ABSTRACT
BACKGROUND: Control measures were instituted in a neonatal intensive care unit (NICU) in Syracuse, New York, when a neonatologist became ill with mumps after returning from Africa. Two health care providers (HCPs) who worked with the neonatologist developed parotitis within 13 days of exposure. Outbreak control included furloughing the neonatologist and the 2 HCPs until after 5 days of the onset of parotitis, cohorting and isolating all exposed infants in the NICU, and implementing droplet precautions. All susceptible HCPs were immunized, and all HCPs were required to wear surgical masks when within 3 feet of patients. RESULTS: Five HCPs developed parotitis. The neonatologist and 2 of the HCPs were confirmed cases, and 2 other HCPs did not meet the case definition. Twenty-six HCPs who worked in other units of the hospital besides the NICU developed nonspecific signs and symptoms of illness. Of the 2,904 HCPs tested, 287 (10%) had negative antibody results, and 153 (8%) were age 40 years or older. Of the 287 HCPs with negative antibody titers, 200 (70%) received the mumps-measles-rubella vaccine in response to this effort. No cases of mumps were reported in exposed infants, children, or adult patients during the time of exposure. CONCLUSION: Infection control efforts, including vaccinating susceptible HCPs and instituting droplet precautions, might have prevented mumps infection in the NICU patients.
Subject(s)
Cross Infection/prevention & control , Disease Outbreaks/prevention & control , Health Personnel , Infant, Premature, Diseases/prevention & control , Infection Control/methods , Intensive Care Units, Neonatal , Mumps/prevention & control , Adult , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/epidemiology , Infant, Premature, Diseases/virology , Measles-Mumps-Rubella Vaccine/administration & dosage , Middle Aged , Mumps/diagnosis , Mumps/epidemiology , Mumps/transmission , Mumps virus/immunology , New York/epidemiology , Patient Isolation , Young AdultABSTRACT
The introduction of disease-modifying therapies (DMTs) for multiple sclerosis (MS) over the last 7 years has had a significant effect on the management of those living with this disease. Initially, the focus of improving treatment outcomes was on ensuring adherence to therapy by managing drug-related adverse events. However, treatment adherence is only one facet of ensuring optimal health outcomes for patients using DMTs. Therefore, a group of 80 nurses from Canada and the United States (The North American MS Nurses' Treatment Optimization Group) developed an evidence-based nursing approach to address the various factors involved in obtaining optimal patient outcomes. The goal of this nursing approach is to ensure the best possible clinical, subclinical, psychosocial, and quality-of-life outcomes for patients with MS using DMTs.
