scholarly journals Investigation of a Limited but Explosive COVID-19 Outbreak in a German Secondary School

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 87
Author(s):  
Sigrid Baumgarte ◽  
Felix Hartkopf ◽  
Martin Hölzer ◽  
Max von Kleist ◽  
Sabine Neitz ◽  
...  
Keyword(s):  
Sequence Analysis ◽  
Secondary School ◽  
Clinical Laboratory ◽  
Primary Case ◽  
Staff Members ◽  
Source Of Infection ◽  
Potential Index ◽  
Contact Data ◽  
Spreading Rates ◽  
High Virus

The role of schools as a source of infection and driver in the coronavirus-pandemic has been controversial and is still not completely clarified. To prevent harm and disadvantages for children and adolescents, but also adults, detailed data on school outbreaks is needed, especially when talking about open schools employing evidence-based safety concepts. Here, we investigated the first significant COVID-19 school outbreak in Hamburg, Germany, after the re-opening of schools in 2020. Using clinical, laboratory, and contact data and spatial measures for epidemiological and environmental studies combined with whole-genome sequencing (WGS) analysis, we examined the causes and the course of the secondary school outbreak. The potential index case was identified by epidemiological tracking and the lessons in classrooms with presumably high virus spreading rates and further infection chains in the setting. Sequence analysis of samples detected one sample of a different virus lineage and 25 virus genomes with almost identical sequences, of which 21 showed 100% similarity. Most infections occurred in connection with two lesson units of the primary case. Likely, 31 students (12–14 years old), two staff members, and three family members were infected in the school or the typical household. Sequence analysis revealed an outbreak cluster with a single source that was epidemiologically identified as a member of the educational staff. In lesson units, two superspreading events of varying degrees with airborne transmission took place. These were influenced by several parameters including the exposure times, the use of respiratory masks while speaking and spatial or structural conditions at that time.

scholarly journals A food-borne outbreak of hepatitis A virus (HAV) infection in a secondary school in Upper Normandy, France, in November 2006

2008 ◽  
Vol 13 (22) ◽  
Author(s):  
N G Schwarz ◽  
M Revillion ◽  
A M Roque-Afonso ◽  
E Dussaix ◽  
M Giraud ◽  
...  
Keyword(s):  
Secondary School ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Control Measures ◽  
Secondary Case ◽  
Primary Case ◽  
District Health ◽  
Source Of Infection ◽  
Food Borne ◽  
Identical Type

In November 2006, six symptomatic cases of hepatitis A in pupils of a secondary school in Upper Normandy, France, were reported to the district health service. This paper describes the outbreak investigation undertaken with the aim to identify the vehicle and source of infection, implement control measures and estimate the size of the outbreak. A primary case at the secondary school was defined as a pupil or a member of the staff with IgM anti-HAV detected in the serum and with onset of symptoms between 12 and 21 November 2006; a secondary case was defined as a contact to a primary case and who developed symptoms and had IgM anti-HAV two to seven weeks later. We performed a case control study of primary cases, controls being pupils visiting the same school (cases/controls 1:4) and inspected the canteen facilities. All 13 canteen employees were examined for anti-HAV IgM antibodies. A phylogenetic analysis of HAV of cases was performed. We identified 10 primary and 5 secondary cases. Among primary cases 90% reported eating liver pate at the canteen compared to 62% among controls (OR 5.5, 95% CI 0.62-256.9).One liver pate sample contained markers of faecal contamination. HAV genotypes were of one identical type. All 13 canteen employees were negative for IgM anti-HAV while four had anti-HAV total antibodies. We found deficiencies regarding food preparing procedures and insufficient hand washing facilities. The vehicle of the outbreak was believed to be the liver pate but the source of HAV could not be identified. Insufficient facilities in the canteen hindered staff from maintaining a high hygiene standard and were subsequently improved.

scholarly journals The role of the dean in the pastoral care structure of a secondary school

2021 ◽  
Author(s):  
◽  
Jennifer Harriet Fraser
Keyword(s):  
New Zealand ◽  
Secondary School ◽  
Pastoral Care ◽  
Local Level ◽  
Well Being ◽  
Direct Care ◽  
Job Descriptions ◽  
Staff Members ◽  
Care Structure

<p>Pastoral care structures in New Zealand schools often include a middle management role of dean. This position has existed in New Zealand schools for decades, influenced by the existing systems and structures adopted from the United Kingdom. The responsibilities included in this role are often defined by schools at the local level in order to satisfy growing expectations of schools’ responsibility for student well-being and achievement. There has been little research concerning this position within the pastoral care structure of schools.  This study aimed to explore the perceptions of members of the school community on the role of the year-level deans within one New Zealand secondary school. Senior managers, deans, teachers, and students from a state co-educational, urban, secondary school were interviewed regarding their views on the role, responsibilities, and effectiveness of the position of the year-level dean within their school. Deans also completed a daily log to record the nature of their tasks completed pertaining to this responsibility. Participants’ responses were analysed for major themes. The themes discussed include the intention of the role of the dean, tensions between the management of academic and pastoral issues, the exploration of the challenge in providing care for all students, and how resources available to the school and the dean can impact their role. A difference in the role between the junior school (Years 9 and 10) and senior school (Years 11, 12, and 13) was reported by all participants. Deans reported engaging in reactive tasks more than proactive, preventative tasks.  Defining the role of the dean and its relationship to other roles within the school proved challenging for the perspectives, and this confusion was evident through a lack of clarity around lines of authority described in the job descriptions. Deans reported some difficulty in understanding their role in relation to managing form teachers, particularly where that staff member may hold a position of responsibility in curriculum.  The reactive nature of the role was revealed. This indicated that deans continue to provide predominantly reactive care concerned with individual students, often meaning that only a small group of students receive direct care from deans. The predominantly reactive nature of the role creates implications for schools in the challenge of delivering care to all students. A more collaborative approach to pastoral care from all staff members may improve the provision of pastoral care for students. A proposed job description that may reflect the role of the dean more accurately is presented.</p>

scholarly journals Laboratory Staff Turnover: A College of American Pathologists Q-Probes Study of 23 Clinical Laboratories

2019 ◽  
Vol 144 (3) ◽  
pp. 350-355 ◽  
Author(s):  
David A. Novis ◽  
Suzanne Nelson ◽  
Barbara J. Blond ◽  
Anthony J. Guidi ◽  
Michael L. Talbert ◽  
...  
Keyword(s):  
Human Resource ◽  
Clinical Laboratory ◽  
Staff Turnover ◽  
Human Resource Practices ◽  
Full Time ◽  
Turnover Rates ◽  
Full Time Equivalent ◽  
Laboratory Staff ◽  
Staff Members ◽  
Clinical Laboratories

Context.— Knowledge of laboratory staff turnover rates are important to laboratory medical directors and hospital administrators who are responsible for ensuring adequate staffing of their clinical laboratories. The current turnover rates for laboratory employees are unknown. Objective.— To determine the 3-year average employee turnover rates for clinical laboratory staff and to survey the types of institutional human resource practices that may be associated with lower turnover rates. Design.— We collected data from participating laboratories spanning a 3-year period of 2015–2017, which included the number of full-time equivalent (FTE) staff members that their laboratories employed in several personnel and departmental categories, and the number of laboratory staff FTEs who vacated each of those categories that institutions intended to refill. We calculated the 3-year average turnover rates for all laboratory employees, for several personnel categories, and for major laboratory departmental categories, and assessed the potential associations between 3-year average all laboratory staff turnover rates with institutional human resource practices. Results.— A total of 23 (20 US and 3 international) participating institutions were included in the analysis. Among the 21 participants providing adequate turnover data, the median of the 3-year average turnover rate for all laboratory staff was 16.2%. Among personnel categories, ancillary staff had the lowest median (11.1% among 21 institutions) and phlebotomist staff had the highest median (24.9% among 20 institutions) of the 3-year average turnover rates. Among laboratory departments, microbiology had the lowest median (7.8% among 18 institutions) and anatomic pathology had the highest median (14.3% among 14 institutions) of the 3-year average turnover rates. Laboratories that developed and communicated clear career paths to their employees and that funded external laboratory continuing education activities had significantly lower 3-year average turnover rates than laboratories that did not implement these strategies. Conclusions.— Laboratory staff turnover rates among institutions varied widely. Two human resource practices were associated with lower laboratory staff turnover rates.

scholarly journals EHEC outbreak among staff at a children's hospital – use of PCR for verocytotoxin detection and PFGE for epidemiological investigation

2004 ◽  
Vol 132 (1) ◽  
pp. 43-49 ◽  
Author(s):  
C. WELINDER-OLSSON ◽  
K. STENQVIST ◽  
M. BADENFORS ◽  
Å. BRANDBERG ◽  
K. FLORÉN ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Fast Method ◽  
Epidemiological Investigation ◽  
Foodborne Outbreak ◽  
E Coli ◽  
Staff Members ◽  
Children's Hospital ◽  
Source Of Infection ◽  
Children’S Hospital ◽  
Culture Positive

This is the first report of a major foodborne outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Sweden. It occurred among the nursing staff at a children's hospital with approximately 1600 employees. Contaminated lettuce was the most likely source of infection. Nine persons were culture-positive for Escherichia coli (E. coli) O157 and verocytotoxin-positive by PCR and a further two were verocytotoxin-positive by PCR only. All 11 EHEC-positive individuals had attended a party for approximately 250 staff members, which was held at the hospital. In a questionnaire 37 persons stated that they had symptoms consistent with EHEC infection during the weeks after the party. There was no evidence of secondary transmission from staff to patients. The value of PCR as a sensitive and fast method for diagnosis is discussed in this paper. Pulsed-field gel electrophoresis (PFGE) was used to ascertain that staff members were infected by the same clone, and that two patients with E. coli O157 infection were not.

scholarly journals CalmBelt: Rapid SARS-CoV-2 Genome Characterization for Outbreak Tracking

2021 ◽  
Vol 8 ◽  
Author(s):  
Hatairat Yingtaweesittikul ◽  
Karrie Ko ◽  
Nurdyana Abdul Rahman ◽  
Shireen Yan Ling Tan ◽  
Niranjan Nagarajan ◽  
...  
Keyword(s):  
Sequence Analysis ◽  
Web Application ◽  
Clinical Laboratory ◽  
Clinical Samples ◽  
Analysis Tool ◽  
Whole Genome ◽  
Multiple Use ◽  
Sequencing Technology ◽  
Health Crisis ◽  
Genome Characterization

Background: The ongoing COVID-19 pandemic is a global health crisis caused by the spread of SARS-CoV-2. Establishing links between known cases is crucial for the containment of COVID-19. In the healthcare setting, the ability to rapidly identify potential healthcare-associated COVID-19 clusters is critical for healthcare worker and patient safety. Increasing sequencing technology accessibility has allowed routine clinical diagnostic laboratories to sequence SARS-CoV-2 in clinical samples. However, these laboratories often lack specialized informatics skills required for sequence analysis. Therefore, an on-site, intuitive sequence analysis tool that enables clinical laboratory users to analyze multiple genomes and derive clinically relevant information within an actionable timeframe is needed.Results: We propose CalmBelt, an integrated framework for on-site whole genome characterization and outbreak tracking. Nanopore sequencing technology enables on-site sequencing and construction of draft genomes for multiple SARS-CoV-2 samples within 12 h. CalmBelt's interactive interface allows users to analyse multiple SARS-CoV-2 genomes by utilizing whole genome information, collection date, and additional information such as predefined potential clusters from epidemiological investigations. CalmBelt also integrates established SARS-CoV-2 nomenclature assignments, GISAID clades and PANGO lineages, allowing users to visualize relatedness between samples together with the nomenclatures. We demonstrated multiple use cases including investigation of potential hospital transmission, mining transmission patterns in a large outbreak, and monitoring possible diagnostic-escape.Conclusions: This paper presents an on-site rapid framework for SARS-CoV-2 whole genome characterization. CalmBelt interactive web application allows non-technical users, such as routine clinical laboratory users in hospitals to determine SARS-CoV-2 variants of concern, as well as investigate the presence of potential transmission clusters. The framework is designed to be compatible with routine usage in clinical laboratories as it only requires readily available sample data, and generates information that impacts immediate infection control mitigations.

scholarly journals Epidemiological characteristics of COVID-19 in medical staff members of neurosurgery departments in Hubei province: A multicentre descriptive study

2020 ◽  
Author(s):  
Qiangping Wang ◽  
Xing Huang ◽  
Yansen Bai ◽  
Xuan Wang ◽  
Haijun Wang ◽  
...  
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Medical Staff ◽  
Epidemiological Data ◽  
Hubei Province ◽  
Staff Members ◽  
Source Of Infection ◽  
Novel Coronavirus ◽  
Epidemiological Characteristics ◽  
Level 2

ABSTRACTBackgroundThe novel coronavirus (SARS-CoV-2) has infected a large number of healthcare workers in Hubei province, China. In addition to infectious and respiratory disease physicians, many doctors in other medical fields have been infected.MethodsWe prospectively collected epidemiological data on medical staff members who are working in neurosurgery departments in 107 hospitals in Hubei province through self-reported questionnaires or telephone interviews. Data of medical staff members with laboratory-confirmed coronavirus disease 2019 (COVID-19) were analysed. The final follow-up date was 1 March 2020.FindingsA total of 5,442 neurosurgery department medical staff members were surveyed. One hundred and twenty cases, involving 54 doctors and 66 nurses, were found to have been infected with SARS-CoV-2. The overall incidence was 2.2%. These cases were concentrated in 26 centres, 16 of which had admitted a total of 59 patients with COVID-19 complicated by craniocerebral disease. Medical staff members in centres receiving COVID-19 patients had a higher risk of contracting infection than those in centres not receiving COVID-19 patients (relative risk: 19.6; 95% confidence interval: 12.6–30.6). Contact with either COVID-19 patients (62.5%, 75/120) or infected colleagues (30.8%, 37/120) was the most common mode of transmission. About 78.3% (94/120) of the infected cases wore surgical masks, whereas 20.8% (25/120) failed to use protection when exposed to the source of infection. Severe infections were observed in 11.7% (14/120) of the cases, with one death (0.8%, 1/120). All the infected medical staff members had been discharged from the hospital. A total of 1,287 medical staff members were dispatched to participate in the frontline response to COVID-19 under level 2 protection of whom one was infected. Medical staff members who took inadequate protection had a higher risk of contracting infection than those using level 2 protection (relative risk: 36.9; 95% confidence interval: 5.2–263.6).ConclusionsNeurosurgical staff members in Hubei province were seriously affected by COVID-19. Level 2 protection and strengthening of protective measures are likely to be effective in preventing medical workers from being infected.

scholarly journals Influence of observable and unobservable exposure on the patient's risk of acquiring influenza-like illness at hospital

2016 ◽  
Vol 144 (10) ◽  
pp. 2025-2030 ◽  
Author(s):  
C. PAYET ◽  
N. VOIRIN ◽  
R. ECOCHARD ◽  
P. VANHEMS
Keyword(s):  
Healthcare Workers ◽  
Credible Interval ◽  
Control Measures ◽  
Primary Case ◽  
Influenza Like Illness ◽  
Source Of Infection ◽  
Influenza Transmission ◽  
The Moment ◽  
Hospital Acquired ◽  
And Control

SUMMARYDuring outbreaks of hospital-acquired influenza-like illness (HA-ILI) healthcare workers (HCWs), patients, and visitors are each a source of infection for the other. Quantifying the effects of these various exposures will help improve prevention and control of HA-ILI outbreaks. We estimated the attributability of HA-ILI to: (1) exposure to recorded or unrecorded sources; (2) exposure to contagious patient or contagious HCW; (3) exposure during observable or unobservable contagious period of the recorded sources; and, (4) the moment of exposure. Among recorded sources, 59% [95% credible interval (CrI) 34–83] of HA-ILI of patients was associated with exposure to contagious patients and 41% (95% CrI 17–66) with exposure to contagious HCWs. Exposure during the unobservable contagiousness period of source patients accounted for 49% (95% CrI 19–75) of HA-ILI, while exposure during the unobservable contagiousness period of source HCWs accounted for 82% (95% CrI 51–99) of HA-ILI. About 80% of HA-ILIs were associated with exposure 1 day earlier. Secondary cases of HA-ILI might appear as soon as the day after the detection of a primary case highlighting the explosive nature of HA-ILI spread. Unobservable transmission was the main cause of HA-ILI transmission suggesting that symptom-based control measures alone might not prevent hospital outbreaks. The results support the rapid implementation of interventions to control influenza transmission.

Outbreak of Burkholderia contaminans endophthalmitis traced to a clinic ventilation system

2021 ◽  
pp. 1-3
Author(s):  
Theodore Spilker ◽  
Jens Kratholm ◽  
Eliza Depoorter ◽  
Peter Vandamme ◽  
John J. LiPuma
Keyword(s):  
Sequence Analysis ◽  
Cataract Surgery ◽  
Genome Sequence ◽  
Ventilation System ◽  
Whole Genome Sequence ◽  
Whole Genome ◽  
Genome Sequence Analysis ◽  
Source Of Infection ◽  
Burkholderia Contaminans

Abstract We describe the follow-up investigation of an outbreak of endophthalmitis due to Burkholderia contaminans following cataract surgery in a single clinic. Whole-genome sequence analysis of bacteria recovered from affected patients and the clinic identified the clinic’s ventilation system as the source of infection.

scholarly journals The Way of Laryngoscope Disinfection: A Survey of Practice in Various Hospitals and Clinics

2021 ◽  
Vol 9 (1) ◽  
pp. 4-10
Author(s):  
Molla Md Rubaiat ◽  
Kazi Ashkar Lateef ◽  
Abdul Quader ◽  
Husain Md Khurshid
Keyword(s):  
Povidone Iodine ◽  
Soap Solution ◽  
Improve Patient Safety ◽  
Tap Water ◽  
National Level ◽  
Chemical Agent ◽  
Source Of Infection ◽  
Potential Source ◽  
Contact Data ◽  
Improve Patient

Background and Aims: During general anaesthesia, laryngoscope is a common equipment for intubation used by anaesthesiologists. Laryngoscope has been identified as a potential source of cross infection. Though guidelines exist for appropriate disinfection practices, recent reviews suggested that current methods of disinfection areless effective and compliance is poor with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists. Methods: A simple questionnaire containing 14 questions was distributed amongst anaesthesiologists through online as well as direct contact. Data were analyzed with percentage analysis. Results: Out of 150 anaesthesiologists, 120 submitted the completed questionnaires. Residents constituted 41% and 46% were consultants. Eighteen (12%) used only tap water for cleaning and 132 (88%) used a chemical agent after rinsing with water. Out of 132, 76 (51%) used detergent/soap solution, 29 (19%) would wash and then soak in disinfectant or germicidal agents (glutaraldehyde, povidone iodine and chlorhexidine) and 18 (12%) would wipe the blade with an alcohol swab. With respect to disinfection of laryngoscope handles, 70% respondents said they used an alcohol swab, 18% did not use any method, 9% were not aware of the method being used, while 3% did not respond. Conclusion: Our results indicate wide variation in methods of decontamination of laryngoscopes. Awareness regarding laryngoscope as a potential source of infection was high. We need to standardize and implement guidelines on a national level and make available resources which will help to improve patient safety. CBMJ 2020 January: Vol. 09 No. 01 P: 04-10

scholarly journals Borderline lepromatous leprosy with primary clinical manifestation in a patient with a long-term dermatological history

2020 ◽  
Vol 96 (5) ◽  
pp. 53-58
Author(s):  
E. Yu. Yanchevskaya ◽  
V. A. Kovtunova ◽  
E. V. Dumchenko ◽  
V. V. Duiko ◽  
Yu. Yu. Levicheva
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Clinical Situation ◽  
Underlying Disease ◽  
Lepromatous Leprosy ◽  
Federal State ◽  
Serological Examination ◽  
Source Of Infection ◽  
The Face

Despite the low number, the cases of leprosy continue to be detected, more often on endemic territories. In Russian Federation one of the endemic territories is located in Astrakhan region. The long incubation period eventually leads to inability to identify the source of infection. The combination of the leprosy with other dermatoses complicates the diagnosing. The isolated and early skin manifestations of leprosy can be mistaken for the clinical features of other dermatoses. This article presents the description of a case study of border line lepromatosis leprosy in a patient with a long-term dermatological background. A 66-year-old male was followed up for 14 years under different dermatological diseases. In 2017, after a change in the nature of rashes, atypical for supervised nosological forms, and in connection with the resistance of clinical manifestations of diseases to the therapy, a clinical diagnosis of leprosy was established. To verify this diagnosis, the patient was sent to the Federal State Budgetary Institution "Research Institute for the Study of Leprosy". At admission, he complained of rashes on the skin of the face, trunk, extremities, accompanied by itching, swelling, weakness and numbness in the distal extremities. As a result of clinical, laboratory examination (bacterioscopic examination of scarification from the skin, serological examination, pathomorphological examination of skin biopsies), the diagnosis of the underlying disease was made: leprosy, borderline lepromatous form, active stage. Complications of the underlying disease: chronic specific polyneuropathy with sensitive disorders. The described clinical situation illustrates the problem of early diagnosis of leprosy due to the variety of manifestations and low alertness of clinicians.

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