tetano
Editor, Senior Moderator
[h=2]Weekly[/h] September 11, 2015 / 64(35);985-986
John G. Jordan, MD1,2; Scott Pritchard, MPH2; Garik Nicholson, MPH3; Tiffany Winston, MPH2; Megan Gumke, MPH2; Heather Rubino, PhD2; Sharon Watkins, PhD2; Lea A. Heberlein-Larson, MPH4; Anna Likos, MD2
In December 2014, the Florida Department of Health, Bureau of Epidemiology, was notified that 18 of 95 (19%) residents at a skilled nursing facility had radiographic evidence of pneumonia and were being treated with antibiotics. Two residents were hospitalized, one of whom died. A second resident died at the facility. The Florida Department of Health conducted an outbreak investigation to ascertain all cases through active case finding, identify the etiology, provide infection control guidance, and recommend treatment or prophylaxis, if indicated.
An outbreak-associated case was defined as the onset of fever or respiratory illness in a nursing facility resident or staff member from November 29?December 29, 2014. Overall, 50 persons, including 44 (46%) residents and six (8%) of 75 staff members met the case definition. The earliest reported onset date was November 29; 68% of cases occurred during December 12?18 (Figure). Antibiotics were prescribed to 36 (72%) patients. Nine (20%) ill residents were hospitalized. Two additional resident deaths occurred on December 21 and December 22, for a total of four, increasing the fatality rate to 9% among residents meeting the case definition (n = 44).
The mean age of affected residents was 81 years (range = 31?98 years); 57% were female. The most frequently reported signs and symptoms among all patients included congestion (72%), cough (60%), and fever (38%). The ill residents' rooms were distributed throughout the facility, with no apparent clustering.
Oropharyngeal swab samples were collected from 13 (30%) ill residents for respiratory viral testing by polymerase chain reaction at the Florida Department of Health Bureau of Public Health Laboratories. Ten specimens tested positive for influenza A H3, and three tested positive for respiratory syncytial virus. Among three specimens selected by the laboratory for atypical bacterial pathogens testing (Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae), all were negative. Urine antigen tests for L. pneumophila conducted at a commercial laboratory for 18 residents were all negative. Resident characteristics were analyzed for their association with illness including age, sex, race, room location, tobacco use, pneumococcal vaccination status, underlying chronic diseases, and obesity; no statistically significant association was found.
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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6435a7.htm?s_cid=mm6435a7_x
John G. Jordan, MD1,2; Scott Pritchard, MPH2; Garik Nicholson, MPH3; Tiffany Winston, MPH2; Megan Gumke, MPH2; Heather Rubino, PhD2; Sharon Watkins, PhD2; Lea A. Heberlein-Larson, MPH4; Anna Likos, MD2
In December 2014, the Florida Department of Health, Bureau of Epidemiology, was notified that 18 of 95 (19%) residents at a skilled nursing facility had radiographic evidence of pneumonia and were being treated with antibiotics. Two residents were hospitalized, one of whom died. A second resident died at the facility. The Florida Department of Health conducted an outbreak investigation to ascertain all cases through active case finding, identify the etiology, provide infection control guidance, and recommend treatment or prophylaxis, if indicated.
An outbreak-associated case was defined as the onset of fever or respiratory illness in a nursing facility resident or staff member from November 29?December 29, 2014. Overall, 50 persons, including 44 (46%) residents and six (8%) of 75 staff members met the case definition. The earliest reported onset date was November 29; 68% of cases occurred during December 12?18 (Figure). Antibiotics were prescribed to 36 (72%) patients. Nine (20%) ill residents were hospitalized. Two additional resident deaths occurred on December 21 and December 22, for a total of four, increasing the fatality rate to 9% among residents meeting the case definition (n = 44).
The mean age of affected residents was 81 years (range = 31?98 years); 57% were female. The most frequently reported signs and symptoms among all patients included congestion (72%), cough (60%), and fever (38%). The ill residents' rooms were distributed throughout the facility, with no apparent clustering.
Oropharyngeal swab samples were collected from 13 (30%) ill residents for respiratory viral testing by polymerase chain reaction at the Florida Department of Health Bureau of Public Health Laboratories. Ten specimens tested positive for influenza A H3, and three tested positive for respiratory syncytial virus. Among three specimens selected by the laboratory for atypical bacterial pathogens testing (Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae), all were negative. Urine antigen tests for L. pneumophila conducted at a commercial laboratory for 18 residents were all negative. Resident characteristics were analyzed for their association with illness including age, sex, race, room location, tobacco use, pneumococcal vaccination status, underlying chronic diseases, and obesity; no statistically significant association was found.
...
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6435a7.htm?s_cid=mm6435a7_x