Hospital-acquired influenza in the United States, FluSurv-NET, 2011–2012 through 2018–2019

2021 ◽  
pp. 1-7
Author(s):  
Charisse N. Cummings ◽  
Alissa C. O’Halloran ◽  
Tali Azenkot ◽  
Arthur Reingold ◽  
Nisha B. Alden ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Respiratory Symptom ◽  
The United States ◽  
Control Measures ◽  
Onset Date ◽  
Surveillance Network ◽  
Cross Sectional ◽  
Hospital Infection Control ◽  
Adjusted Rate ◽  
Hospital Acquired

Abstract Objective: To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza. Design: Cross-sectional study. Setting: US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011–2012 through 2018–2019 seasons. Methods: Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza. Results: Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons. Conclusions: Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.

scholarly journals Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

2020 ◽  
Author(s):  
Richard C Gerkin ◽  
Kathrin Ohla ◽  
Maria G Veldhuizen ◽  
Paule V Joseph ◽  
Christine E Kelly ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Respiratory Symptom ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Olfactory Loss ◽  
Visual Analog Scales ◽  
Cardinal Symptoms ◽  
Smell Loss

Abstract In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<OR<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

scholarly journals Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries

2021 ◽  
Vol 11 (8) ◽  
pp. 106
Author(s):  
Sheikh Saifur Rahman Jony ◽  
Ubydul Haque ◽  
Nathaniel J. Webb ◽  
Emily Spence ◽  
Md. Siddikur Rahman ◽  
...  
Keyword(s):  
Psychological Health ◽  
Age Groups ◽  
Psychosocial Problems ◽  
Relevant Information ◽  
The United States ◽  
Control Measures ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Primary Determinant

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that greater encouragement from government health authorities and the promotion of health education and policies are essential in the dissemination of COVID-19-awareness and increased control of the spread of COVID-19.

Hospital-acquired infection awareness and control practices among healthcare staff: an evaluation

2021 ◽  
Vol 27 (11) ◽  
pp. 296-302
Author(s):  
Pallavi Saraswat ◽  
Rajnarayan R Tiwari ◽  
Muralidhar Varma ◽  
Sameer Phadnis ◽  
Monica Sindhu
Keyword(s):  
Infection Control ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Control Measures ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Control Policies ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background/Aims Hospital-acquired infections pose a risk to the wellbeing of both patients and staff. They are largely preventable, particularly if hospital staff have adequate knowledge of and adherence to infection control policies. This study aimed to assess the knowledge, awareness and practice of hospital-acquired infection control measures among hospital staff. Methods A cross-sectional study was conducted among 71 staff members in a tertiary healthcare facility in Karnataka, India. The researchers distributed a questionnaire containing 33 questions regarding knowledge of hospital-acquired infections, awareness of infection control policies and adherence to control practices. The results were analysed using the Statistical Package for the Social Sciences, version 16.0 and a Kruskal–Wallis test. Results Respondents' mean percentage score on the knowledge of hospital-acquired infections section was 72%. Their mean percentage scores on the awareness and practice of infection prevention measures sections were 82% and 77% respectively. Doctors and those with more years of experience typically scored higher. Conclusion The respondents had an acceptable level of knowledge, awareness and adherence to infection control practices. However, continued training is essential in the prevention of hospital-acquired infections. The majority of the respondents stated that they were willing to undertake training in this area, and this opportunity should be provided in order to improve infection control quality.

scholarly journals Assessing Knowledge, Attitude, and Practices on Hospital Acquired Infections Control by Anaesthesia Practitioners in the Operating Theatres of the Tamale Teaching Hospital (TTH); Ghana

2020 ◽  
Vol 5 (06) ◽  
Author(s):  
Martin Mumuni Danaah Malick ◽  
Edem Yao Akpa ◽  
Peter Paul Bamaalabong
Keyword(s):  
Infection Control ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Hospital Acquired Infections ◽  
Hospital Infection Control ◽  
Operating Theatres ◽  
Control And Prevention ◽  
Healthcare Associated ◽  
Hospital Acquired

Background: Hospital Acquired Infections (HAIs) place a significant economic burden on the healthcare system. Infection control practices are important in minimizing healthcare associated infections. However, low compliance with Universal and Standard Precautions has been reported in a number of studies. The Centre for Disease Control and Prevention (CDC) developed baseline definitions for HAIs that were republished in 2004 and has defined HAIs as those that develop during hospitalization but are neither present nor incubating upon the patient’s admission to the hospital; generally, these infections occur between 48 to 72 hours after admission and within 10 days after hospital discharge. this study aimed at unveiling the level of knowledge, attitude and practices on infection prevention control in the operating theatres by anaesthesia practitioners at TTH. Materials and Methods: A cross-sectional study design was employed. A mixed-method approach was used for data collection which includes a structured questionnaire carried out via face to face interview and observation. Results: The study showed that 100% of the respondents have knowledge on hospital acquired infection control in the theatre in one way or the other whereas attitude and practices toward hospital infection control in the operating theatres are undesirable in some specific areas of infection control such as wearing of sterile gowns and goggle. As high as 80.6% and 69.4% do not wear goggle and gowns respectively whilst performing regional anaesthesia.  Conclusions:  This study demonstrated that anaesthetists at TTH have reported sub-optimal levels of compliance i.e. attitude and practices with selective infection control. The study further demonstrated that discrepancies exist between anaesthetists’ attitudes towards a guideline as well as their actual practice.

scholarly journals Similarities and Differences in COVID-19 Awareness, Concern, and Symptoms by Race and Ethnicity in the United States: Cross-Sectional Survey (Preprint)

2020 ◽  
Author(s):  
Jeb Jones ◽  
Patrick S Sullivan ◽  
Travis H Sanchez ◽  
Jodie L Guest ◽  
Eric W Hall ◽  
...  
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
Online Survey ◽  
Statistical Tests ◽  
The United States ◽  
Control Measures ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Similarities And Differences ◽  
Hispanic White

BACKGROUND Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. OBJECTIVE The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. METHODS We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. RESULTS A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (<i>P</i>=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (<i>P</i>=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. CONCLUSIONS We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information.

scholarly journals 1511. Influenza antiviral use in patients hospitalized with laboratory-confirmed influenza in the United States, FluSurv-NET, 2015 – 2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S759-S759
Author(s):  
Mark W Tenforde ◽  
Charisse N Cummings ◽  
Melissa Sutton ◽  
Sue Kim ◽  
Amber Maslar ◽  
...  
Keyword(s):  
United States ◽  
Symptom Onset ◽  
Early Treatment ◽  
Antiviral Treatment ◽  
The United States ◽  
Sampled Data ◽  
Emerging Infections ◽  
Research Support ◽  
Surveillance Network ◽  
Late Treatment

Abstract Background Antiviral therapy is recommended for all patients hospitalized with influenza to reduce morbidity and mortality. We used data from the population-based Influenza Hospitalization Surveillance Network (FluSurv-NET) to evaluate trends in influenza antiviral use in patients hospitalized with influenza over 4 seasons in the United States. Methods We included cases residing within the FluSurv-NET catchment area and hospitalized with laboratory-confirmed influenza from October 1 – April 30 during 2015-16 through 2018-19 seasons. For 2015-16 and 2016-17, chart abstraction of demographic and clinical characteristics and antiviral use was performed on all cases; for 2017-18 and 2018-19, all patients &lt; 50-years and an age-stratified random sample of older adults were sampled. Data were weighted to reflect the probability of selection. We assessed the frequency of treatment, by season and age group, and evaluated trends by season using the Cochran-Armitage test. Among those receiving antivirals, we used multivariable logistic regression to assess the association between the days from symptom onset to admission and receipt of early (0-2 days from symptom onset) versus late (&gt; 2 days) treatment, adjusting for age, sex, race/ethnicity, and underlying medical conditions. Results Over 4 seasons, we sampled 62,182 patients; 54% female and 63% non-Hispanic white. Overall, 92% of patients received antivirals, increasing from 86% in 2015-16 to 94% in 2018-19; use increased by season in all age strata (p &lt; 0.001) [Figure]. Most received oseltamivir (99%); in 2018-19, 2% received baloxavir. Of those who received antivirals, 38% received early treatment. The median days from symptom onset to admission was 1 day (interquartile range [IQR] 1-3) for those who received early treatment and 4 days (IQR 3-6) for those who received late treatment. Ninety-three percent who received antivirals started within 1 day of admission. For each additional day from symptom onset to admission, the adjusted odds of late treatment was 8.56 (95% confidence interval: 7.83-9.35). Figure. Weighted percentage of hospitalized patients receiving influenza antivirals by influenza season and age strata, FluSurv-NET, 2015-16 through 2018-19. Conclusion In patients hospitalized with influenza, most received antiviral treatment within 1 day of admission. However, a majority had delays from symptoms onset to initiation, due to late presentation of illness. Disclosures Melissa Sutton, MD, MPH, CDC funding (Emerging Infections Program) (Grant/Research Support) Sue Kim, MPH, Council of State and Territorial Epidemiologists (CSTE) (Grant/Research Support) Nisha B. Alden, MPH, CDC (Grant/Research Support)

scholarly journals Protection of healthcare workers against transmission of Mycobacterium tuberculosis in hospitals: a review of the evidence

2020 ◽  
Vol 6 (1) ◽  
pp. 00317-2019 ◽  
Author(s):  
Roland Diel ◽  
Albert Nienhaus ◽  
Peter Witte ◽  
Renate Ziegler
Keyword(s):  
Mycobacterium Tuberculosis ◽  
World Health Organization ◽  
Healthcare Workers ◽  
The United States ◽  
Multidrug Resistant ◽  
Control Measures ◽  
World Health ◽  
Hospital Infection Control ◽  
The World ◽  
Health Organization

BackgroundEmployees in contact with infectious tuberculosis (TB) patients in healthcare facilities of low-incidence countries are still at considerable risk of acquiring TB infections. However, formal precautions recommended on the protection of healthcare workers may not only vary from country to country but also within a single country. The objective of this study was to compare current guidelines with respect to hospital infection control of TB, focusing on common shared priorities and discrepancies between sets of recommendations.MethodsFive types of procedures captured in guidelines of the World Health Organization, the United States of America, the United Kingdom and Germany are compared and the underlying evidence is discussed.ResultsUncontroversially, personal protection by respirators in the TB ward and during aerosol-generating procedures is key to reducing Mycobacterium tuberculosis exposure. However, there is no consensus on the types of masks that should be worn in different situations. Closely connected to this, there is considerable uncertainty with respect to the optimal date of removing sputum smear-negative and multidrug-resistant TB patients from isolation. Indeed, the use of notable new tools for this purpose, such as the highly sensitive PCR tests recommended by the World Health Organization for detecting TB/multidrug-resistant TB, have yet to be sufficiently incorporated into TB guidelines. Perceptions differ, too, as to whether long-term control measures for M. tuberculosis infections in healthcare workers by serial testing for latent TB infection should be established and, if so, how testing results should be interpreted.ConclusionsAlthough the current recommendations on protection of healthcare workers are otherwise homogeneous, there are considerable discrepancies that have important implications for daily practice.

scholarly journals The rate of acute gastrointestinal illness in developed countries

2006 ◽  
Vol 4 (S2) ◽  
pp. 31-69 ◽  
Author(s):  
Sharon L. Roy ◽  
Elaine Scallan ◽  
Michael J. Beach
Keyword(s):  
United States ◽  
Study Design ◽  
Developed Countries ◽  
The United States ◽  
Gastrointestinal Illness ◽  
Point Estimate ◽  
Case Definitions ◽  
Surveillance Network ◽  
Cross Sectional ◽  
Acute Gastrointestinal Illness

This paper reviews estimates of the incidence and prevalence of acute gastrointestinal illness (AGI) from 33 studies. These studies include prospective cohort studies, retrospective cross-sectional population-based surveys, and intervention trials from the United States and six other developed countries published since 1953. The incidence and prevalence estimates for AGI reported in these studies range from 0.1 to 3.5 episodes per person-year. However, comparisons of these rates are problematic owing to significant variation in study design, sampling methodology, and case definitions and should be made with caution. In the United States, the Centers for Disease Control and Prevention's (CDC) Foodborne Diseases Active Surveillance Network (FoodNet) estimates a rate of 0.65 episodes of AGI per person-year. This estimate includes diarrhea and/or vomiting of infectious or non-infectious origin, with a measure of severity (impairment of daily activities or diarrhea duration greater than 1 day), and has been adjusted for combined respiratory–gastrointestinal illnesses. However, it excludes episodes of diarrhea or vomiting due to any long-lasting or chronic illness or condition. Limitations in study design result in an unknown degree of uncertainty around this point estimate.

Influenza Surveillance Islamabad and Rawalpindi, Pakistan, September 2017 - February 2018 (Preprint)

2020 ◽  
Author(s):  
Dr Nadia ◽  
Saima Dil ◽  
Naveed Ullah Khan ◽  
Rana Jawad Asghar ◽  
Farida Khudaidad Khan ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Influenza A ◽  
Case Fatality ◽  
Sudden Onset ◽  
Control Measures ◽  
Influenza Surveillance ◽  
Care Providers ◽  
Surveillance Network ◽  
Cross Sectional ◽  
Influenza A H1n1

BACKGROUND Background: Globally 5-10%adults and 20-30%children are affected by influenza annually. Annual epidemics result in 3-5million cases of serious illness and approximately500,000 deaths. In 2008 a sentinel lab-based influenza surveillance network was established in Pakistan in collaboration with CDC having objectives to assess trends of Influenza-like-Illness(ILI) and Severe Acute Respiratory Illness(SARI). OBJECTIVE Objectives: To assess burden of disease, identify risk factors, and recommend control measures. METHODS Methods: A cross-sectional study was conducted based on influenza surveillance data obtained from NICLP from September 2017 to February 2018.Study was done from the data records and samples of suspected ILI patients received from hospitals of Islamabad and Rawalpindi. A case was defined as sudden onset of fever of ≥ 38 C° and cough, with onset within last 10 days. Samples were tested at NICLP for confirmation by RT-PCR. Frequencies were calculated and data analyzed as per time, place and person RESULTS Results: A total of 1500 samples were received out of which 435(29%) were found positive. Among positive samples 246(56.5%) were Influenza-A(H1N1) pdm09,165(38%) were Influenza-A(H3N1) and 24(5.5%) were influenza B.Mean age was 39 years(range 40 days-80 years)while maximum cases were reported from age group 30-39 years(n=77)followed by 50-59 years(n=59).Males were predominant 256(58.8%). Among cases, 21(4.8%) healthcare workers. Travel history was found in 21(4.8%) cases while 35(8%) cases had contact with influenza patients and 14(3.2%) had contact with birds. Among positive cases 262(60%) were reported from Rawalpindi. Majority of cases were reported in January (277) followed by February (112). 31.4% met SARI case definition. Median hospital stay was 5days.During hospitalization 124(26.3%) were ICU admissions, out of them 2(0.42%) were on ventilator, 83(17.6%) were mechanically ventilated. Prevalence of influenza in reported cases was 0.01%.Six confirmed cases died with Case Fatality Rate=1.27%. CONCLUSIONS Conclusion Most cases reported were of Influenza-A (H1N1) pdm09. Based on the results, policy for inclusion of flu vaccination on annual basis is recommended for health care providers and general community.

scholarly journals Characteristics and Factors Associated with SARS-CoV-2 Infections in Individuals That Attended Referral Hospitals from Southern Region of Bahia State, Brazil: A Surveillance Network Retrospective Study

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2462
Author(s):  
Fabrício Barbosa Ferreira ◽  
Galileu Barbosa Costa ◽  
Anaiá da Paixão Sevá ◽  
George Rego Albuquerque ◽  
Ana Paula Melo Mariano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Clinical Symptoms ◽  
Respiratory Illness ◽  
Southern Region ◽  
Control Measures ◽  
Surveillance Network ◽  
Cross Sectional ◽  
Factors Associated ◽  
Referral Hospitals

In December 2019, a novel coronavirus was detected in Wuhan, China, and rapidly spread worldwide. In Brazil, to date, there have been more than 20,000,000 confirmed cases of COVID-19 and more than 550,000 deaths. The purpose of the current study was to determine the clinical and epidemiological profile of the population affected by COVID-19 that have attended referral hospitals in Southern region of Bahia State, to better understand the disease and its risk factors in order to enable more appropriate conduct for patients. An observational, descriptive, cross-sectional, exploratory study was conducted using secondary data collected from the Laboratório de Farmacogenômica e Epidemiologia Molecular, Universidade Estadual de Santa Cruz (LAFEM/UESC). Chi-squared and Fisher’s exact tests were applied to determine the association between clinical symptoms and laboratory results, and to identify risk factors associated with SARS-CoV-2 infection. A total of 3135 individuals with suspected severe respiratory illness were analyzed and 41.4% of them tested positive for SARS-CoV-2 infection. Male individuals and having comorbidities were risk factors significantly associated with SARS-CoV-2 infection (OR = 1.17 and OR = 1.37, respectively). Interestingly, being a healthcare professional was a significantly protective factor (OR = 0.81, p < 0.001). Our findings highlight the importance of routinely testing the population for early identification of infected individuals, and also provide important information to health authorities and police makers to improve control measures, management, and screening protocols.

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