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  • 1
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    Online Resource
    Nipah encephalitis outbreak in Malaysia, clinical features in patients from Seremban
    Cambridge University Press (CUP) ; 2002
    In:  Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Vol. 29, No. 1 ( 2002-02), p. 83-87
    Details
    In: Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, Cambridge University Press (CUP), Vol. 29, No. 1 ( 2002-02), p. 83-87
    Abstract: Il y a eu une éclosion d'encéphalite virale chez les travailleurs de l'industrie du porc en Malaisie de septembre 1998 à avril 1999. L'encéphalite a été attribuée à un nouveau paramyxovirus, le virus de Nipah. Cet article décrit les caractéristiques cliniques et les facteurs pronostiques de 103 patients traités à l'Hôpital de Seremban. Méthodes: Les dossiers cliniques et les rapports de laboratoire ont été révisés. Les cas étaient définis comme suit: un patient provenant de la région touchée, un contact direct ou un voisinage immédiat avec des porcs, des caractéristiques d'encéphalite selon la clinique ou l'analyse du LCR. Résultats: L'âge moyen était de 38 ans, 89% étaient des hommes, 58% étaient d'ethnie chinoise, 78% étaient des propriétaires ou des travailleurs de l'industrie porcine. La période d'incubation moyenne était de 10 jours. Le patient type consultait pour des symptômes systémiques non spécifiques tels de l'hyperthermie, de la céphalée, des myalgies et un mal de george. Des convulsions et des signes neurologiques focaux ont été observés chez 16% et 5% respectivement. Dans les cas plus sévères, ces symptômes étaient suivis de somnolence et d'une détérioration de l'état de conscience nécessitant une ventilation assistée chez 61%. Des troubles neurovégétatifs et des secousses myocloniques étaient fréquemment observés. La mortalité était élevée, soit 41%. Une hypertension systolique, de la tachycardie et une forte fièvre étaient associées à un mauvais pronostic. D'autre part, 40% ont récupéré complètement. Chez 19%, les signes neurologiques résiduels étaient plutôt légers. Conclusion: Le virus de Nipah a causé une encéphalite dont la période d'incubation était courte et la mortalité élevée. Le pronostic chez les survivants était bon.
    Type of Medium: Online Resource
    ISSN: 0317-1671 , 2057-0155
    URL: Article
    DOI: 10.1017/S0317167100001785
    RVK:
    XA 10000
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2002
    detail.hit.zdb_id: 2577275-2
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  • 2
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    Online Resource
    Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: The experience of a tertiary-care hospital in Singapore
    Cambridge University Press (CUP) ; 2020
    In:  Infection Control & Hospital Epidemiology Vol. 41, No. 7 ( 2020-07), p. 820-825
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 41, No. 7 ( 2020-07), p. 820-825
    Abstract: Patients with COVID-19 may present with respiratory syndromes indistinguishable from those caused by common viruses. Early isolation and containment is challenging. Although screening all patients with respiratory symptoms for COVID-19 has been recommended, the practicality of such an effort has yet to be assessed. Methods: Over a 6-week period during a SARS-CoV-2 outbreak, our institution introduced a “respiratory surveillance ward” (RSW) to segregate all patients with respiratory symptoms in designated areas, where appropriate personal protective equipment (PPE) could be utilized until SARS-CoV-2 testing was done. Patients could be transferred when SARS-CoV-2 tests were negative on 2 consecutive occasions, 24 hours apart. Results: Over the study period, 1,178 patients were admitted to the RSWs. The mean length-of-stay (LOS) was 1.89 days (SD, 1.23). Among confirmed cases of pneumonia admitted to the RSW, 5 of 310 patients (1.61%) tested positive for SARS-CoV-2. This finding was comparable to the pickup rate from our isolation ward. In total, 126 HCWs were potentially exposed to these cases; however, only 3 (2.38%) required quarantine because most used appropriate PPE. In addition, 13 inpatients overlapped with the index cases during their stay in the RSW; of these 13 exposed inpatients, 1 patient subsequently developed COVID-19 after exposure. No patient–HCW transmission was detected despite intensive surveillance. Conclusions: Our institution successfully utilized the strategy of an RSW over a 6-week period to contain a cluster of COVID-19 cases and to prevent patient–HCW transmission. However, this method was resource-intensive in terms of testing and bed capacity.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2020.207
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2106319-9
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  • 3
    Online Resource
    Online Resource
    Focus Group Study of Hand Hygiene Practice among Healthcare Workers in a Teaching Hospital in Toronto, Canada
    Cambridge University Press (CUP) ; 2010
    In:  Infection Control & Hospital Epidemiology Vol. 31, No. 2 ( 2010-02), p. 144-150
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 31, No. 2 ( 2010-02), p. 144-150
    Abstract: To understand the behavioral determinants of hand hygiene in our hospital. Design. Qualitative study based on 17 focus groups. Setting. Mount Sinai Hospital, an acute care tertiary hospital affiliated with the University of Toronto. Participants. We recruited 153 healthcare workers (HCWs) representing all major patient care job categories. Methods. Focus group discussions were transcribed verbatim. Thematic analysis was independently conducted by 3 investigators. Results. Participants reported that the realities of their workload (eg, urgent care and interruptions) make complete adherence to hand hygiene impossible. The guidelines were described as overly conservative, and participants expressed that their judgement is adequate to determine when to perform hand hygiene. Discussions revealed gaps in knowledge among participants; most participants expressed interest in more information and education. Participants reported self-protection as the primary reason for the performance of hand hygiene, and many admitted to prolonged glove use because it gave them a sense of protection. Limited access to hand hygiene products was a source of frustration, as was confusion related to hospital equipment as potential vehicles for transmission of infection. Participants said that they noticed other HCWs' adherence and reported that others HCWs' hygiene practices influenced their own attitudes and practices. In particular, HCWs perceive physicians as role models; physicians, however, do not see themselves as such. Conclusions. Our results confirm previous findings that hand hygiene is practiced for personal protection, that limited access to supplies is a barrier, and that role models and a sense of team effort encourage hand hygiene. Educating HCWs on how to manage workload with guideline adherence and addressing contaminated hospital equipment may improve compliance.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/649792
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
    detail.hit.zdb_id: 2106319-9
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