Lessons learned from a prolonged norovirus GII.P16-GII.4 Sydney 2012 variant outbreak in a long-term care facility in Portugal, 2017

2019 ◽  
Vol 40 (10) ◽  
pp. 1164-1169
Author(s):  
Emma Sáez-López ◽  
Rodrigo Marques ◽  
Nuno Rodrigues ◽  
Mónica Oleastro ◽  
Helena Andrade ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Lessons Learned ◽  
Control Measures ◽  
Term Care ◽  
Environmental Cleaning ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Staff Members

AbstractObjective:To investigate an outbreak of acute gastroenteritis caused by norovirus (NoV) in a long-term care facility (LTCF) in Portugal to describe and estimate its extent, and we implemented control measures.Design:Outbreak investigation.Methods:Probable cases were residents or staff members in the LTCF with at least 1 of the following symptoms: (1) diarrhea, (2) vomiting, (3) nausea, and/or (4) abdominal pain between October 31 and December 8, 2017. Confirmed cases were probable cases with positive NoV infection detected by real-time polymerase chain reaction (RT-PCR) and the same genotype in stool specimens.Results:The outbreak was caused by NoV GII.P16-GII.4 Sydney 2012 variant and affected 146 people. The highest illness rates were observed in residents (97 of 335, 29%) and nurses (16 of 83, 19%). All 11 resident wards were affected. Data on cases and their working or living areas suggest that movement between wards facilitated the transmission of NoV, likely from person to person.Conclusions:The delay in the identification of the causative agent, a lack of restrictions of resident and staff movement between wards, and ineffective initial deep-cleaning procedures resulted an outbreak that continued for >1 month. The outbreak ended only after implementation of strict control measures. Recommendations for controlling future NoV outbreaks in LTCFs include emphasizing the need to control resident’s movements and to restrict visitors, timely and effective environmental cleaning and disinfection, leave of absence for ill staff, and encouraging effective hand hygiene.

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

Failure to Control an Outbreak of Multidrug-ResistantStreptococcus pneumoniaein a Long-Term–Care Facility Emergence and Ongoing Transmission of a Fluoroquinolone-Resistant Strain

2005 ◽  
Vol 26 (3) ◽  
pp. 248-255 ◽  
Author(s):  
Rosalind J. Carter ◽  
Genevieve Sorenson ◽  
Richard Heffernan ◽  
Julia A. Kiehlbauch ◽  
John S. Kornblum ◽  
...  
Keyword(s):  
Long Term Care ◽  
Antimicrobial Prophylaxis ◽  
Care Facility ◽  
Control Measures ◽  
Fluoroquinolone Resistance ◽  
Outbreak Strain ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

AbstractObjectives:To characterize risk factors associated with pneumococcal disease and asymptomatic colonization during an outbreak of multidrug-resistantStreptococcus pneumoniae(MDRSP) among AIDS patients in a long-term–care facility (LTCF), evaluate the efficacy of antimicrobial prophylaxis in eliminating MDRSP colonization, and describe the emergence of fluoroquinolone resistance in the MDRSP outbreak strain.Design:Epidemiologic investigation based on chart review and characterization of SP strains by antimicrobial susceptibility testing and PFGE and prospective MDRSP surveillance.Setting:An 80-bed AIDS-care unit in an LTCF.Participants:Staff and residents on the unit.Results:From April 1995 through January 1996, 7 cases of MDRSP occurred. A nasopharyngeal (NP) swab survey of all residents (n = 65) and staff (n = 70) detected asymptomatic colonization among 6 residents (9%), but no staff. Isolates were sensitive only to rifampin, ofloxacin, and vancomycin. A 7-day course of rifampin and ofloxacin was given to eliminate colonization among residents: NP swab surveys at 1, 4, and 10 weeks after prophylaxis identified 1 or more colonized residents at each follow-up with isolates showing resistance to one or both treatment drugs. Between 1996 and 1999, an additional 6 patients were diagnosed with fluoroquinolone-resistant (FQ-R) MDRSP infection, with PFGE results demonstrating that the outbreak strain had persisted 3 years after the initial outbreak was recognized.Conclusions:Chemoprophylaxis likely contributed to the development of a FQ-R outbreak strain that continued to be transmitted in the facility through 1999. Long-term control of future MDRSP outbreaks should rely primarily on vaccination and strict infection control measures.

Leading a Long-Term Care Facility through the COVID-19 Crisis: Successes, Barriers and Lessons Learned

2021 ◽  
Vol 23 (4) ◽  
pp. 28-34
Author(s):  
Farinaz Havaei ◽  
Maura MacPhee ◽  
David Keselman ◽  
Sabina Staempfli
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Lessons Learned ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals An outbreak of norovirus infection in a long-term care facility in Brazil

2010 ◽  
Vol 8 (4) ◽  
pp. 410-413 ◽  
Author(s):  
Fernando Gatti de Menezes ◽  
Vanessa Maria da Silva de Poli Correa ◽  
Fábio Gazelato de Mello Franco ◽  
Miriam Ikeda Ribeiro ◽  
Maria Fátima dos Santos Cardoso ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Control Strategies ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures

ABSTRACT Objective: To describe a norovirus outbreak in a Brazilian long-term care facility from July 8 to 29, 2005. Methods: In the first 48 to 72 hours after onset of symptoms in inpatients and employees, the main infection control strategies were staff education, emphasis on hand washing, implementing contact precautions up to 48-72 hours after resolution of symptoms, complete cleaning of the rooms and exclusion of symptomatic employees from work until 48-72 hours after resolution of their symptoms. Epidemiological and clinical characteristics of the norovirus infections were described based on chart review. Results: The incidence among inpatients and employees was 41.3% and 16.25%, respectively. The main symptom was diarrhea, affecting 100% of inpatients and employees. Forty-four percent of specimens were positive by RIDASCREEN® Norovirus analyses, and identified as norovirus genogroup GII. Seventy percent of inpatients were women and their age range was 51-98 years. Inpatients had in average two comorbid conditions – 87.3% with cardiovascular or chronic pulmonary condition and 47.6% with dementia. There was not relapse or death. Conclusions: The early infection-control measures associated to surveillance are required to keep long-term care facilities free of noroviruses and to protect those who are most vulnerable.

scholarly journals Responding to a COVID-19 Outbreak at a Long-Term Care Facility

2020 ◽  
Vol 40 (1) ◽  
pp. 14-17
Author(s):  
Carl D. Shrader ◽  
Shauna Assadzandi ◽  
Courtney S. Pilkerton ◽  
Amie M. Ashcraft
Keyword(s):  
Long Term Care ◽  
Index Case ◽  
Care Facility ◽  
Lessons Learned ◽  
Control Treatment ◽  
Sequential Order ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

This article describes an outbreak of COVID-19 in a long-term care facility (LTCF) in West Virginia that was the epicenter of the state’s pandemic. Beginning with the index case, we describe the sequential order of procedures undertaken by the facility including testing, infection control, treatment, and communication with facility residents, staff, and family members. We also describe the lessons learned during the process and provide recommendations for handling an outbreak at other LTCFs.

Abnormal behavior of residents in a long-term care facility and the associated stress of care staff members

2001 ◽  
Vol 33 (3) ◽  
pp. 203-210 ◽  
Author(s):  
Itsugi Nagatomo ◽  
Yasuaki Akasaki ◽  
Masataka Tominaga ◽  
Wataru Hashiguchi ◽  
Masahiro Uchida ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Care Staff ◽  
Abnormal Behavior ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Staff Members
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