News Scan for Jun 19, 2019

News brief

Health workers frequently care for patients when sick, study finds

A study over four flu seasons of influenza and other respiratory illnesses at nine Canadian hospitals found that 95% of health providers have worked while sick, often when symptoms were mild or began during the workday. Researchers reported their findings yesterday in Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

Health workers who worked more than 20 hours a week were asked to complete daily online illness diaries whenever they experienced symptoms. Researchers collected information about symptoms, possible exposure, work attendance, reason for work or absence, and medical consultations.

A total of 2,728 participants completed 10,156 illness diaries, and diaries of those not scheduled to work were excluded, giving researchers 5,281 diaries to analyze. The team found that 69% of participants worked when sick, because their symptoms were mind and they felt well enough to work. Also, 11% said they had things to do at work, 8% felt obligated to do so, and 3% said they couldn't afford to stay home.

Among the study's other findings, half of the participants reported acute respiratory illness symptoms during each flu seasons, of which 95% worked 1 or more days during their illness. Paid sick leave benefits were reported by 79%.

Brenda Coleman, PhD, the study's lead author and clinical scientist in the infectious diseases unit at Mount Sinai Hospital in Toronto, said in a SHEA news release the team found that doctors and those working in areas requiring the most intensive contact with patients were less likely than other workers to stay home or leave work if they felt sicker as the day progressed.

"Managers and senior staff need to both model and insist on workers staying home when symptomatic, as it protects both patients and coworkers from infection," she said. Coleman added that the findings support the need to educate medical staff about the risk of transmission linked to respiratory infection, clarify what symptoms should exclude people from working, and develop policies that address working while symptomatic.
Jul 18 Infect Control Hosp Epidemiol abstract
Jun 18 SHEA press release


Study: Kids with pneumonia and bacteremia have more severe disease

A study today in Pediatrics found that, among 2,143 US children with community-acquired pneumonia, 2.2% had bacteremia, with resulting longer hospital stays and intensive care unit (ICU) admissions.

The study used blood cultures to determine bacteremia prevalence among patients under the age of 18 hospitalized with pneumonia between 2010 and 2012. Blood cultures taken from 2143 (91%) of children showed that 46 (2.2%) had bacteremia.

Bacteremia was associated with more severe pneumonia illnesses and longer lengths of hospital stay (5.8 vs 2.8 days; adjusted hazard ratio, 0.79) and increased odds of ICU admission (43% vs 21%; adjusted odds ratio [aOR], 5.21) and invasive mechanical ventilation or shock (30% vs 8%; aOR, 5.28).

The most common pathogens among children diagnosed as having bacteremia were Streptococcus pneumoniae (21 patients, 46%), Staphylococcus aureus (6, 13%), and Streptococcus pyogenes (4, 9%).

"In an era with widespread pneumococcal vaccination and low prevalence of bacteremia in the United States, children admitted with CAP that have pleural effusion or require ICU admission may represent a high-yield population for identifying bacteremia," the authors concluded.

The authors suggest the low rate of bacteremia could be explained by the wide use of antibiotics before culture, and viral causes of pneumonia.
Jun 19 Pediatrics study


India's Nipah virus outbreak winds down, with no new cases

Indian health officials are scaling back response steps in Kerala state, after surveillance in the wake of one case in a college student found no further cases, according to a recent report from the Deccan Chronicle, an Indian English-language newspaper, based on a media briefing that Kerala state's health minister K.K. Shailaja had with reporters.

She said no new cases among more than 300 people on the contact list were found. On Jun 3, the student was admitted to a private hospital, where he tested positive for Nipah virus. The patient is improving and has been moved from the intensive care unit to a regular room, according to the report. Three patients classified as suspected cases who had been in isolation were discharged on Jun 15.

Testing is under way on samples from 141 fruit bats collected from the Nipah virus patient's location.

According to the report, plans are in the works to establish a modern virology institute in Kerala state, which experienced a Nipah virus outbreak in 2018 that resulted in 17 deaths.
Jun 16 Deccan Chronicle story

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