scholarly journals An outbreak of COVID-19 associated with a fitness centre in Saskatchewan: Lessons for prevention

2021 ◽  
Vol 47 (11) ◽  
pp. 485-490
Author(s):  
Maureen Anderson ◽  
Ashok Chhetri ◽  
Edith Halyk ◽  
Amanda Lang ◽  
Ryan McDonald ◽  
...  
Keyword(s):  
Public Health ◽  
High School ◽  
Laboratory Data ◽  
Control Measures ◽  
Fourth Generation ◽  
Infectious Period ◽  
Epidemiological Methods ◽  
Sequencing Data ◽  
Public Health Action ◽  
Fitness Facility

Background: An outbreak of the coronavirus disease 2019 (COVID-19) occurred in Saskatchewan from September 12 to October 20, 2020. The index event, attendance at a local gym, seeded six additional clusters/outbreaks in multiple settings. These included a high school, a hospital, three workplaces (A, B and C) and several households. The overall cluster comprised 63 cases, 27 gym members and an additional 36 second, third and fourth generation cases. Methods: All outbreak-related, laboratory-confirmed cases of COVID-19 were included in the analysis. Local public health authorities interviewed all cases and contacts and conducted environmental investigations of the fitness facility. We used descriptive epidemiological methods to understand transmission dynamics of the gym-associated cluster using case investigation, contact investigation and laboratory data, including whole genome sequencing. Results: Sequencing data confirmed the unique lineage of cluster-related cases (n=32 sequenced; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] lineage B.1.1.72). In addition to gym attendance, infectious cases attended high school and were involved in other activities. Despite ongoing transmission in the fitness facility, no secondary cases were identified in the high school where four student belonging to the cluster attended class during their infectious period. Conclusion: We describe an outbreak of COVID-19 where the index case(s) attended a fitness facility, and further spread occurred for 38 days despite active-case finding and isolation of positive cases over this period. Due to gym attendance over time, short-term closing and cleaning may not interrupt chains of transmission. Targeted, preventive public health action in fitness facilities may be warranted. Control measures worked to limit in-school acquisition.

scholarly journals Correlation of school absenteeism and laboratory results for Flu A in Alberta, Canada

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Elizabeth Birk-Urovitz ◽  
Ye Li ◽  
Steven Drews ◽  
Christopher Sikora ◽  
Deena Hinshaw ◽  
...  
Keyword(s):  
Public Health ◽  
Regression Models ◽  
Laboratory Data ◽  
Calculated Data ◽  
School Absenteeism ◽  
Linear Regression Models ◽  
Public Health Action ◽  
Percent Positivity ◽  
The Difference ◽  
Student Absenteeism

ObjectiveTo assess the correlations between weekly rates of elementaryschool absenteeism due to illness (SAi) and percent positivity forinfluenza A from laboratory testing (PPFluA) when conducted at acity level from September to December over multiple years.IntroductionRates of student absenteeism in schools have been mainly used todetect outbreaks in schools and prompt public health action to stoplocal transmission1,2. A report by Mogto et al.3stated that aggregatedcounts of school absenteeism (SAi) were correlated with PPFluA, butthe sample may have been biased. The purpose of this study was toassess the correlation between aggregated rates of SAi and PPFluAfor two cities, Calgary and Edmonton, in Alberta. In such situations,SAi could potentially be used as a proxy for PPFluA when there arenot enough samples for stable laboratory estimates.MethodsThe Alberta Real-Time Syndromic Surveillance Net (ARTSSN)4collects elementary SA data from the two major school boards intwo cities in Alberta with populations >800,000. Since reasons forSA are stated, rates of SAi can be calculated. Data were obtained forthree years, 2012 to 2014, for each city. Laboratory data on tests ofrespiratory agents using a standardized protocol were obtained fromAlberta’s Provincial Laboratory for Public Health for the same timeperiod and locations. The dates of the specimens being received bythe laboratory were used in this analysis. For each data source, therelative proportions (SAi and PPFluA) were calculated. Data forthe first week of school in September and for the last two weeks ofDecember were removed for each year due to the SAi rates beingunstable. Linear regression models were constructed, with rates ofSAi predicted by PPFluA. Separate models were run for each cityand for each year, resulting in a total of 6 models. Percent positivityfor entero-rhinoviruses (PPERV) was added to see if it improved themodel. The regression models were created using Excel and checkedin the statistical programs, SAS and R. An analysis to assess theinfluence of a lag period was assessed using R.ResultsFor each city, the provincial lab tested between 4,000 and 6,000specimens each fall and SAi rates were based on denominators ofbetween 20,000 and 36,000 children. The R2, betas, and p-valuesfor all 6 regression models are shown in Table 1. The minimumcorrelation value was 0.693 and the maximum was 0.935. Dueto the strong negative correlations between PPERV and PPFluA,PPERV was not retained in the models. Looking at the lag periods,the maximum correlations occurred at a zero week lag in two years(2012 and 2014) and at a -1 week lag in 2013. The two years with azero lag were both dominated by a H3N2 strain while the year withmainly a H1N1 strain showed a lag of -1. Only one year of H1N1 datawas available for analysis.ConclusionsWe observed strong correlations between the weekly rates ofelementary SAi and PPFluA at the city level over three years, fromSeptember to December. The reasons for the difference in lag timesbetween the H1N1 and H3N2 seasons are being investigated.

scholarly journals Revealing COVID-19 Transmission by SARS-CoV-2 Genome Sequencing and Agent Based Modelling

2020 ◽  
Author(s):  
Rebecca J Rockett ◽  
Alicia Arnott ◽  
Connie Lam ◽  
Rosemarie Sadsad ◽  
Verlaine Timms ◽  
...  
Keyword(s):  
Public Health ◽  
Genome Sequencing ◽  
New South ◽  
Control Measures ◽  
Health Concern ◽  
Public Health Action ◽  
Agent Based ◽  
South Wales ◽  
Health Action ◽  
Community Transmission

ABSTRACTCommunity transmission of the new coronavirus SARS-CoV-2 is a major public health concern that remains difficult to assess. We present a genomic survey of SARS-CoV-2 from a during the first 10 weeks of COVID-19 activity in New South Wales, Australia. Transmission events were monitored prospectively during the critical period of implementation of national control measures. SARS-CoV-2 genomes were sequenced from 209 patients diagnosed with COVID-19 infection between January and March 2020. Only a quarter of cases appeared to be locally acquired and genomic-based estimates of local transmission rates were concordant with predictions from a computational agent-based model. This convergent assessment indicates that genome sequencing provides key information to inform public health action and has improved our understanding of the COVID-19 evolution from outbreak to epidemic.

scholarly journals Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients

2020 ◽  
Author(s):  
Daniel Garzon-Chavez ◽  
Daniel Romero-Alvarez ◽  
Marco Bonifaz ◽  
Juan Gaviria ◽  
Daniel Mero ◽  
...  
Keyword(s):  
Public Health ◽  
Laboratory Data ◽  
Control Measures ◽  
World Health ◽  
Global Pandemic ◽  
First Case ◽  
Short Period ◽  
Health Demand ◽  
Health Organization

Abstract The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on March 11th. In Ecuador, the first case of COVID-19 was recorded on February 29th. Despite efforts to control its spread, SARS-CoV-2 overrun the Ecuadorian public health system which became one of the most affected in Latin America with 22,719 cases reported up to April, 24th. Public health control measures, including social distancing and lockdowns, were implemented at different times in the biggest cities of the country: Guayaquil and Quito. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city.

scholarly journals Sorting the Wheat from the Chaff: Vaccine-Associated Rash Illness Occurring amidst a Large Measles Outbreak—Minnesota, 2017

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S736-S737
Author(s):  
Karen Martin ◽  
Rajal Mody ◽  
Malini Desilva ◽  
Emily Banerjee ◽  
Anna Strain ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccination Campaign ◽  
Health Resources ◽  
Clinical Information ◽  
Control Measures ◽  
Mmr Vaccine ◽  
Public Health Action ◽  
Measles Outbreak ◽  
Health Action ◽  
Council Of State

Abstract Background During April–June 2017, Minnesota experienced the state’s largest measles outbreak in 27 years. A vaccination campaign was implemented. Numerous vaccine-associated rash illnesses (VARI) were detected. VARI is non-contagious, but difficult to distinguish from measles clinically. Often, public health control measures need to be implemented before wild-type measles can be differentiated from VARI by viral genotyping. We compared clinical characteristics of VARI and confirmed measles cases to inform testing practices. Methods We defined measles cases per the Council of State and Territorial Epidemiologists. VARI was defined as a rash occurring in a person within 21 days after receipt of measles, mumps, and rubella (MMR) vaccine, and in whom a measles vaccine strain (genotype A) was detected in naso/oro- pharyngeal swab or urine samples. Minnesota’s immunization information system monitored MMR doses administered. We collected clinical information through routine case investigation. Results Over 42,000 MMR doses above expected were administered during the outbreak. We identified 71 measles cases and 30 VARI. The median age of VARI patients was 1.2 years (range 10 months–48 years) and for measles cases 2.8 years (range 3 months–57 years). VARI diagnosis increased with rising MMR administration (figure); rash onset occurred a median of 11 (range 7–18) days after MMR receipt. Most VARI (97%) occurred following first MMR dose. The presence of fever was similar among VARI and measles cases (97% of VARI vs. 100% of measles cases; P = 0.12), but differences were seen in the proportion with cough (30% vs. 96%; P < 0.001), coryza (47% vs. 85%; P < 0.001), conjunctivitis (23% vs. 68%; P < 0.001), and exposure to infectious measles cases (0% vs. 96%). Conclusions Surges in MMR administration and heightened community awareness during a measles outbreak can result in a large number of VARI, consuming considerable public health resources. When evaluating the need to suspect measles among patients with febrile rash, clinicians should consider time since MMR administration, clinical presentation, and history of measles exposure. Collecting appropriate specimens for timely virus genotyping could inform appropriate public health action. Disclosures All authors: No reported disclosures.

scholarly journals Tuberculosis outbreak among high school students in Novi Pazar, Serbia 2016: a retrospective-cohort study

2019 ◽  
Vol 13 (02) ◽  
pp. 101-110 ◽  
Author(s):  
Maja B Stosic ◽  
Dragana Plavsa ◽  
Nikoletta Mavroeidi ◽  
Dragana Jovanovic ◽  
Violeta Vucinic ◽  
...  
Keyword(s):  
Public Health ◽  
High School ◽  
Cohort Study ◽  
High School Students ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Delayed Diagnosis ◽  
Control Measures ◽  
School Students ◽  
Relative Risks

Introduction: Between February and November 2016, 17 tuberculosis (TB) cases were identified among high school students in Novi Pazar, Serbia. The objectives of our study were to describe the outbreak, to identify potential risk factors and to evaluate the applied control measures. Methodology: The outbreak was described by time, person and place. A retrospective cohort study was conducted. Attack rates, unadjusted relative risks (RR) and 95% confidence intervals (CI) were calculated. Multiple log-binomial regression analysis was performed to calculate adjusted RR. Results: Sixteen of the total 17 cases occurred among grade 3 students, AR 5.5%. Previous TB family history, (RR = 5.29; 95% CI = 1.63-17.12), spending time with a known TB case at school (RR = 5.38; 95% CI = 1.48-19.55) and exposure to secondhand smoke (RR = 3.37; 95% CI = 1.11-10.29) were all significantly and independently associated with the occurrence of TB. Conclusions: Delayed diagnosis and reporting resulted in delayed initiation of the contact investigation and non-identification of latent TB cases probably favored the occurrence of this outbreak in a low incidence country. Public health authorities should consider revising the existing guidelines, promoting inter-sectorial collaboration and increasing awareness of public health professionals.

scholarly journals Preparedness for SARS in the UK in 2003

2004 ◽  
Vol 359 (1447) ◽  
pp. 1131-1132 ◽  
Author(s):  
David R. Harper
Keyword(s):  
Public Health ◽  
Southern China ◽  
Control Measures ◽  
World Health ◽  
Public Health Response ◽  
Public Health Action ◽  
National Public Health ◽  
Health Action ◽  
Health Organization ◽  
The Uk

Severe acute respiratory syndrome (SARS) has been described as the first major emerging infectious disease of the twenty–first century. Having initially emerged, almost unnoticed, in southern China, it rapidly spread across the globe. It severely tested national public health and health systems. However, it also resulted in rapid, intensive international collaboration, led by the World Health Organization, to elucidate its characteristics and cause and to contain its spread. The UK mounted a vigorous public health response. Some particular issues concerned: the practicalities of implementing exit screening had this been required; the likely efficacy of this and other control measures; the legal base for public health action; and the surge capacity in all systems should the disease have taken hold in the UK. We have used this experience of 2003 to inform our preparation of a framework for an integrated, escalating response to a future re–emergence of SARS according to the levels of disease activity worldwide. Recent cases confirm that SARS has not ‘gone away’. We cannot be complacent about our contingency planning.

Estimating the number of cases during COVID-19 pandemics using a web-based tool: first week results of “COVID-19 TRENDS” social media project in the Araba-Alava province in Basque country, Spain. (Preprint)

2020 ◽  
Author(s):  
Ignacio Garitano ◽  
Manuel Linares ◽  
Laura Santos ◽  
Ruth Gil ◽  
Elena Lapuente ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Response Rate ◽  
Basque Country ◽  
Case Definition ◽  
Public Health Action ◽  
Web Based ◽  
Health Action ◽  
Estimate Number ◽  
Media Project

UNSTRUCTURED On 28th February a case of COVID-19 was declared in Araba-Álava province, Spain. In Spain, a confinement and movement restrictions were established by Spanish Government at 14th March 2020. We implemented a web-based tool to estimate number of cases during the pandemic. We present the results in Áraba-Álava province. We reached a response rate of 10,3% out a 331.549 population. We found that 22,4 % fulfilled the case definition. This tool rendered useful to inform public health action.

scholarly journals Reconciling Epidemiology’s Aspirations and Capabilities

2020 ◽  
Author(s):  
David A Savitz
Keyword(s):  
Public Health ◽  
Epidemiologic Studies ◽  
Public Health Importance ◽  
Public Health Action ◽  
Action Current ◽  
Current Trends ◽  
The Face ◽  
Health Action ◽  
New Challenges ◽  
Health Applications

Abstract Interpreting the results of epidemiologic studies calls for objectivity and rigorous scrutiny, acknowledging the limitations that temper the applicability of the findings to public health action. Current trends have posed new challenges to balancing goal of scientific objectivity and validity with public health applications. The ongoing tension between epidemiology’s aspirations and capability has several sources: the need to overpromise in research proposals, compromising methodologic rigor because of public health importance, defending findings in the face of hostile critics, and appealing to core constituencies who have specific expectations from the research.

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