Outbreak of Pertussis Among Healthcare Workers in a Hospital Surgical Unit

2006 ◽  
Vol 27 (6) ◽  
pp. 546-552 ◽  
Author(s):  
F. Brian Pascual ◽  
Candace L. McCall ◽  
Aaron McMurtray ◽  
Tony Payton ◽  
Forrest Smith ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Positive Culture ◽  
Control Measures ◽  
Infectious Period ◽  
Acute Cough ◽  
Face To Face ◽  
Outbreak Period ◽  
Hospital Patients ◽  
Reported Data ◽  
Surgical Unit

Background.In September 1999, a pertussis outbreak was detected among surgical staff of a 138-bed community hospital. Patients were exposed toBordetella pertussisduring the 3-month outbreak period.Objective.To describe the outbreak among surgical staff, to evaluate implemented control measures, and to determine whether nosocomial transmission occurred.Methods.Clinical pertussis was defined as acute cough illness with a duration of 14 days or more without another apparent cause; persons with positive culture, PCR, or serologic test results were defined as having laboratory-confirmed pertussis. Surgical healthcare workers (HCWs) were interviewed regarding pertussis symptoms, and specimens were obtained for laboratory analysis. Patients exposed toB. pertussisduring an ill staff member's 3-week infectious period were interviewed by phone to determine the extent of nosocomial spread.Participants.A total of 53 HCWs assigned to the surgical unit and 146 exposed patients. HCWs with pertussis were defined as case subjects; HCWs without pertussis were defined as non-case subjects.Results.Twelve (23%) of 53 HCWs had clinical pertussis; 6 cases were laboratory confirmed. The median cough duration in the 12 case subjects was 27 days (range, 20-120 days); 10 (83%) had paroxysms. Eleven (92%) of 12 case subjects and 28 (86%) of 41 non-case subjects received antibiotic treatment or prophylaxis. Seven case subjects (58%) reported they always wore a mask when near patients. Of 146 patients potentially exposed to pertussis from the 12 case subjects, 120 (82%) were interviewed; none reported a pertussis-like illness.Conclusions.Surgical staff transmittedB. pertussisamong themselves; self-reported data suggests that these HCWs did not transmitB. pertussisto their patients, likely because of mask use, cough etiquette, and limited face-to-face contact. Control measures might have helped limit the outbreak once pertussis was recognized.

SHEA-CDC TB Survey, Part I: Status of TB Infection Control Programs at Member Hospitals, 1989-1992

1995 ◽  
Vol 16 (3) ◽  
pp. 129-134
Author(s):  
Scott K. Fridkin ◽  
Lilia Manangan ◽  
Elizabeth Bolyard ◽  
William R. Jarvis ◽  
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Skin Testing ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Tuberculin Skin Testing ◽  
Respiratory Protection ◽  
Mdr Tb ◽  
Reported Data ◽  
Tb Infection Control

AbstractObjective:To determine trends in Mycobacterium tuberculosis infection in healthcare workers, tuberculosis (TB) control measures, and compliance with the 1990 Centers for Disease Control and Prevention (CDC) guideline for preventing transmission of TB in healthcare facilities.Design:Voluntary questionnaire sent to all members of the Society for Healthcare Epidemiology of America, representing 359 hospitals.Results:Respondents’ hospitals (210 [58%]) had a median of 2,400 healthcare workers (range, 396 to 13,745), 437 beds (range, 48 to 1,250), 5.6 patients with TB per year (range, 0 to 492), and 0 multidrug-resistant (MDR) TB patients per year (range, 0 to 33). Of 166 respondents’ hospitals for which data were provided for 1989 through 1992, the number caring for MDR-TB patients increased from 10 (6%) in 1989 to 49 (30%) in 1992. Reported policies for routine healthcare worker tuberculin skin testing varied. The median skin-test positivity rate for healthcare workers at the time of hire increased from 0.54% in 1989 to 0.81% in 1992, but the median conversion rate during routine testing remained similar: 0.35% in 1989 and 0.33% in 1992. Among 196 hospitals with reported data on respiratory protection use for 1989 through 1992, the use of either surgical submicron, dust-mist, or dust-fume-mist respirators for healthcare workers increased from 9 (5%) in 1989 to 85 (43%) in 1992. Of 181 hospitals with reported data, 113 (62%) had acid-fast bacilli isolation facilities consistent with the 1990 CDC guideline (ie, a single patient room, negative air pressure relative to the hallway, air exhausted directly outside, and ≥ 6 air exchanges per hour).Conclusions:While the number of surveyed hospitals caring for TB and MDR-TB patients increased during 1989 through 1992, TB infection control measures at many hospitals still did not meet the 1990 CDC guideline recommendations.

scholarly journals Routine saliva testing for the identification of silent coronavirus disease 2019 (COVID-19) in healthcare workers

2021 ◽  
pp. 1-5
Author(s):  
Kevin Zhang ◽  
Affan Shoukat ◽  
William Crystal ◽  
Joanne M. Langley ◽  
Alison P. Galvani ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Healthcare Personnel ◽  
Infectious Period ◽  
Case Detection ◽  
Healthcare Facilities ◽  
Presymptomatic Stage ◽  
Percent Positivity ◽  
Vulnerable Patient ◽  
Testing Schedule ◽  
Reported Data

Abstract Objective: Current COVID-19 guidelines recommend symptom-based screening and regular nasopharyngeal (NP) testing for healthcare personnel in high-risk settings. We sought to estimate case detection percentages with various routine NP and saliva testing frequencies. Design: Simulation modeling study. Methods: We constructed a sensitivity function based on the average infectiousness profile of symptomatic coronavirus disease 2019 (COVID-19) cases to determine the probability of being identified at the time of testing. This function was fitted to reported data on the percent positivity of symptomatic COVID-19 patients using NP testing. We then simulated a routine testing program with different NP and saliva testing frequencies to determine case detection percentages during the infectious period, as well as the presymptomatic stage. Results: Routine biweekly NP testing, once every 2 weeks, identified an average of 90.7% (SD, 0.18) of cases during the infectious period and 19.7% (SD, 0.98) during the presymptomatic stage. With a weekly NP testing frequency, the corresponding case detection percentages were 95.9% (SD, 0.18) and 32.9% (SD, 1.23), respectively. A 5-day saliva testing schedule had a similar case detection percentage as weekly NP testing during the infectious period, but identified ~10% more cases (mean, 42.5%; SD, 1.10) during the presymptomatic stage. Conclusion: Our findings highlight the utility of routine noninvasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities.

scholarly journals Routine saliva testing for the identification of silent COVID-19 infections in healthcare workers

2020 ◽  
Author(s):  
Kevin Zhang ◽  
Affan Shoukat ◽  
William Crystal ◽  
Joanne M. Langley ◽  
Alison P. Galvani ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Simulation Modelling ◽  
Healthcare Personnel ◽  
Infectious Period ◽  
Case Detection ◽  
Healthcare Facilities ◽  
Percent Positivity ◽  
Vulnerable Patient ◽  
Testing Schedule ◽  
Reported Data

AbstractObjectiveCurrent COVID-19 guidelines recommend symptom-based screening and regular nasopharyngeal (NP) testing for healthcare personnel in high-risk settings. We sought to estimate case detection percentages with various routine NP and saliva testing frequencies.DesignSimulation modelling study.MethodsWe constructed a sensitivity function based on the average infectiousness profile of symptomatic COVID-19 cases to determine the probability of being identified at the time of testing. This function was fitted to reported data on the percent positivity of symptomatic COVID-19 patients using NP testing. We then simulated a routine testing program with different NP and saliva testing frequencies to determine case detection percentages during the infectious period, as well as the pre-symptomatic stage.ResultsRoutine bi-weekly NP testing, once every two weeks, identified an average of 90.7% (SD: 0.18) of cases during the infectious period and 19.7% (SD: 0.98) during the pre-symptomatic stage. With a weekly NP testing frequency, the corresponding case detection percentages were 95.9% (SD: 0.18) and 32.9% (SD: 1.23), respectively. A 5-day saliva testing schedule had a similar case detection percentage as weekly NP testing during the infectious period, but identified about 10% more cases (mean: 42.5%; SD: 1.10) during the pre-symptomatic stage.ConclusionOur findings highlight the utility of routine non-invasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities.

Nosocomial Pertussis in Healthcare Workers From a Pediatric Emergency Unit in France

1999 ◽  
Vol 20 (8) ◽  
pp. 549-552 ◽  
Author(s):  
Jean-François Gehanno ◽  
Martine Pestel-Caron ◽  
Michèle Nouvellon ◽  
Jean-François Caillard
Keyword(s):  
Healthcare Workers ◽  
Young Patients ◽  
Positive Culture ◽  
Respiratory Illness ◽  
Pediatric Emergency ◽  
University Hospital ◽  
Emergency Unit ◽  
Acute Cough ◽  
Western Blot Assay ◽  
Diagnosis Criteria

AbstractObjective:After pertussis was diagnosed in July 1997 in a 55-year-old nurse (case) from a pediatric emergency unit who had a respiratory illness and paroxysmal cough for 5 weeks, an epidemiological investigation was initiated to determine if other healthcare workers (HCWs) from the same unit also had pertussis.Design:Interviews were conducted to assess symptoms occurring in the previous months. Two sera were collected 2 to 3 months apart for 59 of 61 HCWs of the unit. The IgG response to pertussis toxin was determined using Western blot assay.Setting:Pediatric emergency unit (61 HCWs) of a 2,500-bed university hospital.Results:There was a total of 10 (5 confirmed and 5 probable) cases of pertussis identified in this outbreak. Nine HCWs (15%) had results suggesting recent or acute pertussis. To avoid transmission to patients and other HCWs, all HCWs with cough were treated for 14 days with erythromycin, and those having acute cough were given a 5-day sick leave. Despite these measures, a new acute pertussis case was identified in a 41-year-old nurse, with a positive culture from nasopharyngeal aspirates. Thus, all HCWs in the unit were prescribed spiramycin for 10 days to prevent any further spread of pertussis.Conclusion:Pertussis should be considered a threat to HCWs who are in contact with children. For HCWs, diagnosis of pertussis should be made on a clinical basis, giving greater importance to sensitivity of diagnosis criteria, and on early bacterial identification by culture of the organism or by polymerase chain reaction.Recommendations:In case of pertussis in an HCW, all staff in the unit who have had unprotected and intensive contact with that person should be provided with macrolide treatment to stop any transmission to colleagues and to young patients. Furthermore, the possibility of providing these HCWs with acellular pertussis vaccines warrants further investigation.

Staphylococcus aureus nasal carriage rate and associated risk factors in individuals in the community

2009 ◽  
Vol 138 (5) ◽  
pp. 702-706 ◽  
Author(s):  
M. A. HALABLAB ◽  
S. M. HIJAZI ◽  
M. A. FAWZI ◽  
G. F. ARAJ
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Nasal Carriage ◽  
Control Measures ◽  
Nasal Colonization ◽  
Carriage Rate ◽  
Nasal Sprays ◽  
Hospital Patients ◽  
Associated Risk Factors

SUMMARYThe increasing prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) strains together with their disease impact on hospital patients and individuals in the community has posed a major challenge to healthcare workers. This study examined the prevalence of S. aureus nasal carriage, antimicrobial susceptibility patterns, and possible risk factors in the community. Of 500 studied subjects (aged from 6 to 65 years) in Lebanon, the overall S. aureus nasal carriage rate was 38·4%, the highest (57·1%) being in children aged 6–10 years. Only eight individuals (1·6%) were carriers of MRSA. Risk factors for S. aureus nasal colonization were male gender, young age, contact with healthcare workers, use of needle injections, and having asthma. A significant decrease in colonization rate was associated with nasal wash with water, use of nasal sprays, and the presence of acne. These findings may assist in better understanding of control measures to decrease nasal colonization with S. aureus in Lebanon and elsewhere.

scholarly journals Infectivity of healthcare workers diagnosed with coronavirus disease 2019 (COVID-19) approximately 2 weeks after onset of symptoms: A cross-sectional study

2021 ◽  
pp. 1-3
Author(s):  
Yves Longtin ◽  
Hugues Charest ◽  
Caroline Quach ◽  
Patrice Savard ◽  
Mariana Baz ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Healthcare Workers ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Viral Shedding ◽  
Viral Culture ◽  
Respiratory Coronavirus ◽  
Respiratory Specimens

Abstract We performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.

scholarly journals Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

2021 ◽  
Vol 18 (1) ◽  
pp. 323
Author(s):  
Oladele Vincent Adeniyi ◽  
David Stead ◽  
Mandisa Singata-Madliki ◽  
Joanne Batting ◽  
Leo Hyera ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Eastern Cape ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

scholarly journals Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fulwah Alqahtani ◽  
Marzouqah Alanazi ◽  
Wajdan Alassaf ◽  
Fadilah Sfouq Aleanizy ◽  
Muna Aljahany ◽  
...  
Keyword(s):  
Emergency Department ◽  
Longitudinal Study ◽  
Healthcare Workers ◽  
Respiratory Symptoms ◽  
Control Measures ◽  
University Hospital ◽  
Respiratory Pathway ◽  
Infection Control Measures ◽  
Separate Pathway ◽  
Respiratory Conditions

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

scholarly journals Evaluating the effectiveness of measures to control the novel coronavirus disease 2019 in Jilin Province, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qinglong Zhao ◽  
Yao Wang ◽  
Meng Yang ◽  
Meina Li ◽  
Zeyu Zhao ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Good Control ◽  
Asymptomatic Infection ◽  
Jilin Province ◽  
Control Measures ◽  
First Case ◽  
Before And After ◽  
Novel Coronavirus ◽  
Reported Data ◽  
And Control

Abstract Background Based on differences in populations and prevention and control measures, the spread of new coronary pneumonia in different countries and regions also differs. This study aimed to calculate the transmissibility of coronavirus disease 2019 (COVID-19), and to evaluate the effectiveness of measures to control the disease in Jilin Province, China. Methods The data of reported COVID-19 cases were collected, including imported and local cases from Jilin Province as of March 14, 2019. A Susceptible–Exposed–Infectious–Asymptomatic–Recovered/Removed (SEIAR) model was developed to fit the data, and the effective reproduction number (Reff) was calculated at different stages in the province. Finally, the effectiveness of the measures was assessed. Results A total of 97 COVID-19 infections were reported in Jilin Province, among which 45 were imported infections (including one asymptomatic infection) and 52 were local infections (including three asymptomatic infections). The model fit the reported data well (R2 = 0.593, P < 0.001). The Reff of COVID-19 before and after February 1, 2020 was 1.64 and 0.05, respectively. Without the intervention taken on February 1, 2020, the predicted cases would have reached a peak of 177,011 on October 22, 2020 (284 days from the first case). The projected number of cases until the end of the outbreak (on October 9, 2021) would have been 17,129,367, with a total attack rate of 63.66%. Based on the comparison between the predicted incidence of the model and the actual incidence, the comprehensive intervention measures implemented in Jilin Province on February 1 reduced the incidence of cases by 99.99%. Therefore, according to the current measures and implementation efforts, Jilin Province can achieve good control of the virus’s spread. Conclusions COVID-19 has a moderate transmissibility in Jilin Province, China. The interventions implemented in the province had proven effective; increasing social distancing and a rapid response by the prevention and control system will help control the spread of the disease.

scholarly journals Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

2021 ◽  
pp. oemed-2020-107060
Author(s):  
Laura Milazzo ◽  
Alessia Lai ◽  
Laura Pezzati ◽  
Letizia Oreni ◽  
Annalisa Bergna ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Referral Hospital ◽  
Control Measures ◽  
Referral Centre ◽  
Single Centre ◽  
Factors Associated ◽  
Infection Control Measures ◽  
Professional Exposure ◽  
First Time ◽  
Time Point

ObjectivesHealthcare workers (HCWs) are at high risk of developing SARS-CoV-2 infection. The aim of this single-centre prospective study was to evaluate the trend of SARS-CoV-2 seroprevalence in HCWs working at the primary referral centre for infectious diseases and bioemergencies (eg, COVID-19) in Northern Italy and investigate the factors associated with seroconversion.MethodsSix hundred and seventy-nine HCW volunteers were tested for anti-SARS-CoV-2 antibodies three times between 4 March and 27 May 2020 and completed a questionnaire covering COVID-19 exposure, symptoms and personal protective equipment (PPE) training and confidence at each time.ResultsSARS-CoV-2 seroprevalence rose from 3/679 to 26/608 (adjusted prevalence: 0.5%, 95% CI 0.1 to 1.7% and 5.4%, 95% CI 3.6 to 7.9, respectively) between the first two time points and then stabilised, in line with the curve of the COVID-19 epidemic in Milan. From the first time point, 61.6% of the HCWs had received training in the use of PPE and 17 (61.5%) of those who proved to be seropositive reported symptoms compatible with SARS-CoV-2 infection. Contacts with ill relatives or friends and self-reported symptoms were independently associated with an increased likelihood of seroconversion (p<0.0001 for both), whereas there was no significant association with professional exposure.ConclusionThe seroprevalence of SARS-CoV-2 among the HCWs at our COVID-19 referral hospital was low at the time of the peak of the epidemic. The seroconversions were mainly attributable to extrahospital contacts, probably because the hospital readily adopted effective infection control measures. The relatively high number of asymptomatic seropositive HCWs highlights the need to promptly identify and isolate potentially infectious HCWs.

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