Implementation of the Canadian Contingency Plan for a Case of Suspected Viral Hemorrhagic Fever

2003 ◽  
Vol 24 (4) ◽  
pp. 280-283 ◽  
Author(s):  
Mark Loeb ◽  
Douglas MacPherson ◽  
Michele Barton ◽  
Jan Olde
Keyword(s):  
High Risk ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Internal Communication ◽  
Contact Tracing ◽  
Suspected Case ◽  
Viral Hemorrhagic Fever ◽  
Laboratory Equipment ◽  
Contingency Plan ◽  
Close Contacts

AbstractObjective:To describe the implementation of the Canadian contingency plan for viral hemorrhagic fever (VHF) in response to a suspected case.Setting:A 300-bed, tertiary-care, university-affiliated hospital.Participants:A 32-year-old Congolese woman admitted to the hospital with suspected VHF in February 2001. Contact evaluation included hospital healthcare workers and laboratory staff.Intervention:Enhanced isolation precautions were implemented in the patient care setting to prevent nosocomial transmission. Contact tracing and evaluation of close and high-risk contacts with symptoms was conducted. Laboratory precautions included barrier precautions and diversion of specimens. Communication occurred to both hospital employees and the media.Results:Three high-risk contacts, 13 close contacts, and 60 casual contacts were identified. Two close contacts became symptomatic and required evaluation. Challenging process issues included tracing of laboratory specimens, decontamination of laboratory equipment, and internal and external communication. After 5 days, a transmissible VHF of public health consequence was ruled out in the index case.Conclusion:Contingency plans for VHF can be implemented in an efficient and feasible manner. Contact tracing, laboratory issues, internal communication, and media interest can be anticipated to be the key challenges.

scholarly journals A comparison of COVID-19 secondary attack rate in household and close contacts compared to current risk stratification guidelines of the Kerala government

2021 ◽  
pp. 004947552110020
Author(s):  
Balram Rathish ◽  
Arun Wilson ◽  
Sonya Joy
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Attack Rate ◽  
Low Risk ◽  
Contact Tracing ◽  
Index Cases ◽  
Current Risk ◽  
Close Contacts

COVID-19 has been found to be highly infectious with a high secondary attack rate with a R0 of 3.3. However, the secondary attack rate based on risk stratification is sparsely reported, if ever. We studied the contact tracing data for two index cases of COVID-19 with some overlap of contacts. We found that 60% of high-risk contacts and 0% of low-risk contacts of symptomatic COVID-19 patients contracted the infection, in keeping with the Kerala government contact risk stratification guidelines.

scholarly journals The Epi Info Viral Hemorrhagic Fever (VHF) Application: A Resource for Outbreak Data Management and Contact Tracing in the 2014–2016 West Africa Ebola Epidemic

2016 ◽  
Vol 214 (suppl 3) ◽  
pp. S122-S136 ◽  
Author(s):  
Ilana J. Schafer ◽  
Erik Knudsen ◽  
Lucy A. McNamara ◽  
Sachin Agnihotri ◽  
Pierre E. Rollin ◽  
...  
Keyword(s):  
West Africa ◽  
Data Management ◽  
Hemorrhagic Fever ◽  
Contact Tracing ◽  
Viral Hemorrhagic Fever

scholarly journals Superspreaders: A Lurking Danger in the Community

2021 ◽  
Vol 12 ◽  
pp. 215013272098743
Author(s):  
Ritin Mohindra ◽  
Arushi Ghai ◽  
Rinnie Brar ◽  
Neha Khandelwal ◽  
Manisha Biswal ◽  
...  
Keyword(s):  
Low Income ◽  
Index Case ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Contact Tracing ◽  
Care Hospital ◽  
Indirect Contact ◽  
Ebola Hemorrhagic Fever ◽  
Slum Dwellers ◽  
Recent Outbreak

A “superspreader” refers to an unusually contagious organism infected with a disease. With respect to a human borne illnesses, a superspreader is someone who is more likely to infect other humans when compared to a typically infected person. The existence of human superspreaders is deeply entrenched in history; the most famous case being that of Typhoid Mary. Through contact tracing, epidemiologists have identified human superspreaders in measles, tuberculosis, rubella, monkeypox, smallpox, Ebola hemorrhagic fever, and SARS. The recent outbreak of Coronavirus disease (COVID-19) has shifted the focus back on the superspreaders. We herein present a case report of a COVID-19 superspreader with a hitherto unusually high number of infected contacts. The index case was a 33 year old male who resided in a low income settlement comprising of rehabilitated slum dwellers and worked as a healthcare worker (HCW) in a tertiary care hospital and had tested positive for COVID-19.On contact tracing, he had a total of 125 contacts, of which 49 COVID-19 infections had direct or indirect contact with the index case, qualifying him as a “superspreader.” This propagated infection led to an outbreak in the community. Contact tracing, testing and isolation of such superspreaders from the other members of the community is essential to stop the spread of this disease and contain the COVID-19 pandemic.

scholarly journals Onsite Mentorship Model for Isolation and Management of Viral Hemorrhagic Fever Syndromes at a Ugandan Hospital

2020 ◽  
Vol 41 (S1) ◽  
pp. s491-s492
Author(s):  
Peter Waitt ◽  
Shillah Nakato ◽  
Rodgers Ayebare ◽  
Umaru Ssekabira ◽  
Judith Nanyondo ◽  
...  
Keyword(s):  
Patient Care ◽  
Healthcare Workers ◽  
Health Workers ◽  
Clinical Care ◽  
Hemorrhagic Fever ◽  
Hospital Staff ◽  
Infection Prevention And Control ◽  
Suspected Case ◽  
Viral Hemorrhagic Fever ◽  
Fever Syndromes

Background:Uganda is prone to viral hemorrhagic fever (VHF) outbreaks. Infection prevention and control capacity is critical to supporting patient care, to preventing nosocomial transmission to health workers, and to limiting spread within the community. Offsite didactic training may increase healthcare worker knowledge, but this approach may be inadequate for assuring confident execution of practical clinical tasks in patient care settings. We aimed to develop a competency-based, onsite mentorship model for sentinel case isolation and management of viral hemorrhagic fever syndromes in Uganda. Methods: The Naguru Regional Referral Hospital (China Uganda Friendship Hospital) Kampala was selected as a site for training after its designation by the Uganda Ministry of Health (MoH) as facility for isolation of healthcare workers with suspected or confirmed VHF. The need for mentorships was determined from information from training providers, MoH assessments, hospital management, and key hospital staff. A list of skills was developed by reviewing WHO case management guidelines and Uganda-approved VHF trainings. The skills, exercised using scenario-based drills, focused on safety practices, identification and isolation of suspect cases, and delivery of optimized clinical care to suspected cases of VHF, among others. Trained facilitators (n = 2–4) supervised drills attended by staff from Naguru and other Kampala-based health facilities. Drills were scheduled weekly and were ordered to progressively increase in complexity. Specific drills could be repeated at the subsequent mentorship visit if gaps were identified. Results: Over 3 months, 12 drills were completed (Table 1). Cadres trained included 10 medical doctors, 12 nurses, 3 clinical officers, 5 laboratory technicians, 6 hygienists, 2 security officers, and 3 administrative officers. On average, 8 hospital staff attended weekly drills. During 3 months of the intervention, 1 suspected case of VHF and 3 cases with laboratory confirmed cholera were managed by the hospital team, and staff demonstrated the capacity for safe handling of patients with infectious bodily fluids. Barriers encountered included practice fatigue from repeated drills, challenges with team cohesion since members were from different institutions, limited personal protective equipment for repeated trainings, and competing routine hospital activities that reduced numbers of staff available for training. Repeated drills included clinical management, cadaver management, and infectious spills. Conclusions: This onsite mentorship project supported healthcare workers to gain confidence in the management of suspected VHF infection and other highly infectious diseases. Continued mentorship, hospital administration support and increase in exercise complexity are needed to consolidate on these gains.Funding: NoneDisclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, and Mylan.

scholarly journals COVID transmission and contact tracing using WHO risk assement tool among frontline healthcare workers : Insights from a South Indian tertiary care centre

2021 ◽  
Author(s):  
Merlin Moni ◽  
Kiran G Kulirankal ◽  
Preetha Prasanna ◽  
Ann Mary ◽  
Elizabeth Mary Thomas ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Low Risk ◽  
Contact Tracing ◽  
Tertiary Care Centre ◽  
South Indian ◽  
Shared Space ◽  
Frontline Healthcare Workers

AbstractBackgroundThe high exposure risk to COVID among frontline heathcare workers was a major challenge to healthcare systems across the globe that warranted close monitoring through risk assessment and contact tracing strategies. The objective of our study was to characterize exposure risk factors for transmission and subsequent COVID positivity among the frontlinehealthcare workers in our institution during the pandemic period.MethodsThe retrospective observational study conducted over a period of 6 months from June 2020 to November 2020 at a 1300-bedded South Indian tertiary care centre included frontline healthcare workers who were assessed for their identified encounter with COVID positive individual using a modified WHO COVID risk assessment tool. Additional risk attributes of exposure characterized among COVID positive healthcare workers comprised of shared space, cluster related transmissions and multiple instances of exposure to COVID.ResultsAmong a total of 4744 contacts with COVID positive individuals assessed for risk stratification during the study period, 942 (19.8%) were high risk and 3802 (80.2%) were low risk exposures respectively. 106 (2.2%) turned COVID positive during the surveillance period of 14 days. Frontline workers working in COVID areas had significant low COVID rates as compared to other areas (N=1, 0.9%). The average monthly COVID positivity rates being 1.66%, the attack rates among high risk and low risk contacts among the total HCWs screened were 5% (46/942) and 1.57% (60/3802) respectively. Shared space (70%) and IPC breaches (66%) were found to be highly prevalent in the COVID positive cohort, along with maskless encounters (43%) and multiple exposure (39%). The attack rate among the 6 identified COVID cluster groups (5.5%) were found to be higher than the attack rate (2.2%) noted among the total contacts screened and no significant association was observed between risk categories in the clusters.DiscussionOur study highlights higher risk of COVID positivity among high risk contacts as compared to low risk contacts. However, the high COVID positivity rate in low risk group among cluster transmissions and its lack of association with risk assessment highlight the suboptimal utility of the risk assessment strategy among cluster groups.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

scholarly journals Investigation of Four Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Rwanda, 2020

2021 ◽  
Vol 18 (13) ◽  
pp. 7018
Author(s):  
Olivier Nsekuye ◽  
Edson Rwagasore ◽  
Marie Aime Muhimpundu ◽  
Ziad El-Khatib ◽  
Daniel Ntabanganyimana ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Symptom Onset ◽  
Attack Rate ◽  
Positive Sample ◽  
Contact Tracing ◽  
Face To Face ◽  
Laboratory Confirmation ◽  
Closed Environment ◽  
Index Cases

We reported the findings of the first Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) four clusters identified in Rwanda. Case-investigations included contact elicitation, testing, and isolation/quarantine of confirmed cases. Socio-demographic and clinical data on cases and contacts were collected. A confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (PCR) while a contact was any person who had contact with a SARS-CoV-2 confirmed case within 72 h prior, to 14 days after symptom onset; or 14 days before collection of the laboratory-positive sample for asymptomatic cases. High risk contacts were those who had come into unprotected face-to-face contact or had been in a closed environment with a SARS-CoV-2 case for >15 min. Forty cases were reported from four clusters by 22 April 2020, accounting for 61% of locally transmitted cases within six weeks. Clusters A, B, C and D were associated with two nightclubs, one house party, and different families or households living in the same compound (multi-family dwelling). Thirty-six of the 1035 contacts tested were positive (secondary attack rate: 3.5%). Positivity rates were highest among the high-risk contacts compared to low-risk contacts (10% vs. 2.2%). Index cases in three of the clusters were imported through international travelling. Fifteen of the 40 cases (38%) were asymptomatic while 13/25 (52%) and 8/25 (32%) of symptomatic cases had a cough and fever respectively. Gatherings in closed spaces were the main early drivers of transmission. Systematic case-investigations contact tracing and testing likely contributed to the early containment of SARS-CoV-2 in Rwanda.

scholarly journals Assessing testing strategies and duration of quarantine in contact tracing for SARS-CoV-2: a retrospective study of San Francisco’s COVID-19 contact tracing program, June- August, 2020

2021 ◽  
Author(s):  
M J A Reid ◽  
P Prado ◽  
H Brosnan ◽  
A Ernst ◽  
H Spindler ◽  
...  
Keyword(s):  
Retrospective Study ◽  
San Francisco ◽  
Contact Tracing ◽  
Testing Strategies ◽  
Close Contacts

Abstract We sought to assess the proportion of elicited close contacts diagnosed with COVID-19 at the start, and before exiting quarantine, in San Francisco, USA. From June 8th to August 31st, 6946 contacts were identified; 3008 (46.3%) tested, 940 (13.5%) tested positive; 90% tested positive in first 9 days of quarantine.

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