Subject(s)
Bacterial Capsules/physiology , Haemophilus Infections/drug therapy , Haemophilus Vaccines/adverse effects , Haemophilus influenzae type b/isolation & purification , Vaccination/adverse effects , Blood Culture , Haemophilus Vaccines/administration & dosage , Haemophilus influenzae type b/pathogenicity , Humans , Infant , Male , Treatment Failure , Vaccines, Conjugate/adverse effectsABSTRACT
Between March 2010 and November 2013 eight laboratory-confirmed cases of serogroup B, invasive meningococcal disease (IMD) were identified in an extended Irish Traveller family across three Health Service Executive (HSE) areas of Ireland. Cases were aged between 5 and 46 months, and were either a cousin or sibling of another case. All eight cases survived. Chemoprophylaxis was given to relevant nuclear family members and close contacts on each occasion, but failed to prevent further cases. Neisseria meningitidis isolates from six cases were highly related, belonging to the ST-41/44 clonal complex, and shared the porA designation 72,4. In November 2013, the outbreak control team recommended that directly observed ciprofloxacin chemoprophylaxis be administered simultaneously to the extended family, and that the four component meningococcal B (4CMenB) vaccine be administered to family members aged 2 months to 23 years inclusive and relevant close contacts of the eighth case. Subsequently these recommendations were implemented at three regional clinics. Additionally pharyngeal swabs (n=112) were collected to assess carriage rates of N. meningitidis in this extended family. Pharyngeal carriage of N. meningitidis was detected in 15 (13%) family members. From the epidemiological investigation and carriage study overcrowding was the most likely risk factor identified in this outbreak. To date, the combination of directly observed ciprofloxacin chemoprophylaxis and use of 4CMenB vaccine have controlled the outbreak with no further cases diagnosed.
Subject(s)
Catchment Area, Health , Ciprofloxacin/administration & dosage , Disease Outbreaks/prevention & control , Family , Meningococcal Infections/epidemiology , Neisseria meningitidis, Serogroup B/isolation & purification , Travel , Adolescent , Adult , Chemoprevention , Child , Child, Preschool , Contact Tracing , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Infant, Newborn , Ireland/epidemiology , Male , Meningococcal Infections/drug therapy , Microbial Sensitivity Tests , Neisseria meningitidis, Serogroup B/drug effects , Neisseria meningitidis, Serogroup B/genetics , Polymerase Chain Reaction , Population Surveillance , Risk Factors , Treatment Outcome , Young AdultABSTRACT
Effects of ultra high speed (UHS) floor burnishing upon air quality in health care facilities were evaluated. A 2,000-rpm burnisher can disseminate high-velocity (190 km/hr) dust and microbial particles. A UHS burnisher used with either inadequate or no air restraint produced significant increases (P less than 0.05) in the levels of airborne dust particles and microorganisms. A UHS burnisher equipped with an air restraint assembly specifically designed for use in health care facilities produced no significant increase (P greater than 0.05) in the levels of airborne dust particles or microorganisms when compared to ambient air levels. The types and distribution of airborne microorganisms isolated from microbial air samples were not unusual nor were they directly influenced by the floor burnishing processes. Furthermore, the UHS floor burnishing process produced a significant reduction (P less than 0.05) in microbial floor contaminants (96%). When the use of UHS floor burnishing is contemplated for productivity improvement and esthetic enhancement, the possible adverse effects on air quality should also be considered.
