NEWS SCAN: ED respiratory protection gaps, sushi Salmonella outbreak update, institutional outbreaks

Apr 17, 2012

Study finds low compliance with respiratory protection in ED staff
A study of respiratory hygiene compliance among workers in two hospital emergency departments found low overall levels, and a companion study on education and attitudes identified some measures facilities could use to improve protection. The two-part study in two emergency departments of a Quebec university hospital included an anonymous observational component conducted in February 2010 and a survey of knowledge, attitudes, and compliance in February 2009. The findings were published online recently by the American Journal of Infection Control. Observers gauged nine respiratory precaution behaviors, such as wearing a mask and isolating patients with respiratory symptoms. The observed median overall compliance with respiratory hygiene was 22%, whereas the overall median score for perceived compliance as shown in the survey was 68%. Despite hygiene posters in the areas, masks and tissues were missing in 9.6% of cases, and patient isolation and decontamination measures were rarely or never used. In the survey, nearly 92% of respondents said masks were an effective prevention measure. The top two obstacles to wearing them were forgetting (37.8%) and discomfort (35.1%). The investigators said the low compliance rate was striking. They recommended better visual tools specifically for emergency departments, modifying waiting-room materials to better specify mask-wearing indications (ie, coughing, sneezing, and runny nose), reminding nurses when patients should wear masks, and providing positive reinforcement of respiratory hygiene measures.
Apr 12 Am J Infect Control abstract

Sushi Salmonella outbreak total jumps to 141 cases
Twenty-five more patients have been sickened in a multistate Salmonella Bareilly outbreak with links to imported raw ground tuna used to make sushi and related products, the US Centers for Disease Control and Prevention (CDC) said today. The number of affected states held at 20, and the newly reported cases are from 14 of them. So far 21 patients have been hospitalized, but no deaths have been reported. The CDC said the investigation is ongoing, and efforts are under way to identify new cases. Results of intensive epidemiologic investigations, which have included exploring orders and sushi recipes among affected case clusters, have linked the illnesses to a California company's yellowfin scrape tuna. Moon Marine USA Corp. has recalled more than 58,000 pounds of the product, which was imported from India.
Apr 17 CDC outbreak update

Study: Healthcare outbreaks may be more common on Mondays, Fridays
Infectious disease outbreaks at healthcare facilities seem to be most common on Mondays and Fridays and least common on the weekends, but those findings might be an artifact of staffing and reporting habits, Ontario researchers reported in the American Journal of Infection Control yesterday. The team used a chi-square goodness-of-fit test to analyze data on 901 outbreaks in Toronto acute, chronic, and long-term healthcare centers and found a significantly lower number on Saturdays and Sundays. Further analysis of weekday outbreaks found a significantly (P < 0.05) higher incidence on Mondays and Fridays (23.1% and 19.3%, respectively, compared with 17.5%, 16.0%, and 15.0% for the other 3 weekdays). The authors write, "We suggest that this might be due to 'deadline' and 'catch-up' reporting related to the 'weekend effect,' whereby structural differences in weekend staffing affect detection of outbreaks."
Apr 16 Am J Infect Control abstract

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