Outbreak of coronavirus disease 2019 (COVID-19) among operating room staff of a tertiary referral center: An epidemiologic and environmental investigation.

OBJECTIVE: Investigate an outbreak of coronavirus disease 2019 (COVID-19) among operating room staff utilizing contact tracing, mass testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and environmental sampling. DESIGN: Outbreak investigation. SETTING: University-affiliated tertiary-care referral center. PATIENTS: Operating room staff with positive SARS-CoV-2 molecular testing. METHODS: Epidemiologic and environmental investigations were conducted including contact tracing, environmental surveys, and sampling and review of the operating room schedule for staff-to-staff, staff-to-patient, and patient-to-staff SARS-CoV-2 transmission. RESULTS: In total, 24 healthcare personnel (HCP) tested positive for SARS-CoV-2, including nurses (29%), surgical technologists (25%), and surgical residents (16%). Moreover, 19 HCP (79%) reported having used a communal area, most commonly break rooms (75%). Overall, 20 HCP (83%) reported symptomatic disease. In total, 72 environmental samples were collected from communal areas for SARS-CoV-2 genomic testing; none was positive. Furthermore, 236 surgical cases were reviewed for transmission: 213 (90%) had negative preoperative SARS-CoV-2 testing, 21 (9%) had a positive test on or before the date of surgery, and 2 (<1%) did not have a preoperative test performed. In addition, 40 patients underwent postoperative testing (mean, 13 days to postoperative testing), and 2 returned positive results. Neither of these 2 cases was linked to our outbreak. CONCLUSIONS: Complacency in infection control practices among staff during peak community transmission of SARS-CoV-2 is believed to have driven staff-to-staff transmission. Prompt identification of the outbreak led to rapid interventions, ultimately allowing for uninterrupted surgical service.

Prevalence and Levels of Parasitemia of Hepatozoon sp. (Apicomplexa: Adeleorina) in Four Gopher Tortoise (Gopherus polyphemus) Populations of South FLORIDA, USA.

Hepatozoon prevalence (occurrence) and parasitemia (intensity) levels were documented in 67 individuals of the threatened gopher tortoise (Gopherus polyphemus) for the first time in four South Florida, US, locations: Jonathan Dickinson State Park (JDSP), Pine Jog Preserve (PJP), Florida Atlantic University Preserve (FAUP), and Blazing Star Preserve (BSP). Sex ratios (males:females) per site were 0.44 at JDSP, 0.72 at PJP, 1.42 at FAUP, and 0.40 at BSP, but no significant differences in the carapace length were found between the two sexes (independent t-test; P=0.101). Hepatozoon sp. was found in 13% (9/67) of tortoises. Percentages of infected tortoises were 22% (5/23) males and 6% (2/33) females. Prevalence and parasitemia were low or nonexistent within sampled tortoises at each of the study sites, although the highest prevalence and parasitemia values were found in gopher tortoises at JDSP (23%, 4/17) which also harbored the highest infection levels, reaching 349/10,000 erythrocytes. No infection was detected within sampled gopher tortoises at PJP.

A Survey of Gopherus polyphemus Intestinal Parasites in South Florida.

Gopherus polyphemus populations are diminishing throughout their range due to urbanization, fragmentation, and poor habitat management. Increased population densities, poor habitat quality, and lack of fire may influence disease transmission. Parasite roles within wild tortoise populations are largely unknown; despite evidence these pathogens may pose significant health risks. This study provides a baseline of gopher tortoise intestinal parasites across South Florida and reports on how varying environmental and tortoise characteristics may affect intestinal parasite species prevalence and approximate loads. Tortoise fecal samples were taken from six tortoise populations across five South Florida sites. Seven species of intestinal parasites were discovered from 123 tortoises. Identified parasites include endohelminths such as cyathostomes, pinworms, ascarids, flukes, and protozoans including Eimeria, Cryptosporidium, and Amoeba species. Significant differences in parasite prevalence and loads were seen between sites, while parasitism among sex, size class, and habitat type remained relatively ubiquitous.