scholarly journals Network Analysis of MERS Coronavirus within Households, Communities, and Hospitals to Identify Most Centralized and Super-Spreading in the Arabian Peninsula, 2012 to 2016

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Oyelola A. Adegboye ◽  
Faiz Elfaki
Keyword(s):  
Healthcare Workers ◽  
Arabian Peninsula ◽  
Healthcare Facility ◽  
Disease Outbreak ◽  
Control Measures ◽  
Human Populations ◽  
Eigenvector Centrality ◽  
Infectious Disease Outbreak ◽  
Centrality Score ◽  
Important Nodes

Contact history is crucial during an infectious disease outbreak and vital when seeking to understand and predict the spread of infectious diseases in human populations. The transmission connectivity networks of people infected with highly contagious Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia were assessed to identify super-spreading events among the infected patients between 2012 and 2016. Of the 1379 MERS cases recorded during the study period, 321 (23.3%) cases were linked to hospital infection, out of which 203 (14.7%) cases occurred among healthcare workers. There were 1113 isolated cases while the number of recorded contacts per MERS patient is between 1 (n=210) and 17 (n=1), with a mean of 0.27 (SD = 0.76). Five super-important nodes were identified based on their high number of connected contacts worthy of prioritization (at least degree of 5). The number of secondary cases in each SSE varies (range, 5–17). The eigenvector centrality was significantly (p<0.05) associated with place of exposure, with hospitals having on average significantly higher eigenvector centrality than other places of exposure. Results suggested that being a healthcare worker has a higher eigenvector centrality score on average than being nonhealthcare workers. Pathogenic droplets are easily transmitted within a confined area of hospitals; therefore, control measures should be put in place to curtail the number of hospital visitors and movements of nonessential staff within the healthcare facility with MERS cases.

scholarly journals What factors influence symptom reporting during an emerging infectious disease outbreak? A rapid review of the evidence

2020 ◽  
Author(s):  
Patrice Carter ◽  
Odette Megnin-Viggars ◽  
Gideon James Rubin
Keyword(s):  
Infectious Disease ◽  
Healthcare Facility ◽  
Disease Outbreak ◽  
Emerging Infectious Disease ◽  
Symptom Reporting ◽  
Rapid Review ◽  
Infectious Disease Outbreak ◽  
The Public ◽  
Ease Of Access ◽  
Informative Communication

Introduction During any emerging infectious disease outbreak, people with symptoms of the illness are often asked to report their symptoms to the health service in a timely manner, to facilitate contract tracing. Numerous factors may influence an individuals willingness to report these symptoms. Understanding these factors has become urgent during the COVID-19 pandemic Objective To determine which factors influence symptom reporting during an emerging infectious disease outbreak Methods We conducted a rapid review of the evidence. We included papers based on primary research, published in peer-reviewed journals, written in English, included factors associated with symptom reporting or accessing healthcare, and related to a major public health incident involving an infectious disease outbreak Results Five themes were identified as facilitators of symptom reporting or accessing healthcare (accurate and informative communication, symptom severity, concern about exposure, ease of access, and relationship with the healthcare provider). Seven themes were identified as barriers of symptom reporting or accessing healthcare (lack of knowledge, fear, stigmatization, invasion of privacy, low concerns about symptoms, economics, and practicalities of attending a healthcare facility) Discussion If contract tracing services are to be effective, members of the public need to have the capability, opportunity and motivation to use them. The themes identified should be used to evaluate the information provided to the public about such a service, the routes of access, and the underlying polices relating to the service, in order to ensure that as many people as possible with relevant symptoms will make contact

scholarly journals An approach to and web-based tool for infectious disease outbreak intervention analysis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Ashlynn R. Daughton ◽  
Nicholas Generous ◽  
Reid Priedhorsky ◽  
Alina Deshpande
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Infectious Diseases ◽  
Disease Outbreak ◽  
Control Measures ◽  
Infectious Disease Outbreak ◽  
Web Based ◽  
The Public ◽  
Health Community ◽  
Parameter Ranges

Abstract Infectious diseases are a leading cause of death globally. Decisions surrounding how to control an infectious disease outbreak currently rely on a subjective process involving surveillance and expert opinion. However, there are many situations where neither may be available. Modeling can fill gaps in the decision making process by using available data to provide quantitative estimates of outbreak trajectories. Effective reduction of the spread of infectious diseases can be achieved through collaboration between the modeling community and public health policy community. However, such collaboration is rare, resulting in a lack of models that meet the needs of the public health community. Here we show a Susceptible-Infectious-Recovered (SIR) model modified to include control measures that allows parameter ranges, rather than parameter point estimates, and includes a web user interface for broad adoption. We apply the model to three diseases, measles, norovirus and influenza, to show the feasibility of its use and describe a research agenda to further promote interactions between decision makers and the modeling community.

scholarly journals Occupational Health and Safety Measures in Healthcare Settings During COVID-19: Strategies for Protecting Staff, Patients and Visitors

2021 ◽  
pp. 1-27
Author(s):  
Isra Asma Ahmad ◽  
Ernest Osei
Keyword(s):  
Occupational Health ◽  
Healthcare Workers ◽  
Health And Safety ◽  
Occupational Health And Safety ◽  
Healthcare Facility ◽  
Healthcare Systems ◽  
Control Measures ◽  
Care Providers ◽  
Infection Control Measures ◽  
Environmental Controls

Abstract The COVID-19 (SARS-CoV-2) pandemic has profoundly impacted almost every aspect of healthcare systems worldwide, placing the health and safety of frontline healthcare workers at risk and still continues to remain an important public health challenge. Several hospitals have put in place strategies to manage space, staff, and supplies in order to continue to deliver optimum care to patients while at the same time protecting the health and safety of staff and patients. However, the emergence of the second and third waves of the virus with the influx of new cases continue to add an additional level of complexity to the already challenging situation of containing the spread and lowering the rate of transmission and thus pushing healthcare systems to the limit. In this narrative review paper we describe various strategies including administrative controls, environmental controls and use of personal protective equipment implemented by occupational health and safety departments for the protection of healthcare workers, patients and visitors from SARS-CoV-2 virus infection. The protection and safeguard of the health and safety of healthcare workers and patients through the implementation of effective infection control measures, adequate management of possible outbreaks and minimization of risk of nosocomial transmission is an important and effective strategy of SARS-CoV-2 pandemic management in any healthcare facility. High quality patient care hinges on ensuring that the care providers are well protected and supported so they can provide the best quality of care to their patients.

MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

scholarly journals Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom

2020 ◽  
pp. 175717742097679
Author(s):  
Kordo Saeed ◽  
Emanuela Pelosi ◽  
Nitin Mahobia ◽  
Nicola White ◽  
Christopher Labdon ◽  
...  
Keyword(s):  
Real Time ◽  
Healthcare Workers ◽  
Healthcare Facility ◽  
Rt Pcr ◽  
Serum Samples ◽  
The United Kingdom ◽  
Key Issues ◽  
Current Infection ◽  
Polymerase Chain ◽  
A Current

Background: We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility. Methodology: A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence. Results: Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff. Conclusion: To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

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 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.

scholarly journals Aggressive Colonization Screening and Infection Control Measures in Containment of NDM-5 Carbapenemase-Producing CRE

2020 ◽  
Vol 41 (S1) ◽  
pp. s458-s459
Author(s):  
Ishrat Kamal-Ahmed ◽  
Kate Tyner ◽  
Teresa Fitzgerald ◽  
Heather Adele Moulton-Meissner ◽  
Gillian McAllister ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Acute Care Hospital ◽  
Healthcare Facility ◽  
The United States ◽  
Control Measures ◽  
Care Hospital ◽  
Clinical Culture ◽  
Medical Histories ◽  
Asymptomatic Case

Background: In April 2019, Nebraska Public Health Laboratory identified an NDM-producing Enterobacter cloacae from a urine sample from a rehabilitation inpatient who had recently received care in a specialized unit (unit A) of an acute-care hospital (ACH-A). After additional infections occurred at ACH-A, we conducted a public health investigation to contain spread. Methods: A case was defined as isolation of NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) from a patient with history of admission to ACH-A in 2019. We conducted clinical culture surveillance, and we offered colonization screening for carbapenemase-producing organisms to all patients admitted to unit A since February 2019. We assessed healthcare facility infection control practices in ACH-A and epidemiologically linked facilities by visits from the ICAP (Infection Control Assessment and Promotion) Program. The recent medical histories of case patients were reviewed. Isolates were evaluated by whole-genome sequencing (WGS). Results: Through June 2019, 7 cases were identified from 6 case patients: 4 from clinical cultures and 3 from 258 colonization screens including 1 prior unit A patient detected as an outpatient (Fig. 1). Organisms isolated were Klebsiella pneumoniae (n = 5), E. cloacae (n = 1), and Citrobacter freundii (n = 1); 1 patient had both NDM-producing K. pneumoniae and C. freundii. Also, 5 case patients had overlapping stays in unit A during February–May 2019 (Fig. 2); common exposures in unit A included rooms in close proximity, inhabiting the same room at different times and shared caregivers. One case-patient was not admitted to unit A but shared caregivers, equipment, and devices (including a colonoscope) with other case patients while admitted to other ACH-A units. No case patients reported travel outside the United States. Screening at epidemiologically linked facilities and clinical culture surveillance showed no evidence of transmission beyond ACH-A. Infection control assessments at ACH-A revealed deficiencies in hand hygiene, contact precautions adherence, and incomplete cleaning of shared equipment within and used to transport to/from a treatment room in unit A. Following implementation of recommended infection control interventions, no further cases were identified. Finally, 5 K. pneumoniae of ST-273 were related by WGS including carriage of NDM-5 and IncX3 plasmid supporting transmission of this strain. Further analysis is required to relate IncX3 plasmid carriage and potential transmission to other organisms and sequence types identified in this study. Conclusions: We identified a multiorganism outbreak of NDM-5–producing CRE in an ACH specialty care unit. Transmission was controlled through improved infection control practices and extensive colonization screening to identify asymptomatic case-patients. Multiple species with NDM-5 were identified, highlighting the potential role of genotype-based surveillance.Funding: NoneDisclosures: Muhammad Salman Ashraf reports that he is the principal investigator for a study funded by an investigator-initiated research grant.

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