Severe pneumonia due to legionella and SARS-CoV-2 co-infection necessitating medical evacuation from a cargo ship.

Cargo ships are at risk of disease outbreaks like Legionella and SARS-CoV-2 due to their cramped and shared conditions. A case of medical evacuation due to co-infection of Legionella pneumophila with SARS-CoV-2 highlights the need for international infection control guidelines, information networks, and molecular epidemiological approaches for identifying infection routes.

Personal protective equipment use by health-care workers in intensive care units during the COVID-19 pandemic in Japan: comparative analysis with the PPE-SAFE survey.

Aim: We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology. Methods: This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list. Results: We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat. Conclusion: Shortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.