scholarly journals Comparing dynamics and determinants of SARS-CoV-2 transmissions among health care workers of adult and pediatric settings in central Paris

Author(s):  
Adrien CONTEJEAN ◽  
Jeremie LEPORRIER ◽  
Etienne CANOUI ◽  
Fanny ALBY-LAURENT ◽  
Emmanuel LAFONT ◽  
...  

Background: From the start of the pandemic, health-care workers (HCW) have paid a heavy toll to the coronavirus disease-19 (COVID-19) outbreak. Objectives: To describe the dynamics and determinants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in HCW. Design: Prospective observational study conducted from February 24th until April 10th, 2020. Setting: Comparison of a 1,500-bed adult and a 600-bed pediatric setting of a tertiary-care university hospital located in central Paris. Participants: All symptomatic HCW screened for SARS-CoV-2 on a nasopharyngeal swab. Measurements: HCW screened positive were prospectively questioned on their profession, symptoms, occupational and non-occupational exposures to SARS-CoV-2. Results: Among 1344 symptomatic HCW tested, 373 were positive (28%) and 336 (90%) corresponding questionnaires were completed. Three hospitalizations and no death were reported. Most HCW (70%) had patient-facing occupational activities (22% in COVID-19 dedicated units). The total number of HCW cases peaked on March 23rd, then decreased slowly, concomitantly with a continuous increase of compliance to preventive measures (including universal medical masking and personal protective equipment (PPE) for direct care to COVID-19 patients). Attack rates were of 3.2% and 2.3% in the adult and pediatric setting, respectively (p=0.0022). In the adult setting, HCW more frequently reported exposure to COVID-19 patients without PPE (25% versus 15%, p=0.046). Report of contacts with children attending out-of-home care facilities dramatically decreased over the study period. Limitations: Lack of COVID-19 negative controls and recall bias. Conclusion: Universal masking, reinforcement of hand hygiene, and PPE with medical masks for patients' care allowed protection of HCW and containment of the outbreak. Residual transmissions were related to persistent exposures with undiagnosed patients or colleagues and not to contacts with children attending out-of-home care facilities.

Author(s):  
Adrien Contejean ◽  
Jérémie Leporrier ◽  
Etienne Canouï ◽  
Fanny Alby-Laurent ◽  
Emmanuel Lafont ◽  
...  

Abstract Background Healthcare workers (HCWs) have paid a heavy toll during the coronavirus disease 2019 (COVID-19) outbreak. Routes of transmission remain to be fully understood. Methods This prospective study compared a 1500-bed adult and 600-bed pediatric setting of a tertiary-care university hospital located in central Paris. From 24 February until 10 April 2020, all symptomatic HCWs were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on a nasopharyngeal swab. HCWs screened positive were questioned on their profession, symptoms, and occupational and nonoccupational exposures to SARS-CoV-2. Results Among 1344 HCWs tested, 373 were positive (28%) and 336 (90%) corresponding questionnaires were completed. Three hospitalizations and no deaths were reported. Most HCWs (70%) had patient-facing occupational activities (22% in COVID-19 dedicated units). The total number of HCW cases peaked on 23 March, then decreased slowly, concomitantly with a continuous increase of compliance to preventive measures (including universal medical masking and personal protective equipment [PPE] for direct care to COVID-19 patients). Attack rates were of 3.2% and 2.3% in the adult and pediatric settings, respectively (P = .0022). In the adult setting, HCWs more frequently reported exposure to COVID-19 patients without PPE (25% vs 15%, P = .046). Report of contacts with children attending out-of-home care facilities dramatically decreased over the study period. Conclusions Universal masking, reinforcement of hand hygiene, and PPE with medical masks for patients’ care allowed protection of HCWs and containment of the outbreak. Residual transmissions were related to persistent exposures with undiagnosed patients or colleagues and not to contacts with children attending out-of-home care facilities.


2017 ◽  
Vol 9 (01) ◽  
pp. 020-025 ◽  
Author(s):  
Varun Goel ◽  
Dinesh Kumar ◽  
Raghavendra Lingaiah ◽  
Sarman Singh

ABSTRACT Introduction: Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs). Aims and Objectives: To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents. Methods: An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3–4 weeks for seroconversion up to 6 months. Results: A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers ≥10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months. Conclusions: The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination.


2020 ◽  
Vol 6 (4) ◽  
pp. 03-06
Author(s):  
Wajeeha Qayyum ◽  
Asad Khalil ◽  
Mohammad Jawad ◽  
Seema Ashraf

Introduction: Infectious pandemics are a significant health risk to the general population, but much more so for the frontline health care workers tending patients at different locations. The increased workload, stress, fear, and anxiety are the burdens to be coped with by health professionals through resort to resiliency and other mechanisms.Objective: To determine the magnitude of depression / anxiety and factors associated with it in health care workers of a tertiary care hospital during the COVID-19 pandemic in Peshawar, Khyber Pakhtunkhwa, Pakistan.Materials & Methods: This cross sectional study was conducted at Rehman Medical Institute, Peshawar after approval from Rehman Medical Institute Research Ethics Committee. A structured questionnaire consisting of two sections was distributed by convenience sampling to health care workers in the hospital, the first part containing demographic information, and the second part consisting of Hospital Anxiety and Depression Scale (HADS) comprised of 14 scales to assess anxiety and depression. Scoring for Normal, Borderline Abnormal, and Definitive Disorder was done as per standard criteria. Data were analyzed for descriptive statistics by SPSS 22. Results: Total 327 participants were included in the study, having mean age of 30.19 ± 7.82 years, of which 230(70.3%) were males. The majority of health care workers 226(69.1%) were suffering from disturbed mental status either in the form of Anxiety (19.9%), Depression (8%) or Mixed Disorder (41.3%). Factors associated with high disease frequency were female gender, age group 21-30 years, nursing staff, workers of ICU and Hostel residence (p value <0.05). Conclusion: COVID-19 related psychological disturbances significantly affected healthcare staff of a tertiary care hospital of Peshawar, being more evident in females, younger age groups, nurses, and ICU staff on duty.


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