospital, which demonstrates that employees in healthcare settings may serve as potential risks for spread of TB even if they have no direct patient contact.Infect Control Hosp Epidemiol 2016;37:1111–1113

Description of an Influenza Vaccination Campaign and Use of a Randomized Survey to Determine Participation Rates

2010 ◽  
Vol 31 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Xuguang (Grant) Tao ◽  
Janine Giampino ◽  
Deborah A. Dooley ◽  
Frances E. Humphrey ◽  
David M. Baron ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Healthcare Workers ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Patient Contact ◽  
Participation Rates ◽  
Immunization Program ◽  
Influenza Immunization ◽  
Direct Patient Contact ◽  
Johns Hopkins University

Objectives.To describe the procedures used during an influenza immunization program and the use of a randomized survey to quantify the vaccination rate among healthcare workers with and without patient contact.Design.Influenza immunization vaccination program and a randomized survey.Setting.Johns Hopkins University and Health System.Methods.The 2008/2009 Johns Hopkins Influenza Immunization Program was administered to 40,000 employees, including 10,763 healthcare workers. A 10% randomized sample (1,084) of individuals were interviewed to evaluate the vaccination rate among healthcare workers with direct patient contact.Results.Between September 23, 2008, and April 30, 2009, a total of 16,079 vaccinations were administered. Ninety-four percent (94.5%) of persons who were vaccinated received the vaccine in the first 7 weeks of the campaign. The randomized survey demonstrated an overall vaccination rate of 71.3% (95% confidence interval, 68.6%-74.0%) and a vaccination rate for employees with direct patient contact of 82.8% (95% confidence interval, 80.1%-85.5%). The main reason (25.3%) for declining the program vaccine was because the employee had received documented vaccination elsewhere.Conclusions.The methods used to increase participation in the recent immunization program were successful, and a randomized survey to assess participation was found to be an efficient means of evaluating the workforce's level of potential immunity to the influenza virus.

A Large Epidemic of Hepatitis B in Serbia: An Integrated Model for Outbreak Investigations in Healthcare Settings

2014 ◽  
Vol 35 (06) ◽  
pp. 732-735 ◽  
Author(s):  
Simone Lanini ◽  
Gorana Ćosić ◽  
Stefano Menzo ◽  
Vincenzo Puro ◽  
Predrag Đurić ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Hepatitis B ◽  
Integrated Model ◽  
Molecular Techniques ◽  
Comprehensive Approach ◽  
Infect Control Hosp ◽  
Bernoulli Model ◽  
Healthcare Settings ◽  
Outbreak Investigations

We report a comprehensive approach for outbreak investigations, including cluster analysis (Bernoulli model), an algorithm to build inferential models, and molecular techniques to confirm cases. Our approach may be an interesting tool to best exploit the large amount of unsystematically collected information available during outbreak investigations in healthcare settings.Infect Control Hosp Epidemiol2014;35(6):732–735

Measles Immunity Among Community Hospital Employees

1991 ◽  
Vol 12 (11) ◽  
pp. 663-668 ◽  
Author(s):  
Peter Houck ◽  
Gay Scott-Johnson ◽  
Lylanne Krebs
Keyword(s):  
Advisory Committee ◽  
Predictive Value ◽  
Community Hospital ◽  
Patient Contact ◽  
Immunosorbant Assay ◽  
Positive History ◽  
Hospital Employees ◽  
History Of ◽  
Serologic Evidence ◽  
Enzyme Linked Immunosorbant Assay

AbstractObjective:To define measles immunity rates among employees at 2 hospitals during a community outbreak in 1990.Design:Cohort survey using enzyme-linked immunosorbant assay (ELISA) and questionnaire.Setting:Two community hospitals.Participants:Seventy-six percent of 2,060 employees.Results:Seven percent (115/1566) of participants lacked ELISA-defined measles immunity. Among employees whose ages were known, 14% (64/467) of those born after 1956 and 5% (50/1086) of those born before 1957 lacked serologic evidence of immunity. Fifty-eight percent of the susceptible persons had substantial patient contact. With ELISA results as the reference for immunity, the predictive value of an undocumented positive history of measles disease or vaccination was 95%; the predictive value of a negative history of both was 52%. Measles developed in 7 employees.Conclusions:A substantial number of hospital employees lacked ELBA-defined measles immunity, including many who had patient contact or who had been born before 1957. Undocumented disease and vaccination histories were not adequate predictors of serologic status. This study supports the recommendations and suggestions of the Immunization Practices Advisory Committee that hospitals should require documented evidence of measles immunity from employees who have patient contact.

scholarly journals Longitudinal, serological study of cytomegalovirus infections in nurses and in personnel without patient contact

1975 ◽  
Vol 2 (5) ◽  
pp. 448-452
Author(s):  
A S Yeager
Keyword(s):  
Complement Fixation ◽  
Pediatric Nurses ◽  
Patient Contact ◽  
Serological Study ◽  
Hospital Employees ◽  
Indirect Hemagglutination ◽  
Cytomegalovirus Infections ◽  
Lower Limits ◽  
Antibody Tests

Sera were obtained at intervals from 172 hospital employees for measurement of cytomegalovirus (CMV) complement fixation (CF) and indirect hemagglutination antibody. No fourfold rises or falls in titer were seen over a 19- to 27-month period among 71 employees with initially positive CMV CF titers. The concurrence rate between the CMV CF and the indirect hemagglutination antibody tests in identifying seronegative personnel was 96%. Five seroconversions were identified during an average follow-up period of 15 to 17 months per person among 65 pediatric nurses whose CMV CF titers had initially been less than 1:8. No seroconversions were seen during an average follow-up period of 29 months per person among 27 hospitad little patient contact. The rate of acquisition of CMV infections in seronegative pediatric nurses was 4.1 to 7.7% per year. Sera from 9 of the 172 employees studied (5.2%) gave inconsistent results at the lower limits of the CF test.

scholarly journals Hepatitis C Contamination of Medication Vials Accessed with Sterile Needles and Syringes

2019 ◽  
Vol 131 (2) ◽  
pp. 305-314 ◽  
Author(s):  
Janet M. van Vlymen ◽  
Julie Magnus ◽  
Melanie Jaeger ◽  
Sophie Breton ◽  
Nathan G. Taylor ◽  
...  
Keyword(s):  
Cell Culture ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Isopropyl Alcohol ◽  
Healthcare Providers ◽  
Virus Infectivity ◽  
Healthcare Settings ◽  
Single Use ◽  
Potential Risks ◽  
Over Time

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Health care–associated hepatitis C virus outbreaks from contaminated medication vials continue to be reported even though most practitioners deny reusing needles or syringes. The hypothesis was that when caring for hepatitis C virus–infected patients, healthcare providers may inadvertently contaminate the medication vial diaphragm and that subsequent access with sterile needles and syringes can transfer hepatitis C virus into the medication, where it remains stable in sufficient quantities to infect subsequent patients. Methods A parallel-arm lab study (n = 9) was performed in which contamination of medication vials in healthcare settings was simulated using cell culture–derived hepatitis C virus. First, surface-contaminated vials were accessed with sterile needles and syringes, and then hepatitis C virus contamination was assessed in cell culture. Second, after contaminating several medications with hepatitis C virus, viral infectivity over time was assessed. Last, surface-contaminated vial diaphragms were disinfected with 70% isopropyl alcohol to determine whether disinfection of the vial surface was sufficient to eliminate hepatitis C virus infectivity. Results Contamination of medication vials with hepatitis C virus and subsequent access with sterile needles and syringes resulted in contamination of the vial contents in sufficient quantities to initiate an infection in cell culture. Hepatitis C virus remained viable for several days in several commonly used medications. Finally, a single or 2- to 3-s wipe of the vial diaphragm with 70% isopropyl alcohol was not sufficient to eliminate hepatitis C virus infectivity. Conclusions Hepatitis C virus can be transferred into commonly used medications when using sterile single-use needles and syringes where it remains viable for several days. Furthermore, cleaning the vial diaphragm with 70% isopropyl alcohol is not sufficient to eliminate the risk of hepatitis C virus infectivity. This highlights the potential risks associated with sharing medications between patients.

Failure of Bland Soap Handwash to Prevent Hand Transfer of Patient Bacteria to Urethral Catheters

1991 ◽  
Vol 12 (11) ◽  
pp. 654-662 ◽  
Author(s):  
N. Joel Ehrenkranz ◽  
Blanca C. Alfonso
Keyword(s):  
Confidence Interval ◽  
Risk Ratio ◽  
Healthcare Workers ◽  
Isopropyl Alcohol ◽  
Gram Negative Bacteria ◽  
Patient Contact ◽  
Urinary Catheters ◽  
Gram Negative ◽  
High Burden ◽  
Direct Patient Contact

AbstractObjective:The study was designed to compare the efficacies of bland soap handwash and isopropyl alcohol hand rinse in preventing transfer of aerobic gram-negative bacilli to urinary catheters via transient hand colonization acquired from direct patient contact. Glove juice recovery of gram-negative bacteria was considered transient colonization; catheter recovery was considered transfer colonization.Design:The contact source for gram-negative bacteria was a single “high burden” groin skin carrier ( ≥ 104/ml cup scrub fluid). Using a two-period cross-over design, 6 healthcare workers had 2 15-second contacts for each hand followed by either soap handwash or alcohol hand rinse (12 experiments with each treatment). Between 4 to 5 minutes after contact, each hand manipulated a catheter; the catheter was then cultured and the hand was glove juice tested.Results:Soap handwash failed to prevent gram-negative bacteria transfer to the catheter in 11 of 12 (92%) experiments; alcohol hand rinse in 2 of 12 (17%) (p< .001). Soap handwash failed to prevent transient colonization in 12 of 12 (100%) experiments; alcohol in 5 of 12 (42%) (risk ratio 2.4,95% confidence interval 1.2-4.7). Single gram-negative bacteria species carried at source levels ≥ 5.5 × 103/ml (heavy contamination) established transient colonization in 23 of 30 (77%) exposures following soap handwash; single gram-negative bacteria species carried at levels ≤ 3.5 × 103/ml established colonization in 1 of 22 (5%) similar exposures (p<.001).Conclusions:Bland soap handwash was generally ineffective in preventing hand transfer of gram-negative bacteria to catheters following brief contact with a heavy-contamination patient source; alcohol hand rinse was generally effective.

An Outbreak of Scabies in Multiple Linked Healthcare Settings in the Netherlands

2012 ◽  
Vol 33 (10) ◽  
pp. 1047-1050 ◽  
Author(s):  
Georgia Ladbury ◽  
Gabriella Morroy ◽  
Sandra van Hoeven-Dekkers ◽  
Corine Botermans ◽  
Cees Veelenturf ◽  
...  
Keyword(s):  
Complex System ◽  
The Netherlands ◽  
The Elderly ◽  
System Of Care ◽  
Infect Control Hosp ◽  
Vulnerable Groups ◽  
Care Provision ◽  
Mentally Disabled ◽  
Healthcare Settings

We report a large scabies outbreak occurring in Tilburg, Netherlands, which affected several different healthcare settings that provide care to the elderly and the mentally disabled. The outbreak demonstrated how the complex system of care provision to vulnerable groups facilitated extensive scabies transmission among multiple linked healthcare settings and the community.Infect Control Hosp Epidemiol 2012;33(10): 1047-1050

scholarly journals Transmission of Ebola Viruses: What We Know and What We Do Not Know

mBio ◽  
2015 ◽  
Vol 6 (2) ◽  
Author(s):  
Michael T. Osterholm ◽  
Kristine A. Moore ◽  
Nicholas S. Kelley ◽  
Lisa M. Brosseau ◽  
Gary Wong ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Transmission ◽  
Strain Differences ◽  
Serial Passage ◽  
Domestic Animals ◽  
Respiratory Pathogens ◽  
Patient Contact ◽  
Small Particles ◽  
Direct Patient Contact

ABSTRACT Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. Key areas requiring further study include (i) the role of aerosol transmission (either via large droplets or small particles in the vicinity of source patients), (ii) the role of environmental contamination and fomite transmission, (iii) the degree to which minimally or mildly ill persons transmit infection, (iv) how long clinically relevant infectiousness persists, (v) the role that “superspreading events” may play in driving transmission dynamics, (vi) whether strain differences or repeated serial passage in outbreak settings can impact virus transmission, and (vii) what role sylvatic or domestic animals could play in outbreak propagation, particularly during major epidemics such as the 2013–2015 West Africa situation. In this review, we address what we know and what we do not know about Ebola virus transmission. We also hypothesize that Ebola viruses have the potential to be respiratory pathogens with primary respiratory spread.

Taenia solium Metacestode Viability in Infected Pork after Preparation with Salt Pickling or Cooking Methods Common in Yucatán, México

2002 ◽  
Vol 65 (4) ◽  
pp. 666-669 ◽  
Author(s):  
R. RODRIGUEZ-CANUL ◽  
F. ARGAEZ-RODRIGUEZ ◽  
D. PACHECO de la GALA ◽  
S. VILLEGAS-PEREZ ◽  
A. FRASER ◽  
...  
Keyword(s):  
Taenia Solium ◽  
Food Preparation ◽  
Cooking Methods ◽  
Pork Meat ◽  
Control Groups ◽  
Preparation Methods ◽  
Cestode Parasite ◽  
Cyst Viability ◽  
Potential Risks ◽  
Foodborne Infection

The cestode parasite Taenia solium is an important cause of foodborne infection throughout tropical and subtropical regions. Ingestion of pork meat infected with T. solium larvae can lead to taeniasis infection in humans. With tourism and the consumption of native food increasing, it is important to investigate potential risks of transmission associated with food preparation methods. In this study, traditional Mexican salt pickling and two methods of pork preparation (as roast pork [cochinita pibil] and in pork and beans [frijol con puerco]) were evaluated in order to determine their effects on T. solium cyst viability in infected tissue. In the control groups, all metacestodes isolated were 100% viable, and only small changes in pH (from 6.0 to 5.9) and temperature (29 to 30°C) were recorded. No viable cysts were detected after 12 and 24 h of salt pickling. The pH of the meat during salting dropped from 6.0 to 5.3. Osmotic changes and dehydration from the salting, rather than a change in pH, could be considered the main cause of cyst death. Temperatures of &gt;65°C damaged T. solium metacestodes in roast pork and in pork and beans. The results of this study indicate that if traditional pork dishes are prepared properly, T. solium cysts are destroyed. The criteria used in this study to evaluate the viability of tissue cysts are discussed.

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