scholarly journals Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

2020 ◽  
pp. 1-4
Author(s):  
Carla Benea ◽  
Laura Rendon ◽  
Jesse Papenburg ◽  
Charles Frenette ◽  
Ahmed Imacoudene ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Control Strategy ◽  
Healthcare Workers ◽  
Control Strategies ◽  
Risk Exposure ◽  
Nasopharyngeal Swab ◽  
Home Based ◽  
Respiratory Coronavirus ◽  
Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

scholarly journals Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to SARS-CoV-2: a cohort study

2020 ◽  
Author(s):  
Carla Benea ◽  
Laura Rendon ◽  
Jesse Papenburg ◽  
Charles Frenette ◽  
Ahmed Imcaoudene ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Control Strategy ◽  
Healthcare Workers ◽  
Control Strategies ◽  
Risk Exposure ◽  
Nasopharyngeal Swab ◽  
Post Exposure ◽  
Home Based ◽  
Second Wave

ABSTRACTBackgroundEvidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to SARS-CoV-2. This study evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy.MethodsHCWs advised by their Infection Control or Occupational Health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May-September 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0-6 post exposure, followed by standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for i) clinical COVID-19 diagnosis from day 8-14 post exposure, and for ii) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9-10 and 14 post exposure. Interim results are reported in the context of a second wave threatening this essential workforce.ResultsAmong 30 HCWs enrolled to date (age 31±9 years, 24 [80.0%] female), 3 were diagnosed with COVID-19 by day 14 post exposure (secondary attack rate 10.0%), with all cases detected by the 7-day infection control strategy: NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95%CI: 93.1-100.0%).InterpretationAmong HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. While ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

scholarly journals 1161. Infection Control After Debridement of Brucella melitensis Hardware Infection

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S349-S349
Author(s):  
Amanda Novack
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Operating Room ◽  
Healthcare Workers ◽  
Brucella Melitensis ◽  
Risk Exposure ◽  
Post Exposure Prophylaxis ◽  
Operating Room Personnel ◽  
Infectious Dose ◽  
High Index Of Suspicion

Abstract Background Brucellosis is the most common laboratory-acquired bacterial infection, according to the Centers for Disease Control and Prevention (CDC), despite the rare incidence of Brucellosis in the population at large. A 34-year-old man presented with pain and swelling of the left leg, where he had previously sustained an open tibia fracture 1 year prior. After the initial injury, he underwent four corrective surgeries (including bone graft and internal-fixation) and was asymptomatic for 6 months before these new symptoms developed. MRI revealed a 6.5 × 5.1 × 2.7 cm abscess and tibial osteomyelitis. Surgical staff performed an aggressive incision and drainage (I&D) with saucerization of the tibia, to treat what seemed to be a routine hardware infection. Five days later, tissue cultures grew Brucella melitensis. Upon further questioning, the patient described butchering a wild boar 10 days prior to symptom onset. Methods The CDC provides guidance on serological testing and post-exposure prophylaxis (PEP) for persons exposed to Brucella in the laboratory setting. Upon identification of this patient’s Brucella isolates, infection control staff identified all laboratory workers that met CDC criteria for “high risk” exposure, as well as other healthcare workers (HCW) exposed to aerosolized infectious material (including those workers in the operating room during pulse lavage of the abscess). Results Staff identified 34 HCW with presumed high-risk exposure, including 19 laboratory personnel, 13 operating room personnel, and two patient care technicians. Baseline serology was obtained on all 34 HCW, and PEP with rifampin and doxycycline was prescribed for each. Nine of the exposed employees changed PEP therapy due to intolerance, and follow-up serology was obtained on 32 of the 34 healthcare workers, with zero seroconversions found. Conclusion Brucellosis is a rare disease in clinical practice, so a high index of suspicion is necessary to enact appropriate precautions before widespread exposures. When exposure is identified after the fact, efficient protocols should be in place to identify all susceptible individuals. Due to the low infectious dose of Brucella melitensis, CDC guidance should be expanded to include aerosolizing procedures outside of the laboratory. Disclosures All authors: No reported disclosures.

scholarly journals Point prevalence survey to evaluate the seropositivity for coronavirus disease 2019 (COVID-19) among high-risk healthcare workers

2020 ◽  
pp. 1-6
Author(s):  
Norihiro Yogo ◽  
Kristina L. Greenwood ◽  
Leslie Thompson ◽  
Pamela J. Wells ◽  
Stephen Munday ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Unit Type ◽  
Point Prevalence Survey ◽  
Positive Antibody ◽  
Respiratory Coronavirus ◽  
Antibody Tests

Abstract Among 1,770 healthcare workers serving in high-risk care areas for coronavirus disease 2019 (COVID-19), 39 (2.2%) were seropositive. Exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in the community was associated with being seropositive. Job or unit type and percentage of time working with COVID-19 patients were not associated with positive antibody tests.

scholarly journals Health Care Acquired COVID-19 is Less Symptomatic than Community Acquired Disease Among Healthcare Workers

2021 ◽  
pp. 1-28
Author(s):  
Jeffrey J Fletcher ◽  
Eric C Feucht ◽  
Peter Y Hahn ◽  
Theresa N McGoff ◽  
Del J Dehart ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Risk Exposure ◽  
Work Exposure ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Low Exposure ◽  
Asymptomatic Disease

ABSTRACT Objective: We hypothesized healthcare workers (HCW) with high-risk exposures outside the healthcare system would have less asymptomatic coronavirus 2019 (COVID-19) disease and more symptoms than those without such exposures. Design: A longitudinal point prevalence study during August 17- September 4 2020 and December 2nd - 23rd. Setting: Community based teaching health system Participants: All HCS were invited to participate. Among HCW who acquired COVID-19, logistic regression models were used to evaluate the adjusted odds of asymptomatic disease using high-risk exposure outside the healthcare system as the explanatory variable. The number of symptoms between exposure groups was evaluated with the Wilcoxon rank-sum test. The risk of seropositivity among all HCS by work exposure was evaluated during both periods. Interventions: Survey and serological testing Result: Seroprevalence increased from 1.9% (95% CI 1.2% - 2.6%) to 13.7% (95% CI 11.9% - 15.5%) during the study. Only during Period 2 did HCW with the highest work exposure (versus low exposure) have an increased risk of seropositivity (RD 7% [95% CI 1% -13%]). Participants who had a high-risk exposure outside of work (compared to those without) had a decreased probability of asymptomatic disease (OR 0.38 [95% CI 0.16 – 0.86]) and demonstrated more symptoms (median of 3 [IQR 5] vs 1 [IQR 2]; P = 0.001). Conclusions Health care acquired COVID-19 increases the probability of asymptomatic or mild COVID-19 disease compared to community acquired disease. This suggests infection prevention strategies (including masks and eye protection) may be mitigating inoculum and supports the variolation theory in COVID-19.

Improving Influenza Immunization Rates Among Healthcare Workers Caring for High-Risk Pediatric Patients

2004 ◽  
Vol 25 (11) ◽  
pp. 912-917 ◽  
Author(s):  
Kristina A. Bryant ◽  
Beth Stover ◽  
Linda Cain ◽  
Gail L. Levine ◽  
Jane Siegel ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Neonatal Intensive Care ◽  
Pediatric Intensive Care ◽  
Vaccination Rates ◽  
Influenza Immunization ◽  
Immunization Rates

AbstractObjective:To assess influenza vaccination rates of healthcare workers (HCWs) in neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and oncology units in Pediatric Prevention Network (PPN) hospitals.Participants:Infection control practitioners and HCWs in NICUs, PICUs, and oncology units.Methods:In November 2000, posters, electronic copies of a slide presentation, and an influenza fact sheet were distributed to 32 of 76 PPN hospitals. In January 2001, a survey was distributed to PPN hospital participants to obtain information about the immunization campaigns. On February 7, 2001, a survey of influenza immunization was conducted among HCWs in NICU, PICU, and oncology units at participating hospitals.Results:Infection control practitioners from 19 (25%) of the 76 PPN hospitals completed the surveys. The median influenza immunization rate was 43% (range, 12% to 63%), with 7 hospitals exceeding 50%. HCWs (n = 1,123) at 15 PPN hospitals completed a survey; 53% of HCWs reported receiving influenza immunization. Immunization rates varied by work site: 52% in NICUs and PICUs compared with 60% in oncology units. Mobile carts and PPN educational fact cards were associated with higher rates among these subpopulations (P < .001) (361 [63%] of 575 vs 236 [44%] of 541 for mobile carts; 378 [60%] of 633 vs 219 [45%] of 483 for fact cards).Conclusion:Despite delayed distribution of influenza vaccine during the 2000–2001 season, immunization rates at 7 hospitals and among HCWs in high-risk units exceeded the National Association of Children's Hospitals and Related Institutions goal of 50%.

scholarly journals Comparison of infection control strategies to reduce COVID-19 outbreaks in homeless shelters in the United States: a simulation study

2020 ◽  
Author(s):  
Lloyd A.C. Chapman ◽  
Margot Kushel ◽  
Sarah N. Cox ◽  
Ashley Scarborough ◽  
Caroline Cawley ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Local Community ◽  
Control Strategies ◽  
The United States ◽  
Homeless Shelters ◽  
Homeless Shelter ◽  
Cross Sectional ◽  
Risk Environments ◽  
Symptom Screening

AbstractBackgroundMultiple COVID-19 outbreaks have occurred in homeless shelters across the US, highlighting an urgent need to identify the most effective infection control strategy to prevent future outbreaks.MethodsWe developed a microsimulation model of SARS-CoV-2 transmission in a homeless shelter and calibrated it to data from cross-sectional polymerase-chain-reaction (PCR) surveys conducted during COVID-19 outbreaks in five shelters in three US cities from March 28 to April 10, 2020. We estimated the probability of averting a COVID-19 outbreak in a representative homeless shelter of 250 residents and 50 staff over 30 days under different infection control strategies, including daily symptom-based screening, twice-weekly PCR testing and universal mask wearing.ResultsThe proportion of PCR-positive residents and staff at the shelters with observed outbreaks ranged from 2.6% to 51.6%, which translated to basic reproduction number (R0) estimates of 2.9−6.2. The probability of averting an outbreak diminished with higher transmissibility (R0) within the simulated shelter and increasing incidence in the local community. With moderate community incidence (∼30 confirmed cases/1,000,000 people/day), the estimated probabilities of averting an outbreak in a low-risk (R0=1.5), moderate-risk (R0=2.9), and high-risk (R0=6.2) shelter were, respectively: 0.33, 0.11 and 0.03 for daily symptom-based screening; 0.52, 0.27, and 0.04 for twice-weekly PCR testing; 0.47, 0.20 and 0.06 for universal masking; and 0.68, 0.40 and 0.08 for these strategies combined.ConclusionsIn high-risk homeless shelter environments and locations with high community incidence of COVID-19, even intensive infection control strategies (incorporating daily symptom-screening, frequent PCR testing and universal mask wearing) are unlikely to prevent outbreaks, suggesting a need for non-congregate housing arrangements for people experiencing homelessness. In lower-risk environments, combined interventions should be adopted to reduce outbreak risk.

Infection Control and Employee Health: Marketing a Hepatitis B Vaccine Program

1986 ◽  
Vol 7 (6) ◽  
pp. 339-341 ◽  
Author(s):  
William M. Valenti ◽  
Rose Haas ◽  
Mary Ellen Beideman
Keyword(s):  
Hepatitis B Virus ◽  
High Risk ◽  
Hepatitis B ◽  
Infection Control ◽  
Healthcare Workers ◽  
Employee Health ◽  
Health Marketing ◽  
B Virus ◽  
Viral Hepatitis B ◽  
Healthcare Professions

Viral hepatitis B is one of the major concerns of today's healthcare workers. Of the 100,000 Americans infected each year, 5% to 10% of them are employed in healthcare professions. For every 500 identified high-risk personnel, as many as 50 could become infected with hepatitis B virus. Every hospital should have procedures in writing for pre- and post-exposure prevention of hepatitis B.

scholarly journals We must rigorously follow basic infection control procedures to protect our healthcare workers from SARS-CoV-2

2020 ◽  
Vol 41 (12) ◽  
pp. 1438-1440 ◽  
Author(s):  
Samuel W. Dooley ◽  
Thomas R. Frieden
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Source Control ◽  
Protective Equipment ◽  
Healthcare Facilities ◽  
Environmental Controls ◽  
Increased Risk ◽  
Control Procedures ◽  
Respiratory Coronavirus ◽  
Established Infection

AbstractBecause severe acute respiratory coronavirus virus 2 (SARS-CoV-2) spreads easily and healthcare workers are at increased risk of both acquiring and transmitting infection, all healthcare facilities must rapidly and rigorously implement the full hierarchy of established infection controls: source control (removal or mitigation of infection sources), engineering and environmental controls, administrative controls, and personal protective equipment.

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