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.

Distribution of MR-CoNS in the clinical staffs of tertiary care hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 100-102
Author(s):  
Sonu S. Ahirwar ◽  
Prabhat Jatav ◽  
Kirti Kushwaha
Keyword(s):  
Low Income ◽  
Nasal Swab ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Automated System ◽  
Diffusion Method ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Vitek 2

Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) associated infection is a growing concern in healthcare settings now a day. MR-CoNS are the main infectious agents of the hospital acquired infection. Clinical staffs to patients transmission of resistant strains have caused a rapid increase in the prevalence of antimicrobial resistance in recent years. Growing rate of antimicrobial resistant against available antibiotics of MR-CoNS is a developing problem in low income or lower middle income counties. This study was conducted to determine the occurrence MR-CoNS isolated from different clinical staffs of tertiary care hospital. This prospective study conducted in clinical staffs, nasal swab were collected from all the participants. Screening of CoNS were done on the basis of cultural, morphological and biochemical tests, identification and AST analysis done by VITEK-2 automated system. Methicillin resistance pattern was checked by VITEK-2 and Kirby-Bauer disc diffusion method according to CLSI guideline. A total of 129 nasal swab samples were collected from clinical staffs, of which n=81 isolates (85.6%) were CoNS. Among n=81 CoNS, (48.12%) , (41.97%) , (7.4%) and (2.4%) were reported. Out of n=81 CoNS isolates, n=26 were conformed as MR-CoNS. Maximum methicillin resistance were reported in 53.48% (14/26), 42.30% (11/26), 3.84% (1/26) and 0% (0/26). Theoccurrence rate of MR-CoNS are higher (20.6%) in the healthcare workers and most of the methicillin resistant-CoNS isolates shows high level of resistance against widely used antibiotics but all the isolates susceptible against vancomycin.

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

scholarly journals Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
Author(s):  
Senthil Kumar K. ◽  
Rajendran N. K. ◽  
Ajith Brabhukumar C.
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Warning Signs ◽  
Clinical Profile ◽  
Severe Dengue ◽  
High Morbidity ◽  
Care Hospital ◽  
High Grade Fever

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

scholarly journals Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Muhammad Aqil Soomro ◽  
Maryam Aftab ◽  
Maria Hasan ◽  
Hana Arbab
Keyword(s):  
Gastric Outlet Obstruction ◽  
Low Income ◽  
Tertiary Care ◽  
Outlet Obstruction ◽  
Low Income Countries ◽  
Care Hospital ◽  
Creative Commons ◽  
Pyloric Stricture ◽  
Special Supplement ◽  
Corrosive Ingestion

Corrosive ingestion in children is a common problem in low income countries. These agents cause injuries and later strictures of esophagus and stomach. Gastric outlet obstruction is known complication of acids and surgery is the mainstay of treatment. There are multitude of surgical options for these strictures depending on the involved segment of the stomach and experience of the surgeon. Here we present three cases of children who accidentally ingested acid stored in soda bottles and subsequently developed isolated pyloric strictures. These cases presented between August 2018 and April 2019 to our facility, a tertiary care hospital in Karachi, Pakistan. All three patients had an initial latent period of one to two weeks following corrosive ingestion, after which symptoms of gastric outlet obstruction appeared. Intraoperatively, all three had normal esophagus and antrum but scarred and strictured pylorus. Heineke-Mikulicz pyloroplasty was done in these cases without complications and the outcomes were satisfactory. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 How to cite this:Soomro MA, Aftab M, Hasan M, Arbab H. Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S87-S90.  doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 2455. Outbreak of carbapenemase-producing Enterobacteriaceae in cardiology units associated with contaminated water dispenser and sink drain in Korea

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S849-S850
Author(s):  
Jiwon Jung ◽  
Hye-Suk Choi ◽  
Jeong-Young Lee ◽  
Min Jee Hong ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care ◽  
Water Environment ◽  
Water System ◽  
Contact Tracing ◽  
Contact Precaution ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Patient Room ◽  
Large Outbreak

Abstract Background There is a growing concern about the importance of hospital water environment for the transmission of carbapenemase-producing Enterobacteriaceae (CPE). Herein, we report a large outbreak in cardiology units involving intensive care units (ICU) and wards at a tertiary care hospital. Methods During a CPE outbreak between July and December 2018, contact tracing and environmental sampling were performed. For outbreak control, we performed education to healthcare workers, hand hygiene enforcement, active surveillance test, preemptive isolation, chlorhexidine bathing for CPE positive patients, and deep terminal cleaning including UV and hydrogen peroxide non-touch disinfection. Patients with CPE were isolated at a single room with dedicated staffs, contact precaution was implemented, and when case patients were located in multi-patient room, we performed surveillance culture for exposed patients in the room. Results A total of 87 patients with CPE infection or colonization were identified at two cardiology ICUs and three cardiology wards. CPE from the first two index patients were identified from sputum culture suspecting pneumonia, and the remaining 85 patients were identified to harbor CPE through surveillance culture (exposed patients n = 22, active surveillance test n = 63). Diverse organisms were identified; organisms with blakpc (n = 13), blaNDM-1 (n = 55), blaVIM or blaIMP (n = 12), blaOXA-48 (n = 3), and co-producing organisms (n = 4). We performed environmental culture; KPC-producing Escherichia coli was isolated from water dispenser in ICU and NDM-1 producing Citrobacter freundii and Enterobacter cloacae were isolated from sinks in the patient room. Outbreak ended after the removal of water dispenser and the replacement of sink drain with pouring bleach to the sink drain. Conclusion Water dispenser and sink drain were suspected for the possible reservoirs of CPE in this outbreak. Replacement of plumbing system and use of bleach for pouring to sink as well as the removal of water dispenser was needed to control outbreak. Investigation of water system is warranted for finding the source of CPE. Disclosures All authors: No reported disclosures.

scholarly journals Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ramakrishna Pai Jakribettu ◽  
Rekha Boloor ◽  
Andrew Thaliath ◽  
Sharanya Yesudasan George ◽  
Thomas George ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Leucocyte Count ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Haematological Parameters ◽  
Total Leucocyte Count ◽  
Care Hospital ◽  
Significant Difference

Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquitoAedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

Crimean-Congo hemorrhagic fever: experience at a tertiary care hospital in Karachi, Pakistan

2005 ◽  
Vol 99 (8) ◽  
pp. 577-584 ◽  
Author(s):  
Bushra Jamil ◽  
Rumina S. Hasan ◽  
Arif R. Sarwari ◽  
Jane Burton ◽  
Roger Hewson ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Care Hospital ◽  
Crimean Congo Hemorrhagic Fever

scholarly journals Dengue Viral Augmentation among the Population of Few Districts of Assam and Neighbourhood Visiting Tezpur Medical College & Hospital

2021 ◽  
Vol 6 (2) ◽  
pp. 25-36
Author(s):  
Samrat Biswas ◽  
Jyoti Hazarika ◽  
Mihirjyoti Pathak
Keyword(s):  
Tertiary Care ◽  
Febrile Illness ◽  
Hemorrhagic Fever ◽  
Severe Bleeding ◽  
Care Hospital ◽  
Serum Samples ◽  
Epidemic Disease ◽  
College Hospital ◽  
Diagnostic Laboratory ◽  
Medical College

Dengue virus (DENV) has rapidly expanded its range through tropical and subtropical regions in recent years. This pathogen causes acute febrile illness (dengue fever, DF) and severe bleeding disease (dengue hemorrhagic fever, DHF) in humans. In this study we are trying to analyze the data obtained from the diagnosis conducted upon the Dengue suspected patients visiting tertiary care hospital, Sonitpur, Assam and to give a scientific evaluation to the pattern or spread of this epidemic disease. A total of 361 serum samples are analysed from suspected dengue cases during this study period. This study basically gives our research team to go more investigating the dengue viral expansion in coming days as we were able to discriminate among the patients on the basis of primary and secondary infections, what they were previously not examined for. Significant clue for the presence of secondary dengue viral infections (17.3%) among 10 different districts is found. Keywords: Dengue, Viral Research and Diagnostic Laboratory (VRDL), Tezpur Medical College & Hospital (TMCH).

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