scholarly journals Genetic testing and serological screening for SARS-CoV-2 infection in a COVID-19 outbreak in a nursing facility in Japan

2020 ◽  
Author(s):  
Yong Chong ◽  
Naoki Tani ◽  
Hideyuki Ikematsu ◽  
Nobuto Terazawa ◽  
Hitoshi Nakashima ◽  
...  
Keyword(s):  
The Other ◽  
Healthcare Personnel ◽  
Nursing Facilities ◽  
Serological Testing ◽  
Serological Tests ◽  
Serological Screening ◽  
Nursing Facility ◽  
Unit Unit ◽  
Spread Of Infection ◽  
Antibody Tests

Abstract Background: The Pandemic of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has critically impacted the spread of infection within nursing facilities. We evaluated the usefulness of genetic and serological tests conducted during a COVID-19 outbreak in a nursing facility in Japan.Methods: After the first identification of SARS-CoV-2 infection, a comprehensive, facility- and/or unit-wide PCR testing from nasopharyngeal swabs was repeatedly performed in a three-unit facility including 99 residents with dementia and 53 healthcare personnel. Additionally, PCR testing was conducted separately for residents and staff with fever of ≥37.5 oC. Facility-wide serological testing, including rapid kit testing and quantitative assay, was conducted twice over 1 month apart.Results: A total of 322 PCR and 257 antibody tests were performed. 37 (24.3%) of the 152 individuals (25/99 residents, 25.3%; 12/53 staff, 22.6%) were identified as PCR-positive. Seven residents died with a mortality of 7.1% (7/99). Among the 37 individuals, 10 (27.0%) were asymptomatic at the time of testing. PCR positivity was concentrated on one unit (Unit 1) (20/30 residents, 66.7%; 9/14 staff, 64.3%). The other units showed a limited spread of infection. In unit-wide and separate tests, PCR positivity detection was highly prevalent (22.9% and 44.4%, respectively) in Unit 1, compared with that in the other units. Serological testing identified two additional infected residents with a negative PCR result and showed that no staff was newly identified as infected.Conclusions: Thorough PCR testing, in combination with comprehensive and separate tests, is critical for managing COVID-19 outbreaks in nursing facilities, particularly, in units considered an epicenter. Serological testing is also beneficial for tracing contacts, confirming the number of infected individuals, and authorizing the termination of the outbreak.

scholarly journals Genetic testing and serological screening for SARS-CoV-2 infection in a COVID-19 outbreak in a nursing facility in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Chong ◽  
Naoki Tani ◽  
Hideyuki Ikematsu ◽  
Nobuto Terazawa ◽  
Hitoshi Nakashima ◽  
...  
Keyword(s):  
The Other ◽  
Healthcare Personnel ◽  
Nursing Facilities ◽  
Serological Testing ◽  
Serological Tests ◽  
Serological Screening ◽  
Nursing Facility ◽  
Unit Unit ◽  
Spread Of Infection ◽  
Antibody Tests

Abstract Background The Pandemic of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has critically impacted the spread of infection within nursing facilities. We evaluated the usefulness of genetic and serological tests conducted during a COVID-19 outbreak in a nursing facility in Japan. Methods After the first identification of SARS-CoV-2 infection, a comprehensive, facility- and/or unit-wide PCR testing from nasopharyngeal swabs was repeatedly performed in a three-unit facility including 99 residents with dementia and 53 healthcare personnel. Additionally, PCR testing was conducted separately for residents and staff with fever of ≥37.5 °C. Facility-wide serological testing, including rapid kit testing and quantitative assay, was conducted twice over 1 month apart. Results A total of 322 PCR and 257 antibody tests were performed. 37 (24.3%) of the 152 individuals (25/99 residents, 25.3%; 12/53 staff, 22.6%) were identified as PCR-positive. Seven residents died with a mortality of 7.1% (7/99). Among the 37 individuals, 10 (27.0%) were asymptomatic at the time of testing. PCR positivity was concentrated on one unit (Unit 1) (20/30 residents, 66.7%; 9/14 staff, 64.3%). The other units showed a limited spread of infection. In unit-wide and separate tests, PCR positivity detection was highly prevalent (22.9 and 44.4%, respectively) in Unit 1, compared with that in the other units. Serological testing identified two additional infected residents with a negative PCR result and showed that no staff was newly identified as infected. Conclusions Thorough PCR testing, in combination with comprehensive and separate tests, is critical for managing COVID-19 outbreaks in nursing facilities, particularly, in units considered an epicenter. Serological testing is also beneficial for tracing contacts, confirming the number of infected individuals, and authorizing the termination of the outbreak.

scholarly journals Serological Tests in the Detection of SARS-CoV-2 Antibodies

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 678
Author(s):  
Kissy Guevara-Hoyer ◽  
Jesús Fuentes-Antrás ◽  
Eduardo De la Fuente-Muñoz ◽  
Antonia Rodríguez de la Peña ◽  
Marcos Viñuela ◽  
...  
Keyword(s):  
Binding Site ◽  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
Time Lapse ◽  
Healthcare Personnel ◽  
Serological Testing ◽  
Serological Tests ◽  
Early Management ◽  
Health Strategy ◽  
Large Center

Early detection of SARS-CoV-2 is essential for a timely update of health policies and allocation of resources. Particularly, serological testing may allow individuals with low-risk of being contagious of SARS-CoV-2 to return to daily activities. Both private and academic initiatives have sought to develop serological assays to detect anti-SARS-CoV-2 antibodies. Herein, we compared five different assays in active healthcare personnel exposed to SARS-CoV-2 in a large center in Madrid, Spain, in a retrospective study. Median time lapse between polymerase chain-reaction (PCR) and serological testing was 11 days (7–21). All tests assessed IgM/IgG titers except for Euroimmun (IgA/IgG) and The Binding-Site (IgA/IgM/IgG). The highest concordance rate was observed between Dia.Pro and Euroimmun (75.76%), while it was lowest between The Binding-Site and Euroimmun (44.55%). The Binding-Site assay showed the highest concordance (85.52%) with PCR results. Considering PCR results as reference, Dia.Pro was the most sensitive test, although The Binding-Site assay exhibited the highest area under the curve (AUC; 0.85). OrientGene and MAGLUMI tests were performed in a smaller cohort with confirmed infection and thus were not adequate to estimate sensitivity and specificity. The Binding-Site assay presented the best joint sensitivity and specificity among all the tests analyzed in our cohort. Likewise, this serological assay presents a greater repertoire of antibodies and antigen-regions tested, which is why each individual’s humoral immunity is more accurately reflected. The better the immunity test, the most adequate the health strategy to take in terms of organization of consultations, surgery, and treatments in vulnerable patients. The three antibody classes (IgG/IgM/IgA) were determined jointly, which translates to an economic impact on healthcare. While their role in the protection status remains elusive, serological tests add a valuable tool in the early management of SARS-CoV-2 after known exposition.

scholarly journals Verification of Healthcare Personnel Immunity as a Strategy for Measles Preparedness

2020 ◽  
Vol 41 (S1) ◽  
pp. s431-s432
Author(s):  
Rachael Snyders ◽  
Hilary Babcock ◽  
Christopher Blank
Keyword(s):  
Infectious Diseases ◽  
Multidisciplinary Team ◽  
The United States ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Serological Tests ◽  
Preparedness Plan ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreaks ◽  
Centralized Database

Background: Immunization resistance is fueling a resurgence of vaccine-preventable diseases in the United States, where several large measles outbreaks and 1,282 measles cases were reported in 2019. Concern about these measles outbreaks prompted a large healthcare organization to develop a preparedness plan to limit healthcare-associated transmission. Verification of employee rubeola immunity and immunization when necessary was prioritized because of transmission risk to nonimmune employees and role of the healthcare personnel in responding to measles cases. Methods: The organization employs ∼31,000 people in diverse settings. A multidisciplinary team was formed by infection prevention, infectious diseases, occupational health, and nursing departments to develop the preparedness plan. Immunity was monitored using a centralized database. Employees without evidence of immunity were asked to provide proof of vaccination, defined by the CDC as 2 appropriately timed doses of rubeola-containing vaccine, or laboratory confirmation of immunity. Employees were given 30 days to provide documentation or to obtain a titer at the organization’s expense. Staff with negative titers were given 2 weeks to coordinate with the occupational heath department for vaccination. Requests for medical or religious accommodations were evaluated by occupational heath staff, the occupational heath medical director, and the human resources department. All employees were included, though patient-interfacing employees in departments considered higher risk were prioritized. These areas were the emergency, dermatology, infectious diseases, labor and delivery, obstetrics, and pediatrics departments. Results: At the onset of the initiative in June 2019, 4,009 employees lacked evidence of immunity. As of November 2019, evidence of immunity had been obtained for 3,709 employees (92.5%): serological evidence of immunity was obtained for 2,856 (71.2%), vaccine was administered to 584 (14.6%), and evidence of previous vaccination was provided by 269 (6.7%). Evidence of immunity has not been documented for 300 (7.5%). The organization administered 3,626 serological tests and provided 997 vaccines, costing ∼$132,000. Disposition by serological testing is summarized in Table 1. Conclusions: A measles preparedness strategy should include proactive assessment of employees’ immune status. It is possible to expediently assess a large number of employees using a multidisciplinary team with access to a centralized database. Consideration may be given to prioritization of high-risk departments and patient-interfacing roles to manage workload.Funding: NoneDisclosures: None

scholarly journals COVID-19 serological testing for Healthcare Workers in Lombardy, Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Del Castillo ◽  
A Castrofino ◽  
F Grosso ◽  
A Barone ◽  
L Crottogini ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Geographical Area ◽  
Healthcare Facility ◽  
Nasopharyngeal Swab ◽  
Infection Prevalence ◽  
Serological Testing ◽  
Prevention Policy ◽  
Rt Pcr ◽  
Serological Tests ◽  
Screening Process

Abstract Issue COVID-19 pandemic began in Italy on February 20th, 2020. Since the beginning of the emergency Healthcare Workers' (HCWs) involvement was prominent, mainly due to direct assistance to COVID-19 patients. Therefore, we implemented a prevention policy for HCW screening through serological and RT-PCR testing. Description of the problem HCW screening for SARS-CoV-2 infection is essential for prevention and control of the pandemic. Lombardy's Healthcare authorities settled a screening process for HCWs divided into three steps: 1) body temperature assessment at the beginning and the end of work shift, if fever > 37.5 °C was present the HCW was sent back home and a nasopharyngeal swab was performed; 2) progressive recruitment for serological testing; 3) on those positive to IgG a nasopharyngeal swab was performed and tested for viral RNA by RT-PCR. Results Among 79185 HCW tested, 9589 (12%) were positive on serological IgG testing. Of the 9589 positive a nasopharyngeal swab was performed on 6884. Of these 358 (5%) tested positive and the remaining 6526 (95%) negative to RT-PCR. We calculated a Positive Predictive Value of 5.2%. The rate of positive serological tests for each Healthcare facility varied between 0% and 78%. Five percent of all facilities, belonging to Brescia, Bergamo and Cremona area, reported a positivity rate higher than 40% in HCWs. A second cluster (18% of all facilities), involving the same geographical area, reported a rate between 20% and 40%, whereas the remaining facilities (76%) of the region a rate <20%. Lessons Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs especially in a high infection prevalence setting. Key messages Serological IgG testing can be, if followed by immediate nasopharyngeal swab testing, a valid screening intervention on asymptomatic HCWs. Infection prevention in HCW may benefit from a screening campaign especially in high prevalence settings.

scholarly journals SARS-CoV-2 serological assay and viral testing: a report of professional football setting

2021 ◽  
pp. postgradmedj-2021-140176
Author(s):  
Bahar Hassanmirzaei ◽  
Zohreh Haratian ◽  
Ali Ahmadzadeh Amiri ◽  
Amir Ahmadzadeh Amiri ◽  
Navid Moghadam
Keyword(s):  
Standard Test ◽  
Football Players ◽  
Professional Football ◽  
Serological Testing ◽  
Igg Antibodies ◽  
Current Standard ◽  
Serological Tests ◽  
The Mean ◽  
Viral Testing ◽  
Pcr Test

Purpose of the studyPCR is the current standard test for the diagnosis of SARS-CoV-2 infection. However, due to its limitations, serological testing is considered an alternative method for detecting SARS-CoV-2 exposure. In this study, we measured the level of SARS-CoV-2 IgM and IgG antibodies of male professional football players and compared the results with the standard PCR test to investigate the association between the two tests.Study designParticipants were male professional football players and team officials. Nasopharyngeal swabs and peripheral blood samples were collected for the PCR and serological tests, respectively. Also, previous records of COVID-19 testing and symptoms were gathered. Those with previous positive PCR tests who tested negative for the second time were considered to be recovered patients.ResultsOf the 1243 subjects, 222 (17.9%) were seropositive, while 29 (2.3%) tested positive for the SARS-CoV-2 PCR test. Sixty percent of symptomatic cases with a negative PCR were found to be seropositive. The mean level of IgM was significantly higher in PCR-positive and symptomatic subjects, whereas the recovered cases showed significantly higher levels of IgG.ConclusionOur study revealed an inconsistency of results between the two tests; therefore, although application of serological assays alone seems insufficient in diagnosing COVID-19 disease, the findings are beneficial in the comprehension and the management of the disease.

A Prospective 12-Month Study of Prescriptions in Long-Term Care Nursing Facility Residents

2019 ◽  
Vol 34 (3) ◽  
pp. 206-214
Author(s):  
Edward L. Schneider ◽  
Jung Ki Kim ◽  
Diana Hyun ◽  
Anjali Lobana ◽  
Rick Smith ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Los Angeles ◽  
Long Term Care ◽  
Medical Center ◽  
Full Time ◽  
Nursing Facilities ◽  
Geriatric Population ◽  
Nursing Facility ◽  
Term Care

AIM: The most frequent use of medications in the geriatric population occurs in skilled nursing facilities. This quality assurance study prospectively examines the high number of prescriptions ordered for long-term nursing facility residents throughout their first year after admission. METHODS: The investigators prospectively followed 101 consecutive long-term-stay older adult residents at the Joyce Eisenberg Keefer Medical Center, a nursing facility of Los Angeles Jewish Home for the Aging (LAJH) over a 12-month period. Preadmission prescriptions were obtained for 91 residents, as well as prescriptions at 1 week, 1 month, 3 months, 6 months, and 1 year after admission. The number of prescriptions by staff physicians and outside physicians was examined. RESULTS: Over the 12 months following admission, the mean number of scheduled prescriptions increased significantly from 11.1 prior to admission to 13.0 by 6 months and to 13.3 by 12 months (P-value < 0.05). The residents who were hospitalized during the 12 months of observation received significantly more scheduled, as needed, and total prescriptions than those not hospitalized. Physicians employed full time by LAJH ordered significantly fewer additional prescriptions than physicians with outside practices. The patients of the staff physicians also had fewer hospitalizations than those of the outside physicians. CONCLUSION: This quality assurance study reveals a statistically significant increase in the number of prescriptions made in a long-term care setting over a 12-month prospective study. Patients of staff physicians received fewer prescriptions and were hospitalized less frequently than patients of physicians who practiced outside LAJH.

scholarly journals Ευθανασία: Πρακτικές που εφαρμόζουν οι χώρες της Ευρωπαϊκής Ένωσης

Bioethica ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. 89
Author(s):  
Αλεξάνδρα Κοζαμάνη (Alexandra Kozamani)
Keyword(s):  
European Union ◽  
End Of Life ◽  
The Other ◽  
Self Determination ◽  
Healthcare Personnel ◽  
The European Union ◽  
Other Hand ◽  
Receive Treatment ◽  
The Right

Euthanasia is one of the issues that bioethics deals with, which is one of the outmost importance. Furthermore it is very up-to-date. In Greece and in most countries of the European Union euthanasia has not been subject to specialized legislation. It is only occasionally debated, resulting in tension and conflict. On one hand, people have the right to self determination, so the end of life should be among them. On the other hand, life is considered to be of the highest value and it is the duty of healthcare personnel to guard and preserve it by any means, using their expertise and knowledge.In this paper, a brief report is made to the practices used across countries in the European Union regarding the end of life. Most countries are opposed to euthanasia while acknowledging the right of a patient to refuse or receive treatment. Only three countries have passed bills that legalize euthanasia under strict conditions. The rest, due to sensitivity in this matter, have not yet proceeded in reforming their laws accordingly. It seems that society does not have the necessary reassurances so that they can engulf that issue guarding the true will of a person.

scholarly journals Clinical Courses and Characteristics of Residents During a SARS-CoV-2 Outbreak at a Central Indiana Skilled Nursing Facility

2020 ◽  
Vol 3 ◽  
Author(s):  
Lauren Albert ◽  
Kristi Lieb ◽  
Laramie Mack ◽  
Kathleen Unroe
Keyword(s):  
Older Adults ◽  
Case Reports ◽  
Skilled Nursing Facility ◽  
Nursing Facilities ◽  
Retrospective Case ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Increased Risk ◽  
Symptom Load ◽  
Retrospective Case Study

Background/Objective: Older adults such as skilled nursing facility residents have increased risk of serious SARS-CoV-2 infection and comprise a large proportion of the COVID-19 pandemic’s deceased—the US Centers for Medicare & Medicaid Services report 232,831 cases and 38,518 resident deaths to date. Recent case reports reveal, as in other diseases, older adults may experience atypical symptomology, complicating identification of ill residents and efforts to slow transmission. While a few facility outbreaks have been characterized epidemiologically, little research exists regarding clinical timelines and trajectories which residents experience during COVID-19 illness.   Methods: From May 9, 2020-June 1, 2020, daily notes on each COVID-19 positive resident’s status (n = 69) were taken by the medical director of a central Indiana nursing facility. Combined with a retrospective resident chart review of this same period, these notes were examined for COVID-19 infection symptoms and illness timelines to descriptively categorize a number of common illness trajectories and symptoms seen in residents with SARS-CoV-2 infection.  Results: Residents fit four descriptive clinical timelines: concurrent symptom load with quick death (Avg 5.6 days) (n = 5), accumulating symptom load with gradual decline (Avg. 13.9 days) (n = 9), prolonged active symptom load with periods of stabilization and symptom reoccurrence (n = 42), and asymptomatic or atypical symptom load (n = 12). Most common symptoms were fever, hypoxia, anorexia, and fatigue/malaise. Of the 14 residents who died (20.3% of infected), 8 died in the facility and 6 died in the hospital.  Conclusion and Implications: This retrospective case study adds to literature describing the presentation and symptomology of SARS-CoV-2 infection in residents of skilled nursing facilities and aids efforts to evaluate resident presentation, prognosis, and disease course. Robust descriptions of expected clinical courses may support realistic expectations of disease progression for residents and their family members experiencing future outbreaks.

scholarly journals Leptospira interrogans serotype hardjo in dairy cows

2003 ◽  
Vol 57 (5-6) ◽  
pp. 349-630
Author(s):  
Branka Vidic ◽  
Stanko Bobos
Keyword(s):  
Dairy Cows ◽  
Early Stage ◽  
Clinical Mastitis ◽  
Economic Problem ◽  
Low Fertility ◽  
Serological Tests ◽  
Primary Host ◽  
Source Of Infection ◽  
Drastic Increase ◽  
Spread Of Infection

Data on L. hardjo infection of dairy cows in the world pint out its important role in the occurrence of health and economic problem. L. interrogans serotype hardjo has been described as the cause of miscarriages, stillbirts, or the birhs of poorly vital calves, agalactia, mastitis, and low fertility in cows. Two L. hardjo genotypes have been identified in cows, namely, hardjopraitno and hardjobovis. Serological investigations have established a drastic increase in this leptospiral infection in cows. L. hardjo has become adapted to cattle as the primary host, so that an infection is maintained in herds and becomes deeply rooted because of the permanent presence of the source of infection. It was believed that sheep were accidental hosts, but the latest research suggest that they are yet another, transitory, host for maintining this leptospira serotype. L. hardjo is also important from the aspect of human health, especially of persons who are professionally exposed to this infection. L. hardjo infection is detected using serological tests and by proving the presence of leptospira. The medicine of choice in the therapy of leptospiral infections is streptomycin (DSM). Therapy using oxytetracyclines for clinical mastitis was also proven effective. Treatment is most successful in the early stage of the disease. A single dose of streptomycin administered in infected herds reduces the duration period of leptospira excretion through urine, thus preventing the spread of infection thorugh contaminated urine. The basic components of the plan to contain leptospira are the following: serological investigations, sanitary-higiene measures, the elimination of animals which excrete leptospira through urine, therapy, vaccination, quarantine.

scholarly journals Yellow fever in two unvaccinated French tourists to Brazil, January and March, 2018

2018 ◽  
Vol 23 (21) ◽  
Author(s):  
Emma Oliosi ◽  
Chantal Serero Corcos ◽  
Paulo Feijo Barroso ◽  
Alexandre Bleibtreu ◽  
Gilda Grard ◽  
...  
Keyword(s):  
At Risk ◽  
Yellow Fever ◽  
Minas Gerais ◽  
The Other ◽  
Rt Pcr ◽  
Serological Tests ◽  
Vaccination Recommendation

We report two yellow fever cases in unvaccinated French travellers in Brazil in January and March 2018, respectively; one exposed during an excursion in Minas Gerais and the other in Ilha Grande. Both presented with fever, hepatitis, thrombocytopenia and leucopenia. Yellow fever diagnosis was based on RT-PCR and serological tests. Both patients recovered within a few days. The increasing occurrence of cases in unvaccinated travellers highlights the need to reinforce vaccination recommendation for travellers at-risk.

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