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Kleynhans J, Dall'Amico L, Gauvin L, Tizzoni M, Maloma L, Walaza S, Martinson NA, von Gottberg A, Wolter N, Makhasi M, Cohen C, Cattuto C, Tempia S. Association of close-range contact patterns with SARS-CoV-2: a household transmission study. eLife 2023; 12:e84753. [PMID: 37461328 DOI: 10.7554/elife.84753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/04/2023] [Indexed: 07/21/2023] Open
Abstract
Background Households are an important location for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, especially during periods when travel and work was restricted to essential services. We aimed to assess the association of close-range contact patterns with SARS-CoV-2 transmission. Methods We deployed proximity sensors for two weeks to measure face-to-face interactions between household members after SARS-CoV-2 was identified in the household, in South Africa, 2020-2021. We calculated the duration, frequency, and average duration of close-range proximity events with SARS-CoV-2 index cases. We assessed the association of contact parameters with SARS-CoV-2 transmission using mixed effects logistic regression accounting for index and household member characteristics. Results We included 340 individuals (88 SARS-CoV-2 index cases and 252 household members). On multivariable analysis, factors associated with SARS-CoV-2 acquisition were index cases with minimum Ct value <30 (aOR 16.8 95% CI 3.1-93.1) vs >35, and female contacts (aOR 2.5 95% CI 1.3-5.0). No contact parameters were associated with acquisition (aOR 1.0-1.1) for any of the duration, frequency, cumulative time in contact, or average duration parameters. Conclusions We did not find an association between close-range proximity events and SARS-CoV-2 household transmission. Our findings may be due to study limitations, that droplet-mediated transmission during close-proximity contacts plays a smaller role than airborne transmission of SARS-CoV-2 in the household, or due to high contact rates in households. Funding Wellcome Trust (Grant number 221003/Z/20/Z) in collaboration with the Foreign, Commonwealth, and Development Office, United Kingdom.
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Affiliation(s)
- Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Laetitia Gauvin
- ISI Foundation, Turin, Italy
- Institute for Research on Sustainable Development, Aubervilliers, France
| | - Michele Tizzoni
- ISI Foundation, Turin, Italy
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | - Lucia Maloma
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil A Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Johns Hopkins University Center for TB Research, Baltimore, United States
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mvuyo Makhasi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ciro Cattuto
- ISI Foundation, Turin, Italy
- Department of Informatics, University of Turin, Turin, Italy
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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2
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Gustin MP, Pujo-Menjouet L, Vanhems P. Influenza transmissibility among patients and health-care professionals in a geriatric short-stay unit using individual contact data. Sci Rep 2023; 13:10547. [PMID: 37386032 PMCID: PMC10310843 DOI: 10.1038/s41598-023-36908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
Detailed information are lacking on influenza transmissibility in hospital although clusters are regularly reported. In this pilot study, our goal was to estimate the transmission rate of H3N2 2012-influenza, among patients and health care professionals in a short-term Acute Care for the Elderly Unit by using a stochastic approach and a simple susceptible-exposed-infectious-removed model. Transmission parameters were derived from documented individual contact data collected by Radio Frequency IDentification technology at the epidemic peak. From our model, nurses appeared to transmit infection to a patient more frequently with a transmission rate of 1.04 per day on average compared to 0.38 from medical doctors. This transmission rate was 0.34 between nurses. These results, even obtained in this specific context, might give a relevant insight of the influenza dynamics in hospitals and will help to improve and to target control measures for preventing nosocomial transmission of influenza. The investigation of nosocomial transmission of SARS-COV-2 might gain from similar approaches.
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Affiliation(s)
- Marie-Paule Gustin
- Department of Public Health, Institute of Pharmacy, CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, CNRS, UMR 5308, ENS Lyon, Equipe PHIE3D, University Lyon, University Claude Bernard Lyon 1, 7 Rue Guillaume Paradin, 69372, Lyon, France
| | - Laurent Pujo-Menjouet
- University of Lyon, University Claude Bernard Lyon 1, CNRS UMR5208, Inria, Dracula Team, Institut Camille Jordan, 69622, Villeurbanne, France.
| | - Philippe Vanhems
- Hospices Civils de Lyon, Service Hygiène, CIRI-Centre International de Recherche en Infectiologie, Université Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
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3
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Zhong S, Ma F, Gao J, Bian L. Who Gets the Flu? Individualized Validation of Influenza-like Illness in Urban Spaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105865. [PMID: 37239591 DOI: 10.3390/ijerph20105865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Urban dwellers are exposed to communicable diseases, such as influenza, in various urban spaces. Current disease models are able to predict health outcomes at the individual scale but are mostly validated at coarse scales due to the lack of fine-scaled ground truth data. Further, a large number of transmission-driving factors have been considered in these models. Because of the lack of individual-scaled validations, the effectiveness of factors at their intended scale is not substantiated. These gaps significantly undermine the efficacy of the models in assessing the vulnerability of individuals, communities, and urban society. The objectives of this study are twofold. First, we aim to model and, most importantly, validate influenza-like illness (ILI) symptoms at the individual scale based on four sets of transmission-driving factors pertinent to home-work space, service space, ambient environment, and demographics. The effort is supported by an ensemble approach. For the second objective, we investigate the effectiveness of the factor sets through an impact analysis. The validation accuracy reaches 73.2-95.1%. The validation substantiates the effectiveness of factors pertinent to urban spaces and unveils the underlying mechanism that connects urban spaces and population health. With more fine-scaled health data becoming available, the findings of this study may see increasing value in informing policies that improve population health and urban livability.
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Affiliation(s)
- Shiran Zhong
- Department of Geography, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Fenglong Ma
- College of Information Sciences and Technology, Pennsylvania State University, University Park, State College, PA 16802, USA
| | - Jing Gao
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Ling Bian
- Department of Geography, University at Buffalo, The State University of New York, Buffalo, NY 14261, USA
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Mazzoli M, Gallotti R, Privitera F, Colet P, Ramasco JJ. Spatial immunization to abate disease spreading in transportation hubs. Nat Commun 2023; 14:1448. [PMID: 36941266 PMCID: PMC10027826 DOI: 10.1038/s41467-023-36985-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
Proximity social interactions are crucial for infectious diseases transmission. Crowded agglomerations pose serious risk of triggering superspreading events. Locations like transportation hubs (airports and stations) are designed to optimize logistic efficiency, not to reduce crowding, and are characterized by a constant in and out flow of people. Here, we analyze the paradigmatic example of London Heathrow, one of the busiest European airports. Thanks to a dataset of anonymized individuals' trajectories, we can model the spreading of different diseases to localize the contagion hotspots and to propose a spatial immunization policy targeting them to reduce disease spreading risk. We also detect the most vulnerable destinations to contagions produced at the airport and quantify the benefits of the spatial immunization technique to prevent regional and global disease diffusion. This method is immediately generalizable to train, metro and bus stations and to other facilities such as commercial or convention centers.
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Affiliation(s)
- Mattia Mazzoli
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Campus UIB, 07122, Palma de Mallorca, Spain.
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Paris, France.
| | - Riccardo Gallotti
- CHuB Lab, Fondazione Bruno Kessler, Via Sommarive 18, 38123, Povo (TN), Trento, Italy
| | | | - Pere Colet
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Campus UIB, 07122, Palma de Mallorca, Spain
| | - José J Ramasco
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Campus UIB, 07122, Palma de Mallorca, Spain.
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Effect of influenza vaccination among healthcare workers on hospital-acquired influenza in short-stay hospitalized patients: A multicenter pilot study in France. Infect Control Hosp Epidemiol 2022; 43:1828-1832. [PMID: 35382916 DOI: 10.1017/ice.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs. METHODS A case-case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season. RESULTS The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21-1.29) to 0.14 (95% CI, 0.03-0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01-0.78). CONCLUSIONS Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.Trial Registration: clinicaltrials.gov identifier: NCT02198638.
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Peel L, Peixoto TP, De Domenico M. Statistical inference links data and theory in network science. Nat Commun 2022; 13:6794. [PMID: 36357376 PMCID: PMC9649740 DOI: 10.1038/s41467-022-34267-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/18/2022] [Indexed: 11/11/2022] Open
Abstract
The number of network science applications across many different fields has been rapidly increasing. Surprisingly, the development of theory and domain-specific applications often occur in isolation, risking an effective disconnect between theoretical and methodological advances and the way network science is employed in practice. Here we address this risk constructively, discussing good practices to guarantee more successful applications and reproducible results. We endorse designing statistically grounded methodologies to address challenges in network science. This approach allows one to explain observational data in terms of generative models, naturally deal with intrinsic uncertainties, and strengthen the link between theory and applications. Theoretical models and structures recovered from measured data serve for analysis of complex networks. The authors discuss here existing gaps between theoretical methods and real-world applied networks, and potential ways to improve the interplay between theory and applications.
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Maltezou HC, Dounias G, Rapisarda V, Ledda C. Vaccination policies for healthcare personnel: Current challenges and future perspectives. Vaccine X 2022; 11:100172. [PMID: 35719325 PMCID: PMC9190304 DOI: 10.1016/j.jvacx.2022.100172] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/10/2022] [Accepted: 05/09/2022] [Indexed: 01/05/2023] Open
Abstract
Healthcare personnel (HCP) are at occupational risk for acquisition of several vaccine-preventable diseases and transmission to patients. Vaccinations of HCP are justified to confer them immunity but also to protect susceptible patients and healthcare services from outbreaks, HCP absenteeism and presenteeism. Mandatory vaccination policies for HCP are increasingly adopted and achieve high and sustainable vaccination rates in short term. In this article we review the scientific evidence for HCP vaccination. We also address issues pertaining to vaccination policies for HCP and present the challenges of implementation of mandatory versus voluntary vaccination policies. Finally, we discuss the issue of mandatory vaccination of HCP against COVID-19.
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Key Words
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- HCP, healthcare personnel
- Healthcare personnel
- ICU, intensive care unit
- ILI, influenza-like illness
- Immunization
- MMR, measles-mumps-rubella
- Mandatory
- NICU, neonatal intensive care unit
- Occupational
- PCR, polymerase chain reaction
- Policies
- RR, relative risk
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- US, United States
- VE, vaccine effectiveness
- VPD, vaccine-preventable disease
- Vaccination
- Vaccine-preventable diseases
- WHO, World Health Organization
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens 15123, Greece
| | - George Dounias
- Department of Occupational and Environmental Health, University of West Attica, Athens, Greece
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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8
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Agar G, Oliver C, Richards C. Direct assessment of overnight parent-child proximity in children with behavioral insomnia: Extending models of operant and classical conditioning. Behav Sleep Med 2022; 21:254-272. [PMID: 35796281 DOI: 10.1080/15402002.2022.2076681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Explanatory models of behavioral insomnia typically draw on operant learning theory with behavioral techniques focused on altering parent-child interactions to improve sleep. However, there are no data describing parent-child interactions overnight beyond parent report. In this study we used radio frequency identification technology to quantify parent-child proximity overnight in two groups at elevated risk of behavioral insomnia, Angelman syndrome (AS) and Smith-Magenis syndrome (SMS). MATERIALS AND METHODS Nineteen children aged 4-15 years (8 with AS, 11 with SMS) participated in a week-long at-home assessment of sleep and overnight parent-child proximity. Sleep parameters were recorded using the Philips Actiwatch 2 and proximity data were recorded using custom-built radio frequency identification watches. RESULTS Three patterns of proximity data between parent-child dyads overnight were evident: "checking" (six with AS, five with SMS), "co-sleeping" (four with SMS) and those who had "no proximity" overnight (two with AS, two with SMS). In the AS group, 25.45% of actigraphy-defined wakes resulted in a parent-child interaction. In the SMS group, 39.34% of wakes resulted in a parent-child interaction. Children who interacted with their parents when settling to sleep were not significantly more likely to interact at waking. DISCUSSION The novel application of radio frequency identification technology is a feasible method for studying overnight parent-child proximity. Profiles of proximity between participants that are not closely aligned with operant models of behavioral insomnia were evident. These results have significant implications for the etiology of poor sleep and the application of behavioral sleep interventions.
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Affiliation(s)
- Georgie Agar
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, UK
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Influenza Vaccination Programs for Healthcare Personnel: Organizational Issues and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111122. [PMID: 34769641 PMCID: PMC8583029 DOI: 10.3390/ijerph182111122] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Healthcare personnel (HCP) are a high priority group for influenza vaccination aiming to protect them but also to protect vulnerable patients and healthcare services from healthcare-associated influenza and HCP absenteeism. Multi-component influenza vaccination programs targeting behavioral, organizational, and administrative barriers are critical, if influenza vaccination rates among HCP are to be raised on a sustained basis. Mandatory influenza vaccination policy is the only single intervention that can achieve high and sustainable vaccination rates in HCP in short term. In this article, we provide an overview of issues pertaining to influenza vaccination of HCP, with an emphasis on organizational issues of influenza vaccination programs.
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10
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Reorganization of nurse scheduling reduces the risk of healthcare associated infections. Sci Rep 2021; 11:7393. [PMID: 33795708 PMCID: PMC8016903 DOI: 10.1038/s41598-021-86637-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
Abstract
Efficient prevention and control of healthcare associated infections (HAIs) is still an open problem. Using contact data from wearable sensors at a short-stay geriatric ward, we propose a proof-of-concept modeling study that reorganizes nurse schedules for efficient infection control. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. Through a Susceptible-Colonized-Susceptible transmission model, we found that schedules reorganization reduced HAI risk by 27% (95% confidence interval [24, 29]%) while preserving timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. Nurse scheduling can be reorganized to break potential chains of transmission and substantially limit HAI risk, while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for infection control in hospitals.
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11
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van Niekerk JM, Stein A, Doting MHE, Lokate M, Braakman-Jansen LMA, van Gemert-Pijnen JEWC. A spatiotemporal simulation study on the transmission of harmful microorganisms through connected healthcare workers in a hospital ward setting. BMC Infect Dis 2021; 21:260. [PMID: 33711939 PMCID: PMC7953685 DOI: 10.1186/s12879-021-05954-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 03/03/2021] [Indexed: 12/21/2022] Open
Abstract
Background Hand transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against these transmissions is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time. The spatiotemporal effects on hand transmission and spread of these microorganisms for varying hand hygiene compliance levels are unknown. This study aims to (1) identify a healthcare worker occupancy group of potential super-spreaders and (2) quantify spatiotemporal effects on the hand transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance caused by this group. Methods Spatiotemporal data were collected in a hospital ward of an academic hospital using radio frequency identification technology for 7 days. A potential super-spreader healthcare worker occupation group was identified using the frequency identification sensors’ contact data. The effects of five probability distributions of hand hygiene compliance and three harmful microorganism transmission rates were simulated using a dynamic agent-based simulation model. The effects of initial simulation assumptions on the simulation results were quantified using five risk outcomes. Results Nurses, doctors and patients are together responsible for 81.13% of all contacts. Nurses made up 70.68% of all contacts, which is more than five times that of doctors (10.44%). This identifies nurses as the potential super-spreader healthcare worker occupation group. For initial simulation conditions of extreme lack of hand hygiene compliance (5%) and high transmission rates (5% per contact moment), a colonised nurse can transfer microbes to three of the 17 healthcare worker or patients encountered during the 98.4 min of visiting 23 rooms while colonised. The harmful microorganism transmission potential for nurses is higher during weeknights (5 pm – 7 am) and weekends as compared to weekdays (7 am – 5 pm). Conclusion Spatiotemporal behaviour and social mixing patterns of healthcare can change the expected number of hand transmissions and spread of harmful microorganisms by super-spreaders in a closed healthcare setting. These insights can be used to evaluate spatiotemporal safety behaviours and develop infection prevention and control strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05954-7.
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Affiliation(s)
- J M van Niekerk
- Department of Psychology, Health and Technology/Center for eHealth Research and Disease Management, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands. .,Department of Earth Observation Sciences, Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands. .,Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - A Stein
- Department of Earth Observation Sciences, Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - M H E Doting
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Lokate
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L M A Braakman-Jansen
- Department of Psychology, Health and Technology/Center for eHealth Research and Disease Management, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
| | - J E W C van Gemert-Pijnen
- Department of Psychology, Health and Technology/Center for eHealth Research and Disease Management, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands.,Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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12
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Temime L, Gustin MP, Duval A, Buetti N, Crépey P, Guillemot D, Thiébaut R, Vanhems P, Zahar JR, Smith DRM, Opatowski L. A Conceptual Discussion About the Basic Reproduction Number of Severe Acute Respiratory Syndrome Coronavirus 2 in Healthcare Settings. Clin Infect Dis 2021; 72:141-143. [PMID: 32473007 PMCID: PMC7314155 DOI: 10.1093/cid/ciaa682] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022] Open
Abstract
To date, no specific estimate of R0 for SARS-CoV-2 is available for healthcare settings. Using interindividual contact data, we highlight that R0 estimates from the community cannot translate directly to healthcare settings, with pre-pandemic R0 values ranging 1.3-7.7 in 3 illustrative healthcare institutions. This has implications for nosocomial COVID-19 control.
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Affiliation(s)
- Laura Temime
- MESuRS laboratory, Conservatoire national des arts et métiers, Paris, France
- PACRI Unit, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France
| | - Marie-Paule Gustin
- Institute of Pharmaceutic and Biological Sciences, University Claude Bernard Lyon 1, Villeurbanne, France
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Audrey Duval
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
| | - Niccolò Buetti
- UPRES-EA 7449 REPERES “Recherche en Pharmaco-Epidémiologie et Recours aux Soins” – EHESP – Université de Rennes, Rennes, France
| | - Pascal Crépey
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
| | - Didier Guillemot
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
- AP-HP Paris Saclay, Public Health, Medical Information, Clinical research, Le Kremlin-Bicêtre, France
| | - Rodolphe Thiébaut
- INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
- INRIA SISTM team, Talence, France
- Vaccine Research Institute, Créteil, France
| | - Philippe Vanhems
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
- Service d’Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437, Lyon, France
- Inserm, F CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - Jean-Ralph Zahar
- IAME, UMR1137, Inserm, Univ. Paris 13, Sorbonne Paris Cité, Paris, France
- Service de Microbiologie Clinique et Unité de Contrôle et de Prévention du Risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - David R M Smith
- MESuRS laboratory, Conservatoire national des arts et métiers, Paris, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
| | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
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Qalla-Widmer L, Héquet D, Troillet N, Petignat C, Balmelli C, Bassi C, Bellini C, Chave JP, Cometta A, Christin L, Clerc O, Daher O, Fuehrer U, Marchetti O, Merz L, Portillo V, Pralong G, Sandoz L, Senn L, Tâche F, Iten A. Nosocomial influenza in south-western Swiss hospitals during two seasonal epidemics: an observational study. J Hosp Infect 2021; 109:115-122. [PMID: 33422590 DOI: 10.1016/j.jhin.2020.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/24/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In Switzerland each year, influenza leads to between 112,000 and 275,000 medical consultations. Data on nosocomial influenza infection are limited. AIM To describe nosocomial cases of seasonal influenza in south-western Switzerland. METHODS This study was conducted during two seasonal influenza epidemics from 2016 to 2018 in 27 acute care public hospitals in south-western Switzerland. During these two time-periods, every patient hospitalized for >72 h who was positively screened by reverse transcription-polymerase chain reaction or antigen detection for influenza was included in the survey. Characteristics of patients included age, sex, and comorbidities. Included patients were followed up until discharge or death. Complications and administration of antineuraminidases and/or antibiotics were registered. FINDINGS The median influenza vaccine coverage of healthcare workers was 40%. In all, 836 patients were included (98% with type A influenza virus in 2016-2017; 77% with type B virus in 2017-2018). Most patients (81%) had an unknown vaccine status. Overall, the incidence of nosocomial influenza was 0.5 per 100 admissions (0.35 per 1000 patient-days). The most frequent comorbidities were diabetes (20%), chronic respiratory diseases (19%), and malnutrition (17%). Fever (77%) and cough (66%) were the most frequent symptoms. Seventy-one percent of patients received antineuraminidases, 28% received antibiotics. Infectious complications such as pneumonia were reported in 9%. Overall, the all-cause mortality was 6%. CONCLUSION The occurrence of nosocomial influenza underlines the importance of vaccinating patients and healthcare workers, rapidly recognizing community- or hospital-acquired cases, and applying adequate additional measures to prevent dissemination, including the timely administration of antineuraminidases to avoid antibiotic use (and misuse).
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Affiliation(s)
- L Qalla-Widmer
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland
| | - D Héquet
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland.
| | - N Troillet
- Service of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland
| | - C Petignat
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland
| | - C Balmelli
- Servizio di Prevenzione delle Infezioni e Medicina del Personale, Ente Ospedaliero Cantonale, Ticino, Switzerland
| | - C Bassi
- Prevention and Control of Infection, Hôpital du Jura Bernois, Moutier, Saint-Imier, Switzerland
| | - C Bellini
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - J-P Chave
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - A Cometta
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Christin
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - O Clerc
- Department of Internal Medicine and Infectious Diseases, Pourtalès Hospital, Neuchâtel, Switzerland
| | - O Daher
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - U Fuehrer
- Department of Internal Medicine and Infectious Diseases, Hôpital de Bienne, Switzerland
| | - O Marchetti
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Merz
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - V Portillo
- Prevention and Control of Infection, Hôpital du Jura, Switzerland
| | - G Pralong
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Sandoz
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Senn
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - F Tâche
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - A Iten
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
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14
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Jacobsen M, Dembek TA, Kobbe G, Gaidzik PW, Heinemann L. Noninvasive Continuous Monitoring of Vital Signs With Wearables: Fit for Medical Use? J Diabetes Sci Technol 2021; 15:34-43. [PMID: 32063034 PMCID: PMC7783016 DOI: 10.1177/1932296820904947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Wearables (= wearable computer) enable continuous and noninvasive monitoring of a range of vital signs. Mobile and cost-effective devices, combined with powerful data analysis tools, open new dimensions in assessing body functions ("digital biomarkers"). METHODS To answer the question whether wearables are ready for use in the medical context, a PubMed literature search and analysis for their clinical-scientific use using publications from the years 2008 to 2018 was performed. RESULTS A total of 79 out of 314 search hits were publications on clinical trials with wearables, of which 16 were randomized controlled trials. Motion sensors were most frequently used to measure defined movements, movement disorders, or general physical activity. Approximately 20% of the studies used sensors to detect cardiovascular parameters. As for the sensor location, the wrist was chosen in most studies (22.8%). CONCLUSION Wearables can be used in a precisely defined medical context, when taking into account complex influencing factors.
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Affiliation(s)
- Malte Jacobsen
- University Witten/Herdecke, Germany
- Malte Jacobsen, MD, University Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58455 Witten, Germany.
| | - Till A. Dembek
- Department of Neurology, University Hospital of Cologne, Germany
| | - Guido Kobbe
- Clinic for Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Germany
| | - Peter W. Gaidzik
- Institute for Health Care Law, University Witten/Herdecke, Germany
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Influenza Vaccination Hesitancy among Healthcare Workers in South Al Batinah Governorate in Oman: A Cross-Sectional Study. Vaccines (Basel) 2020; 8:vaccines8040661. [PMID: 33172064 PMCID: PMC7712351 DOI: 10.3390/vaccines8040661] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/15/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background: Seasonal influenza infections are a major cause of morbidity and mortality worldwide. Healthcare workers (HCWs) are an important target group for vaccination against influenza due to their increased risk of infection and their potential to transmit the infection to their patients, families and communities. The aim of this study was to assess the potential hesitancy and its associated factors towards influenza vaccination amongst HCWs in the South Al Batinah governorate in Oman. Methods: A cross-sectional survey of 390 HCWs with direct or indirect patient contact was conducted in May and June 2019 using a self-administered questionnaire. Associations between HCW characteristics and vaccination status were examined using bivariate and multivariate analyses to identify the likelihood of vaccination against seasonal influenza among HCWs. Results: Overall, 60% of HCWs were vaccinated in the 2018/2019 season; vaccine uptake among nurses was 52% and uptake was higher among women. Self-protection and protection of the community were the most cited reasons for vaccine acceptance, with side effects being the main reason for hesitancy. Vaccinated respondents had a higher mean knowledge score (7.18; standard deviation SD: 2.14) than unvaccinated respondents (6.30; SD: 2.2). Odds of vaccination were highest among respondents who believed influenza vaccine should be mandatory for HCWs (Odds ratio (OR): 2.04 [1.30–3.18]), those working in the general medicine, emergency medicine, or intensive care units (OR: 1.92 [1.20–3.10]), nurses and doctors (OR: 1.75 [1.09–2.79]) and those who believe that HCWs should receive an influenza vaccine (OR: 1.35 [1.07–2.77]). Conclusions: The study provides valuable insights into the enablers and barriers of influenza vaccination practices among HCWs and may inform interventions to increase acceptance of vaccination.
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16
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Braithwaite I, Callender T, Bullock M, Aldridge RW. Automated and partly automated contact tracing: a systematic review to inform the control of COVID-19. Lancet Digit Health 2020; 2:e607-e621. [PMID: 32839755 PMCID: PMC7438082 DOI: 10.1016/s2589-7500(20)30184-9] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Evidence for the use of automated or partly automated contact-tracing tools to contain severe acute respiratory syndrome coronavirus 2 is scarce. We did a systematic review of automated or partly automated contact tracing. We searched PubMed, EMBASE, OVID Global Health, EBSCO Medical COVID Information Portal, Cochrane Library, medRxiv, bioRxiv, arXiv, and Google Advanced for articles relevant to COVID-19, severe acute respiratory syndrome, Middle East respiratory syndrome, influenza, or Ebola virus, published from Jan 1, 2000, to April 14, 2020. We also included studies identified through professional networks up to April 30, 2020. We reviewed all full-text manuscripts. Primary outcomes were the number or proportion of contacts (or subsequent cases) identified. Secondary outcomes were indicators of outbreak control, uptake, resource use, cost-effectiveness, and lessons learnt. This study is registered with PROSPERO (CRD42020179822). Of the 4036 studies identified, 110 full-text studies were reviewed and 15 studies were included in the final analysis and quality assessment. No empirical evidence of the effectiveness of automated contact tracing (regarding contacts identified or transmission reduction) was identified. Four of seven included modelling studies that suggested that controlling COVID-19 requires a high population uptake of automated contact-tracing apps (estimates from 56% to 95%), typically alongside other control measures. Studies of partly automated contact tracing generally reported more complete contact identification and follow-up compared with manual systems. Automated contact tracing could potentially reduce transmission with sufficient population uptake. However, concerns regarding privacy and equity should be considered. Well designed prospective studies are needed given gaps in evidence of effectiveness, and to investigate the integration and relative effects of manual and automated systems. Large-scale manual contact tracing is therefore still key in most contexts.
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Affiliation(s)
- Isobel Braithwaite
- UCL Public Health Data Science Research Group, Institute of Health Informatics, University College London, London, UK
| | - Thomas Callender
- Department of Applied Health Research, University College London, London, UK
| | - Miriam Bullock
- UCL Collaborative Centre for Inclusion Health, University College London, London, UK
| | - Robert W Aldridge
- UCL Public Health Data Science Research Group, Institute of Health Informatics, University College London, London, UK
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17
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Saadatian-Elahi M, Picot V, Hénaff L, Pradel FK, Escuret V, Dananché C, Elias C, Endtz HP, Vanhems P. Protocol for a prospective, observational, hospital-based multicentre study of nosocomial SARS-CoV-2 transmission: NOSO-COR Project. BMJ Open 2020; 10:e039088. [PMID: 33093033 PMCID: PMC7582335 DOI: 10.1136/bmjopen-2020-039088] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The newly identified SARS-CoV-2 can cause serious acute respiratory infections such as pneumonia. In France, mortality rate in the general population was approximately 10% and could reach higher levels at the hospital. In the current context of high incidence rates of SARS-CoV-2 in the community, a significant increase in the rate of nosocomial transmission is expected. The risk of nosocomial transmission could even be higher in low-income countries that have fragile healthcare systems. This protocol is intended to estimate the prevalence and incidence of suspected or confirmed cases of nosocomial SARS-CoV-2 infection, the clinical spectrum and the determinants (risk factors/protective) at participating hospitals. METHODS AND ANALYSIS This will be an international multicentre prospective, observational, hospital-based study in adults and children. It will include volunteer patients and healthcare professionals in France and hospitals affiliated with the GABRIEL network. Demographic and clinical data will be collected using case report forms designed especially for the purpose of the project. A nasopharyngeal swab will be collected and tested for SARS-CoV-2 by reverse-transcriptase PCR. Characteristics of the study participants, the proportion of confirmed nosocomial SARS-CoV-2 infections relative to all patients with syndromes suggestive of SARS-CoV-2 infection, will be analysed. Appropriate multivariate modelling will be used to identify the determinants associated with nosocomial onset. ETHICS AND DISSEMINATION This study was approved by the clinical research and committee of all participating countries. The findings will be submitted to peer-reviewed journal for publication and shared with national health authorities. TRIAL REGISTRATION NUMBER NCT04290780.
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Affiliation(s)
- Mitra Saadatian-Elahi
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Valentina Picot
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Fondation Merieux, Lyon, Rhône-Alpes, France
| | - Laetitia Hénaff
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
| | - Florence K Pradel
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Fondation Merieux, Lyon, Rhône-Alpes, France
| | - Vanessa Escuret
- Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Virpath, Grippe, de l'émergence au contrôle, Centre International de Recherche en Infectiologie (CIRI), Inserm U111, CNRS 5308, ENS, UCBL1, Faculté de Médecine RTH Laënnec, Lyon, France
| | - Cédric Dananché
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Christelle Elias
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Hubert P Endtz
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Fondation Merieux, Lyon, Rhône-Alpes, France
| | - Philippe Vanhems
- Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS, Lyon, France
- Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Inserm, F-CRIN, Lyon center of Innovative Clinical Research Network in Vaccinology (I REIVAC), CIC 1417, Paris, France
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18
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Bu F, Aiello AE, Xu J, Volfovsky A. Likelihood-Based Inference for Partially Observed Epidemics on Dynamic Networks. J Am Stat Assoc 2020. [DOI: 10.1080/01621459.2020.1790376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Fan Bu
- Department of Statistical Science, Duke University, Durham, NC
| | - Allison E. Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason Xu
- Department of Statistical Science, Duke University, Durham, NC
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Anglemyer A, Moore TH, Parker L, Chambers T, Grady A, Chiu K, Parry M, Wilczynska M, Flemyng E, Bero L. Digital contact tracing technologies in epidemics: a rapid review. Cochrane Database Syst Rev 2020; 8:CD013699. [PMID: 33502000 PMCID: PMC8241885 DOI: 10.1002/14651858.cd013699] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Reducing the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global priority. Contact tracing identifies people who were recently in contact with an infected individual, in order to isolate them and reduce further transmission. Digital technology could be implemented to augment and accelerate manual contact tracing. Digital tools for contact tracing may be grouped into three areas: 1) outbreak response; 2) proximity tracing; and 3) symptom tracking. We conducted a rapid review on the effectiveness of digital solutions to contact tracing during infectious disease outbreaks. OBJECTIVES To assess the benefits, harms, and acceptability of personal digital contact tracing solutions for identifying contacts of an identified positive case of an infectious disease. SEARCH METHODS An information specialist searched the literature from 1 January 2000 to 5 May 2020 in CENTRAL, MEDLINE, and Embase. Additionally, we screened the Cochrane COVID-19 Study Register. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-RCTs, quasi-RCTs, cohort studies, cross-sectional studies and modelling studies, in general populations. We preferentially included studies of contact tracing during infectious disease outbreaks (including COVID-19, Ebola, tuberculosis, severe acute respiratory syndrome virus, and Middle East respiratory syndrome) as direct evidence, but considered comparative studies of contact tracing outside an outbreak as indirect evidence. The digital solutions varied but typically included software (or firmware) for users to install on their devices or to be uploaded to devices provided by governments or third parties. Control measures included traditional or manual contact tracing, self-reported diaries and surveys, interviews, other standard methods for determining close contacts, and other technologies compared to digital solutions (e.g. electronic medical records). DATA COLLECTION AND ANALYSIS Two review authors independently screened records and all potentially relevant full-text publications. One review author extracted data for 50% of the included studies, another extracted data for the remaining 50%; the second review author checked all the extracted data. One review author assessed quality of included studies and a second checked the assessments. Our outcomes were identification of secondary cases and close contacts, time to complete contact tracing, acceptability and accessibility issues, privacy and safety concerns, and any other ethical issue identified. Though modelling studies will predict estimates of the effects of different contact tracing solutions on outcomes of interest, cohort studies provide empirically measured estimates of the effects of different contact tracing solutions on outcomes of interest. We used GRADE-CERQual to describe certainty of evidence from qualitative data and GRADE for modelling and cohort studies. MAIN RESULTS We identified six cohort studies reporting quantitative data and six modelling studies reporting simulations of digital solutions for contact tracing. Two cohort studies also provided qualitative data. Three cohort studies looked at contact tracing during an outbreak, whilst three emulated an outbreak in non-outbreak settings (schools). Of the six modelling studies, four evaluated digital solutions for contact tracing in simulated COVID-19 scenarios, while two simulated close contacts in non-specific outbreak settings. Modelling studies Two modelling studies provided low-certainty evidence of a reduction in secondary cases using digital contact tracing (measured as average number of secondary cases per index case - effective reproductive number (R eff)). One study estimated an 18% reduction in R eff with digital contact tracing compared to self-isolation alone, and a 35% reduction with manual contact-tracing. Another found a reduction in R eff for digital contact tracing compared to self-isolation alone (26% reduction) and a reduction in R eff for manual contact tracing compared to self-isolation alone (53% reduction). However, the certainty of evidence was reduced by unclear specifications of their models, and assumptions about the effectiveness of manual contact tracing (assumed 95% to 100% of contacts traced), and the proportion of the population who would have the app (53%). Cohort studies Two cohort studies provided very low-certainty evidence of a benefit of digital over manual contact tracing. During an Ebola outbreak, contact tracers using an app found twice as many close contacts per case on average than those using paper forms. Similarly, after a pertussis outbreak in a US hospital, researchers found that radio-frequency identification identified 45 close contacts but searches of electronic medical records found 13. The certainty of evidence was reduced by concerns about imprecision, and serious risk of bias due to the inability of contact tracing study designs to identify the true number of close contacts. One cohort study provided very low-certainty evidence that an app could reduce the time to complete a set of close contacts. The certainty of evidence for this outcome was affected by imprecision and serious risk of bias. Contact tracing teams reported that digital data entry and management systems were faster to use than paper systems and possibly less prone to data loss. Two studies from lower- or middle-income countries, reported that contact tracing teams found digital systems simpler to use and generally preferred them over paper systems; they saved personnel time, reportedly improved accuracy with large data sets, and were easier to transport compared with paper forms. However, personnel faced increased costs and internet access problems with digital compared to paper systems. Devices in the cohort studies appeared to have privacy from contacts regarding the exposed or diagnosed users. However, there were risks of privacy breaches from snoopers if linkage attacks occurred, particularly for wearable devices. AUTHORS' CONCLUSIONS The effectiveness of digital solutions is largely unproven as there are very few published data in real-world outbreak settings. Modelling studies provide low-certainty evidence of a reduction in secondary cases if digital contact tracing is used together with other public health measures such as self-isolation. Cohort studies provide very low-certainty evidence that digital contact tracing may produce more reliable counts of contacts and reduce time to complete contact tracing. Digital solutions may have equity implications for at-risk populations with poor internet access and poor access to digital technology. Stronger primary research on the effectiveness of contact tracing technologies is needed, including research into use of digital solutions in conjunction with manual systems, as digital solutions are unlikely to be used alone in real-world settings. Future studies should consider access to and acceptability of digital solutions, and the resultant impact on equity. Studies should also make acceptability and uptake a primary research question, as privacy concerns can prevent uptake and effectiveness of these technologies.
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Affiliation(s)
- Andrew Anglemyer
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Methods Support Unit, Editorial Methods Department, London, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Methods Support Unit, Editorial Methods Department, London, UK
- NIHR ARC West, Bristol, UK
| | - Lisa Parker
- Sydney School of Pharmacy, The University of Sydney, Sydney, Australia
| | - Timothy Chambers
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Alice Grady
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Kellia Chiu
- Charles Perkins Centre and School of Pharmacy, The University of Sydney, Sydney, Australia
| | - Matthew Parry
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Magdalena Wilczynska
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Ella Flemyng
- Editorial and Methods Department, Cochrane, London, UK
| | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, Australia
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Abstract
Infectious disease research spans scales from the molecular to the global—from specific mechanisms of pathogen drug resistance, virulence, and replication to the movement of people, animals, and pathogens around the world. All of these research areas have been impacted by the recent growth of large-scale data sources and data analytics. Some of these advances rely on data or analytic methods that are common to most biomedical data science, while others leverage the unique nature of infectious disease, namely its communicability. This review outlines major research progress in the past few years and highlights some remaining opportunities, focusing on data or methodological approaches particular to infectious disease.
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Affiliation(s)
- Peter M. Kasson
- Department of Biomedical Engineering and Department of Molecular Physiology, University of Virginia, Charlottesville, Virginia 22908, USA
- Science for Life Laboratory, Department of Cell and Molecular Biology, Uppsala University, 752 37 Uppsala, Sweden
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21
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Krieger MS, Denison CE, Anderson TL, Nowak MA, Hill AL. Population structure across scales facilitates coexistence and spatial heterogeneity of antibiotic-resistant infections. PLoS Comput Biol 2020; 16:e1008010. [PMID: 32628660 PMCID: PMC7365476 DOI: 10.1371/journal.pcbi.1008010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/16/2020] [Accepted: 06/02/2020] [Indexed: 12/31/2022] Open
Abstract
Antibiotic-resistant infections are a growing threat to human health, but basic features of the eco-evolutionary dynamics remain unexplained. Most prominently, there is no clear mechanism for the long-term coexistence of both drug-sensitive and resistant strains at intermediate levels, a ubiquitous pattern seen in surveillance data. Here we show that accounting for structured or spatially-heterogeneous host populations and variability in antibiotic consumption can lead to persistent coexistence over a wide range of treatment coverages, drug efficacies, costs of resistance, and mixing patterns. Moreover, this mechanism can explain other puzzling spatiotemporal features of drug-resistance epidemiology that have received less attention, such as large differences in the prevalence of resistance between geographical regions with similar antibiotic consumption or that neighbor one another. We find that the same amount of antibiotic use can lead to very different levels of resistance depending on how treatment is distributed in a transmission network. We also identify parameter regimes in which population structure alone cannot support coexistence, suggesting the need for other mechanisms to explain the epidemiology of antibiotic resistance. Our analysis identifies key features of host population structure that can be used to assess resistance risk and highlights the need to include spatial or demographic heterogeneity in models to guide resistance management.
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Affiliation(s)
- Madison S. Krieger
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Carson E. Denison
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Thayer L. Anderson
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Martin A. Nowak
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Alison L. Hill
- Department of Organismic & Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
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22
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Neumann B, Bender JK, Maier BF, Wittig A, Fuchs S, Brockmann D, Semmler T, Einsele H, Kraus S, Wieler LH, Vogel U, Werner G. Comprehensive integrated NGS-based surveillance and contact-network modeling unravels transmission dynamics of vancomycin-resistant enterococci in a high-risk population within a tertiary care hospital. PLoS One 2020; 15:e0235160. [PMID: 32579600 PMCID: PMC7314025 DOI: 10.1371/journal.pone.0235160] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Vancomycin-resistant E. faecium (VRE) are an important cause of nosocomial infections, which are rapidly transmitted in hospitals. To identify possible transmission routes, we applied combined genomics and contact-network modeling to retrospectively evaluate routine VRE screening data generated by the infection control program of a hemato-oncology unit. Over 1 year, a total of 111 VRE isolates from 111 patients were collected by anal swabs in a tertiary care hospital in Southern Germany. All isolated VRE were whole-genome sequenced, followed by different in-depth bioinformatics analyses including genotyping and determination of phylogenetic relations, aiming to evaluate a standardized workflow. Patient movement data were used to overlay sequencing data to infer transmission events and strain dynamics over time. A predominant clone harboring vanB and exhibiting genotype ST117/CT469 (n = 67) was identified. Our comprehensive combined analyses suggested intra-hospital spread, especially of clone ST117/CT469, despite of extensive screening, single room placement, and contact isolation. A new interactive tool to visualize these complex data was designed. Furthermore, a patient-contact network-modeling approach was developed, which indicates both the periodic import of the clone into the hospital and its spread within the hospital due to patient movements. The analyzed spread of VRE was most likely due to placement of patients in the same room prior to positivity of screening. We successfully demonstrated the added value for this combined strategy to extract well-founded knowledge from interdisciplinary data sources. The combination of patient-contact modeling and high-resolution typing unraveled the transmission dynamics within the hospital department and, additionally, a constant VRE influx over time.
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Affiliation(s)
- Bernd Neumann
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
- * E-mail:
| | - Jennifer K. Bender
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
| | - Benjamin F. Maier
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Department of Physics, Humboldt University of Berlin, Berlin, Germany
| | - Alice Wittig
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology, Humboldt University of Berlin, Berlin, Germany
| | - Stephan Fuchs
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
| | - Dirk Brockmann
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology, Humboldt University of Berlin, Berlin, Germany
| | | | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Wüzburg, Germany
| | - Sabrina Kraus
- Department of Internal Medicine II, University Hospital Würzburg, Wüzburg, Germany
| | | | - Ulrich Vogel
- Institute for Hygiene and Microbiology, Julius-Maximilians University Würzburg, Würzburg, Germany
| | - Guido Werner
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
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23
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Klein EY, Tseng KK, Hinson J, Goodman KE, Smith A, Toerper M, Amoah J, Tamma PD, Levin SR, Milstone AM. The Role of Healthcare Worker-Mediated Contact Networks in the Transmission of Vancomycin-Resistant Enterococci. Open Forum Infect Dis 2020; 7:ofaa056. [PMID: 32166095 PMCID: PMC7060899 DOI: 10.1093/ofid/ofaa056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 02/13/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND User- and time-stamped data from hospital electronic health records (EHRs) present opportunities to evaluate how healthcare worker (HCW)-mediated contact networks impact transmission of multidrug-resistant pathogens, such as vancomycin-resistant enterococci (VRE). METHODS This is a retrospective analysis of incident acquisitions of VRE between July 1, 2016 and June 30, 2018. Clinical and demographic patient data were extracted from the hospital EHR system, including all recorded HCW contacts with patients. Contacts by an HCW with 2 different patients within 1 hour was considered a "connection". Incident VRE acquisition was determined by positive clinical or surveillance cultures collected ≥72 hours after a negative surveillance culture. RESULTS There were 2952 hospitalizations by 2364 patients who had ≥2 VRE surveillance swabs, 112 (4.7%) patients of which had incident nosocomial acquisitions. Patients had a median of 24 (interquartile range [IQR], 18-33) recorded HCW contacts per day, 9 (IQR, 5-16) of which, or approximately 40%, were connections that occurred <1 hour after another patient contact. Patients that acquired VRE had a higher average number of daily connections to VRE-positive patients (3.1 [standard deviation {SD}, 2.4] versus 2.0 [SD, 2.1]). Controlling for other risk factors, connection to a VRE-positive patient was associated with increased odds of acquiring VRE (odds ratio, 1.64; 95% confidence interval, 1.39-1.92). CONCLUSIONS We demonstrated that EHR data can be used to quantify the impact of HCW-mediated patient connections on transmission of VRE in the hospital. Defining incident acquisition risk of multidrug-resistant organisms through HCWs connections from EHR data in real-time may aid implementation and evaluation of interventions to contain their spread.
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Affiliation(s)
- Eili Y Klein
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics & Policy, Washington, District of Columbia, USA
| | - Katie K Tseng
- Center for Disease Dynamics, Economics & Policy, Washington, District of Columbia, USA
| | - Jeremiah Hinson
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Katherine E Goodman
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aria Smith
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Matt Toerper
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joe Amoah
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pranita D Tamma
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Scott R Levin
- The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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24
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Guo S, Yu J, Shi X, Wang H, Xie F, Gao X, Jiang M. Droplet-Transmitted Infection Risk Ranking Based on Close Proximity Interaction. Front Neurorobot 2020; 13:113. [PMID: 32038220 PMCID: PMC6985151 DOI: 10.3389/fnbot.2019.00113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 12/13/2019] [Indexed: 11/28/2022] Open
Abstract
We propose an automatic method to identify people who are potentially-infected by droplet-transmitted diseases. This high-risk group of infection was previously identified by conducting large-scale visits/interviews, or manually screening among tons of recorded surveillance videos. Both are time-intensive and most likely to delay the control of communicable diseases like influenza. In this paper, we address this challenge by solving a multi-tasking problem from the captured surveillance videos. This multi-tasking framework aims to model the principle of Close Proximity Interaction and thus infer the infection risk of individuals. The complete workflow includes three essential sub-tasks: (1) person re-identification (REID), to identify the diagnosed patient and infected individuals across different cameras, (2) depth estimation, to provide a spatial knowledge of the captured environment, (3) pose estimation, to evaluate the distance between the diagnosed and potentially-infected subjects. Our method significantly reduces the time and labor costs. We demonstrate the advantages of high accuracy and efficiency of our method. Our method is expected to be effective in accelerating the process of identifying the potentially infected group and ultimately contribute to the well-being of public health.
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Affiliation(s)
- Shihui Guo
- School of Informatics, Xiamen University, Xiamen, China
| | - Jubo Yu
- School of Informatics, Xiamen University, Xiamen, China
| | - Xinyu Shi
- School of Informatics, Xiamen University, Xiamen, China
| | - Hongran Wang
- School of Informatics, Xiamen University, Xiamen, China
| | - Feibin Xie
- Department of Orthopaedic Trauma, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xing Gao
- School of Informatics, Xiamen University, Xiamen, China
| | - Min Jiang
- School of Informatics, Xiamen University, Xiamen, China
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25
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Kiti MC, Melegaro A, Cattuto C, Nokes DJ. Study design and protocol for investigating social network patterns in rural and urban schools and households in a coastal setting in Kenya using wearable proximity sensors. Wellcome Open Res 2019; 4:84. [PMID: 31489381 PMCID: PMC6719676 DOI: 10.12688/wellcomeopenres.15268.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Social contact patterns shape the transmission of respiratory infections spread via close interactions. There is a paucity of observational data from schools and households, particularly in developing countries. Portable wireless sensors can record unbiased proximity events between individuals facing each other, shedding light on pathways of infection transmission. Design and methods: The aim is to characterize face-to-face contact patterns that may shape the transmission of respiratory infections in schools and households in Kilifi, Kenya. Two schools, one each from a rural and urban area, will be purposively selected. From each school, 350 students will be randomly selected proportional to class size and gender to participate. Nine index students from each school will be randomly selected and followed-up to their households. All index household residents will be recruited into the study. A further 3-5 neighbouring households will also be recruited to give a maximum of 350 participants per household setting. The sample size per site is limited by the number of sensors available for data collection. Each participant will wear a wireless proximity sensor lying on their chest area for 7 consecutive days. Data on proximal dyadic interactions will be collected automatically by the sensors only for participants who are face-to-face. Key characteristics of interest include the distribution of degree and the frequency and duration of contacts and their variation in rural and urban areas. These will be stratified by age, gender, role, and day of the week. Expected results: Resultant data will inform on social contact patterns in rural and urban areas of a previously unstudied population. Ensuing data will be used to parameterize mathematical simulation models of transmission of a range of respiratory viruses, including respiratory syncytial virus, and used to explore the impact of intervention measures such as vaccination and social distancing.
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Affiliation(s)
- Moses Chapa Kiti
- Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
| | - Alessia Melegaro
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | - Ciro Cattuto
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Turin, Italy
| | - David James Nokes
- Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya.,Zeeman Institute of Systems Biology and Infectious Disease Research, University of Warwick, Coventry, UK.,School of Life Sciences, University of Warwick, Coventry, UK
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26
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Jenkin DC, Mahgoub H, Morales KF, Lambach P, Nguyen-Van-Tam JS. A rapid evidence appraisal of influenza vaccination in health workers: An important policy in an area of imperfect evidence. Vaccine X 2019; 2:100036. [PMID: 31384750 PMCID: PMC6668237 DOI: 10.1016/j.jvacx.2019.100036] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The World Health Organization recommends vaccination of health workers (HWs) against influenza, but low uptake is intransigent.We conducted a Rapid Evidence Appraisal on: the risk of influenza in HWs, transmission risk from HWs to patients, the benefit of HW vaccination, and strategies for improving uptake. We aimed to capture a 'whole-of-system' perspective to consider possible benefits for HWs, employers and patients. METHODS We executed a comprehensive search of the available literature published from 2006 to 2018 in the English language. We developed search terms for seven separate questions following the PICO framework (population, intervention, comparators, outcomes) and queried nine databases. RESULTS Of 3784 publications identified, 52 met inclusion criteria. Seven addressed HW influenza risk, of which four found increased risk; 15 addressed influenza vaccine benefit to HWs or their employers, of which 10 found benefit; 11 addressed influenza transmission from HWs to patients, of which 6 found evidence for transmission; 12 unique studies addressed whether vaccinating HWs produced patient benefit, of which 9 concluded benefits accrued. Regarding the number of HWs needed to vaccinate (NNV) to deliver patient benefit, NNV estimates ranged from 3 to 36,000 but were in significant disagreement. Fourteen studies provided insights on strategies to improve uptake; the strongest evidence was for mandatory vaccination. CONCLUSIONS The evidence on most questions related to influenza vaccination in HWs is mixed and often of low-quality. Substantial heterogeneity exists in terms of study designs and settings, making comparison between studies difficult. Notwithstanding these limitations, a majority of studies suggests that influenza vaccination benefit HWs and their employers; and HWs are implicated in transmission events. The effects of vaccinating HWs on patient morbidity and mortality may include reductions in all-cause mortality and influenza-like illness (ILI). Taken together, the evidence suggests that HW vaccination is an important policy for HWs themselves, their employers, and their patients.
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Key Words
- GAVI, the global alliance for vaccines and immunization
- HW, health workers
- Health worker
- Healthcare
- ILI, influenza like illness
- Influenza
- LTCF, long-term care facility(ies)
- NNV, number needed to vaccinate
- OR, odds ratio
- Policy
- RCTs, randomised controlled trials
- RR, relative risk
- Transmission
- Vaccine
- WHO, World Health organization
- cRCTs, clustered randomised controlled trials
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Affiliation(s)
- Dawn C. Jenkin
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
| | - Hamid Mahgoub
- East of England Health Protection Team, Public Health England, United Kingdom
| | | | | | - Jonathan S. Nguyen-Van-Tam
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
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27
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Wilson-Aggarwal JK, Ozella L, Tizzoni M, Cattuto C, Swan GJF, Moundai T, Silk MJ, Zingeser JA, McDonald RA. High-resolution contact networks of free-ranging domestic dogs Canis familiaris and implications for transmission of infection. PLoS Negl Trop Dis 2019; 13:e0007565. [PMID: 31306425 PMCID: PMC6658143 DOI: 10.1371/journal.pntd.0007565] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/25/2019] [Accepted: 06/20/2019] [Indexed: 02/04/2023] Open
Abstract
Contact patterns strongly influence the dynamics of disease transmission in both human and non-human animal populations. Domestic dogs Canis familiaris are a social species and are a reservoir for several zoonotic infections, yet few studies have empirically determined contact patterns within dog populations. Using high-resolution proximity logging technology, we characterised the contact networks of free-ranging domestic dogs from two settlements (n = 108 dogs, covering >80% of the population in each settlement) in rural Chad. We used these data to simulate the transmission of an infection comparable to rabies and investigated the effects of including observed contact heterogeneities on epidemic outcomes. We found that dog contact networks displayed considerable heterogeneity, particularly in the duration of contacts and that the network had communities that were highly correlated with household membership. Simulations using observed contact networks had smaller epidemic sizes than those that assumed random mixing, demonstrating the unsuitability of homogenous mixing models in predicting epidemic outcomes. When contact heterogeneities were included in simulations, the network position of the individual initially infected had an important effect on epidemic outcomes. The risk of an epidemic occurring was best predicted by the initially infected individual's ranked degree, while epidemic size was best predicted by the individual's ranked eigenvector centrality. For dogs in one settlement, we found that ranked eigenvector centrality was correlated with range size. Our results demonstrate that observed heterogeneities in contacts are important for the prediction of epidemiological outcomes in free-ranging domestic dogs. We show that individuals presenting a higher risk for disease transmission can be identified by their network position and provide evidence that observable traits hold potential for informing targeted disease management strategies.
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Affiliation(s)
| | - Laura Ozella
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - Michele Tizzoni
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - Ciro Cattuto
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - George J. F. Swan
- Environment and Sustainability Institute, University of Exeter, Cornwall, United Kingdom
| | - Tchonfienet Moundai
- Guinea Worm Eradication Programme, Ministry of Public Health, N’Djamena, Republic of Chad
| | - Matthew J. Silk
- Environment and Sustainability Institute, University of Exeter, Cornwall, United Kingdom
| | | | - Robbie A. McDonald
- Environment and Sustainability Institute, University of Exeter, Cornwall, United Kingdom
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28
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Kiti MC, Melegaro A, Cattuto C, Nokes DJ. Study design and protocol for investigating social network patterns in rural and urban schools and households in a coastal setting in Kenya using wearable proximity sensors. Wellcome Open Res 2019; 4:84. [DOI: 10.12688/wellcomeopenres.15268.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Social contact patterns shape the transmission of respiratory infections spread via close interactions. There is a paucity of observational data from schools and households, particularly in developing countries. Portable wireless sensors can record unbiased proximity events between individuals facing each other, shedding light on pathways of infection transmission. Design and methods: The aim is to characterize face-to-face contact patterns that may shape the transmission of respiratory infections in schools and households in Kilifi, Kenya. Two schools, one each from a rural and urban area, will be purposively selected. From each school, 350 students will be randomly selected proportional to class size and gender to participate. Nine index students from each school will be randomly selected and followed-up to their households. All index household residents will be recruited into the study. A further 3-5 neighbouring households will also be recruited to give a maximum of 350 participants per household setting. The sample size per site is limited by the number of sensors available for data collection. Each participant will wear a wireless proximity sensor lying on their chest area for 7 consecutive days. Data on proximal dyadic interactions will be collected automatically by the sensors only for participants who are face-to-face. Key characteristics of interest include the distribution of degree and the frequency and duration of contacts and their variation in rural and urban areas. These will be stratified by age, gender, role, and day of the week. Expected results: Resultant data will inform on social contact patterns in rural and urban areas of a previously unstudied population. Ensuing data will be used to parameterize mathematical simulation models of transmission of a range of respiratory viruses, including respiratory syncytial virus, and used to explore the impact of intervention measures such as vaccination and social distancing.
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29
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Pinotti F, Fleury É, Guillemot D, Böelle PY, Poletto C. Host contact dynamics shapes richness and dominance of pathogen strains. PLoS Comput Biol 2019; 15:e1006530. [PMID: 31112541 PMCID: PMC6546247 DOI: 10.1371/journal.pcbi.1006530] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 06/03/2019] [Accepted: 04/29/2019] [Indexed: 02/07/2023] Open
Abstract
The interaction among multiple microbial strains affects the spread of infectious diseases and the efficacy of interventions. Genomic tools have made it increasingly easy to observe pathogenic strains diversity, but the best interpretation of such diversity has remained difficult because of relationships with host and environmental factors. Here, we focus on host-to-host contact behavior and study how it changes populations of pathogens in a minimal model of multi-strain interaction. We simulated a population of identical strains competing by mutual exclusion and spreading on a dynamical network of hosts according to a stochastic susceptible-infectious-susceptible model. We computed ecological indicators of diversity and dominance in strain populations for a collection of networks illustrating various properties found in real-world examples. Heterogeneities in the number of contacts among hosts were found to reduce diversity and increase dominance by making the repartition of strains among infected hosts more uneven, while strong community structure among hosts increased strain diversity. We found that the introduction of strains associated with hosts entering and leaving the system led to the highest pathogenic richness at intermediate turnover levels. These results were finally illustrated using the spread of Staphylococcus aureus in a long-term health-care facility where close proximity interactions and strain carriage were collected simultaneously. We found that network structural and temporal properties could account for a large part of the variability observed in strain diversity. These results show how stochasticity and network structure affect the population ecology of pathogens and warn against interpreting observations as unambiguous evidence of epidemiological differences between strains.
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Affiliation(s)
- Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), 75012 Paris, France
| | | | - Didier Guillemot
- Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Paris, France
| | - Pierre-Yves Böelle
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), 75012 Paris, France
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), 75012 Paris, France
- * E-mail:
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30
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Duval A, Obadia T, Boëlle PY, Fleury E, Herrmann JL, Guillemot D, Temime L, Opatowski L. Close proximity interactions support transmission of ESBL-K. pneumoniae but not ESBL-E. coli in healthcare settings. PLoS Comput Biol 2019; 15:e1006496. [PMID: 31145725 PMCID: PMC6542504 DOI: 10.1371/journal.pcbi.1006496] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/08/2019] [Indexed: 11/19/2022] Open
Abstract
Antibiotic-resistance of hospital-acquired infections is a major public health issue. The worldwide emergence and diffusion of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, including Escherichia coli (ESBL-EC) and Klebsiella pneumoniae (ESBL-KP), is of particular concern. Preventing their nosocomial spread requires understanding their transmission. Using Close Proximity Interactions (CPIs), measured by wearable sensors, and weekly ESBL-EC-and ESBL-KP-carriage data, we traced their possible transmission paths among 329 patients in a 200-bed long-term care facility over 4 months. Based on phenotypically defined resistance profiles to 12 antibiotics only, new bacterial acquisitions were tracked. Extending a previously proposed statistical method, the CPI network's ability to support observed incident-colonization episodes of ESBL-EC and ESBL-KP was tested. Finally, mathematical modeling based on our findings assessed the effect of several infection-control measures. A potential infector was identified in the CPI network for 80% (16/20) of ESBL-KP acquisition episodes. The lengths of CPI paths between ESBL-KP incident cases and their potential infectors were shorter than predicted by chance (P = 0.02), indicating that CPI-network relationships were consistent with dissemination. Potential ESBL-EC infectors were identified for 54% (19/35) of the acquisitions, with longer-than-expected lengths of CPI paths. These contrasting results yielded differing impacts of infection control scenarios, with contact reduction interventions proving less effective for ESBL-EC than for ESBL-KP. These results highlight the widely variable transmission patterns among ESBL-producing Enterobacteriaceae species. CPI networks supported ESBL-KP, but not ESBL-EC spread. These outcomes could help design more specific surveillance and control strategies to prevent in-hospital Enterobacteriaceae dissemination.
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Affiliation(s)
- Audrey Duval
- Equipe PheMI, unité B2PHI, Inserm, Université de Versailles Saint Quentin, Institut Pasteur,Paris, France
| | - Thomas Obadia
- Malaria: Parasites & Hosts Unit, Department of Parasites & Insect Vectors, Institut Pasteur,Paris, France
- Institut Pasteur—Bioinformatics and Biostatistics Hub—C3BI, USR 3756 IP CNRS—Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, PARIS France
| | - Eric Fleury
- Univ Lyon, Cnrs, ENS de Lyon, Inria, UCB Lyon 1, LIP UMR 5668, Lyon, FRANCE
| | - Jean-Louis Herrmann
- INSERM U1173, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France AP-HP, Service de Microbiologie, Hôpital Raymond Poincaré, Garches, France
| | - Didier Guillemot
- Equipe PheMI, unité B2PHI, Inserm, Université de Versailles Saint Quentin, Institut Pasteur,Paris, France
| | - Laura Temime
- Laboratoire MESuRS, Conservatoire national des Arts et Métiers, Paris, France
- Institut Pasteur, Cnam, unité PACRI, Paris, France
| | - Lulla Opatowski
- Equipe PheMI, unité B2PHI, Inserm, Université de Versailles Saint Quentin, Institut Pasteur,Paris, France
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31
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Ozella L, Gauvin L, Carenzo L, Quaggiotto M, Ingrassia PL, Tizzoni M, Panisson A, Colombo D, Sapienza A, Kalimeri K, Della Corte F, Cattuto C. Wearable Proximity Sensors for Monitoring a Mass Casualty Incident Exercise: Feasibility Study. J Med Internet Res 2019; 21:e12251. [PMID: 31025944 PMCID: PMC6658323 DOI: 10.2196/12251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over the past several decades, naturally occurring and man-made mass casualty incidents (MCIs) have increased in frequency and number worldwide. To test the impact of such events on medical resources, simulations can provide a safe, controlled setting while replicating the chaotic environment typical of an actual disaster. A standardized method to collect and analyze data from mass casualty exercises is needed to assess preparedness and performance of the health care staff involved. OBJECTIVE In this study, we aimed to assess the feasibility of using wearable proximity sensors to measure proximity events during an MCI simulation. In the first instance, our objective was to demonstrate how proximity sensors can collect spatial and temporal information about the interactions between medical staff and patients during an MCI exercise in a quasi-autonomous way. In addition, we assessed how the deployment of this technology could help improve future simulations by analyzing the flow of patients in the hospital. METHODS Data were obtained and collected through the deployment of wearable proximity sensors during an MCI functional exercise. The scenario included 2 areas: the accident site and the Advanced Medical Post, and the exercise lasted 3 hours. A total of 238 participants were involved in the exercise and classified in categories according to their role: 14 medical doctors, 16 nurses, 134 victims, 47 Emergency Medical Services staff members, and 27 health care assistants and other hospital support staff. Each victim was assigned a score related to the severity of his/her injury. Each participant wore a proximity sensor, and in addition, 30 fixed devices were placed in the field hospital. RESULTS The contact networks show a heterogeneous distribution of the cumulative time spent in proximity by the participants. We obtained contact matrices based on the cumulative time spent in proximity between the victims and rescuers. Our results showed that the time spent in proximity by the health care teams with the victims is related to the severity of the patient's injury. The analysis of patients' flow showed that the presence of patients in the rooms of the hospital is consistent with the triage code and diagnosis, and no obvious bottlenecks were found. CONCLUSIONS Our study shows the feasibility of the use of wearable sensors for tracking close contacts among individuals during an MCI simulation. It represents, to our knowledge, the first example of unsupervised data collection-ie, without the need for the involvement of observers, which could compromise the realism of the exercise-of face-to-face contacts during an MCI exercise. Moreover, by permitting detailed data collection about the simulation, such as data related to the flow of patients in the hospital, such deployment provides highly relevant input for the improvement of MCI resource allocation and management.
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Affiliation(s)
- Laura Ozella
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - Laetitia Gauvin
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - Luca Carenzo
- Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.,Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie SIMNOVA, Università del Piemonte Orientale, Novara, Italy
| | - Marco Quaggiotto
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy.,Department of Design, Politecnico di Milano, Milano, Italy
| | - Pier Luigi Ingrassia
- Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie SIMNOVA, Università del Piemonte Orientale, Novara, Italy
| | - Michele Tizzoni
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - André Panisson
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | - Davide Colombo
- Department of Translational Medicine, Eastern Piedmont University, Novara, Italy
| | - Anna Sapienza
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy.,University of Southern California Information Sciences Institute, Marina del Rey, CA, United States
| | - Kyriaki Kalimeri
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
| | | | - Ciro Cattuto
- Data Science Laboratory, Institute for Scientific Interchange Foundation, Torino, Italy
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32
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Parkash N, Beckingham W, Andersson P, Kelly P, Senanayake S, Coatsworth N. Hospital-acquired influenza in an Australian tertiary Centre 2017: a surveillance based study. BMC Pulm Med 2019; 19:79. [PMID: 30991976 PMCID: PMC6469028 DOI: 10.1186/s12890-019-0842-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/01/2019] [Indexed: 11/22/2022] Open
Abstract
Background In 2017, Australia experienced its highest levels of influenza virus activity since the 2009 pandemic. This allowed detailed comparison of the characteristics of patients with community and hospital-acquired influenza, and infection control factors that contributed to influenza spread. Methods A surveillance based study was conducted on hospitalised patients with laboratory-confirmed influenza at the Canberra Hospital during April–October 2017. Differences between the hospital-acquired and community-acquired patient characteristics and outcomes were assessed by univariate analysis. Epidemiologic curves were developed and cluster distribution within the hospital was determined. Results Two hundred and ninety-two patients were included in the study. Twenty-eight (9.6%) acquired influenza in hospital, representing a higher proportion than any of the previous 5 years (range 0.9–5.8%). These patients were more likely to have influenza A (p = 0.021), had higher rates of diabetes (p = 0.015), malignancy (p = 0.046) and chronic liver disease (p = 0.043). Patients acquiring influenza in hospital met clinical criteria for influenza like illness in 25% of cases, compared with 64.4% for community-acquired cases (p < 0.001). Hospital-acquired influenza cases occurred in two distinct clusters. Patients were moved an average of 5 times after diagnosis. Mean length of stay following diagnosis was 13 days compared to 5 days for community-acquired cases (p < 0.001). Of the patients with hospital-acquired influenza, 22 were in shared rooms during their incubation period and 9 were not isolated in single rooms following diagnosis. Treatment was initiated within the recommended 48 h period following symptom onset for 62.5% of hospital-acquired cases compared with 39.8% of community-acquired cases (p = 0.033). Conclusions Our results show that clinical presentation differed between patients with hospital-acquired influenza compared with those who acquired influenza in the community. Cases occurred in two clusters suggesting intra-hospital transmission rather than random importation from the community, highlighting the importance of infection control measures to limit influenza spread. Patients with hospital-acquired influenza may present without classical features of an influenza-like illness and this should promote earlier diagnostic testing and isolation to limit spread. Movement of patients after diagnosis is likely to facilitate spread within the hospital.
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Affiliation(s)
- Nikita Parkash
- Department of Infectious Diseases, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.
| | - Wendy Beckingham
- Infection Prevention and Control, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia
| | - Patiyan Andersson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Paul Kelly
- Australian National University Medical School, Canberra, Australian Capital Territory, Australia.,Population Health and Prevention Division, ACT Health, Canberra, Australian Capital Territory, Australia
| | - Sanjaya Senanayake
- Department of Infectious Diseases, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.,Australian National University Medical School, Canberra, Australian Capital Territory, Australia
| | - Nicholas Coatsworth
- Department of Infectious Diseases, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.,Australian National University Medical School, Canberra, Australian Capital Territory, Australia
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Dawson DE, Farthing TS, Sanderson MW, Lanzas C. Transmission on empirical dynamic contact networks is influenced by data processing decisions. Epidemics 2019; 26:32-42. [PMID: 30528207 PMCID: PMC6613374 DOI: 10.1016/j.epidem.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/01/2018] [Accepted: 08/27/2018] [Indexed: 11/02/2022] Open
Abstract
Dynamic contact data can be used to inform disease transmission models, providing insight into the dynamics of infectious diseases. Such data often requires extensive processing for use in models or analysis. Therefore, processing decisions can potentially influence the topology of the contact network and the simulated disease transmission dynamics on the network. In this study, we examine how four processing decisions, including temporal sampling window (TSW), spatial threshold of contact (SpTh), minimum contact duration (MCD), and temporal aggregation (daily or hourly) influence the information content of contact data (indicated by changes in entropy) as well as disease transmission model dynamics. We found that changes made to information content by processing decisions translated to significant impacts to the transmission dynamics of disease models using the contact data. In particular, we found that SpTh had the largest independent influence on information content, and that some output metrics (R0, time to peak infection) were more sensitive to changes in information than others (epidemic extent). These findings suggest that insights gained from transmission modeling using dynamic contact data can be influenced by processing decisions alone, emphasizing the need to carefully consideration them prior to using contact-based models to conduct analyses, compare different datasets, or inform policy decisions.
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Affiliation(s)
- Daniel E Dawson
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606, USA.
| | - Trevor S Farthing
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606, USA
| | - Michael W Sanderson
- Center for Outcomes Research and Epidemiology, Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Cristina Lanzas
- Department of Pathobiology and Population Health, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606, USA
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Gervasi O, Franzoni V, Riganelli M, Tasso S. Automating facial emotion recognition. WEB INTELLIGENCE 2019. [DOI: 10.3233/web-190397] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Osvaldo Gervasi
- Department of Mathematics and Computer Science, University of Perugia, Via Vanvitelli, 1 – 06123 Perugia, Italy. E-mails: ,
| | - Valentina Franzoni
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Via Ariosto, 20, Rome, Italy. E-mail:
| | | | - Sergio Tasso
- Department of Mathematics and Computer Science, University of Perugia, Via Vanvitelli, 1 – 06123 Perugia, Italy. E-mails: ,
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Milwid RM, O’Sullivan TL, Poljak Z, Laskowski M, Greer AL. Validation of modified radio-frequency identification tag firmware, using an equine population case study. PLoS One 2019; 14:e0210148. [PMID: 30625195 PMCID: PMC6326514 DOI: 10.1371/journal.pone.0210148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 12/18/2018] [Indexed: 11/21/2022] Open
Abstract
Background Contact networks can be used to assess disease spread potential within a population. However, the data required to generate the networks can be challenging to collect. One method of collecting this type of data is by using radio-frequency identification (RFID) tags. The OpenBeacon RFID system generally consists of tags and readers. Communicating tags should be within 10m of the readers, which are powered by an external power source. The readers are challenging to implement in agricultural settings due to the lack of a power source and the large area needed to be covered. Methods OpenBeacon firmware was modified to use the tag’s onboard flash memory for data storage. The tags were deployed within an equine facility for a 7-day period. Tags were attached to the horses’ halters, worn by facility staff, and placed in strategic locations around the facility to monitor which participants had contact with the specified locations during the study period. When the tags came within 2m of each other, they recorded the contact event participant IDs, and start and end times. At the end of the study period, the data were downloaded to a computer and analyzed using network analysis methods. Results The resulting networks were plausible given the facility schedule as described in a survey completed by the facility manager. Furthermore, changes in the daily facility operations as described in the survey were reflected in the tag-collected data. In terms of the battery life, 88% of batteries maintained a charge for at least 6 days. Lastly, no consistent trends were evident in the horses’ centrality metrics. Discussion This study demonstrates the utility of RFID tags for the collection of equine contact data. Future work should include the collection of contact data from multiple equine facilities to better characterize equine disease spread potential in Ontario.
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Affiliation(s)
- Rachael M. Milwid
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | | | - Zvonimir Poljak
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Marek Laskowski
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Amy L. Greer
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
- * E-mail:
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Baier C, Linderkamp C, Beilken A, Thol F, Heuser M, Ebadi E, Ganzenmueller T, Heim A, Bange FC. Influenza and respiratory syncytial virus screening for the detection of asymptomatically infected patients in hematology and oncology. GMS HYGIENE AND INFECTION CONTROL 2018; 13:Doc08. [PMID: 30460173 PMCID: PMC6234716 DOI: 10.3205/dgkh000314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Respiratory syncytial virus (RSV) and influenza virus infections are a significant healthcare risk for immunocompromised patients. In addition to community onset, nosocomial acquisition and transmission may also occur. Detection of asymptomatic shedders (e.g., patients in the incubation period or immunosuppressed long term shedders) facilitates control of nosocomial transmission. Methods: To strengthen the existing infection control concept, a PCR-based screening for RSV and influenza virus was implemented for all patients lacking respiratory symptoms (asymptomatic patients) who were hospitalized on an adult and a pediatric hemato-oncological ward. Laboratory results of this screening were analyzed retrospectively. Results: 665 respiratory specimens were obtained for screening from 251 patients (26% were 18 years and younger) from December 2016 to April 2017. In 23 patients without respiratory symptoms, either influenza virus or RSV infection was found, resulting in a detection rate of about 9%. In 6 patients, the infection was presumably detected during the incubation period, because an increase of viral load was observed in subsequent specimens. Positive screening results facilitated timely implementation of adequate infection control precautions. Nosocomial clusters of RSV or influenza were not detected during the screening period on the two wards. Conclusion: The seasonal screening program expanded our existing infection control concept in terms of patients lacking respiratory symptoms who shed influenza virus or RSV. It enabled us to identify 23 RSV or influenza infections in patients lacking respiratory symptoms in a 4-month period and thus to rapidly take isolation precautions.
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Affiliation(s)
- Claas Baier
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany
| | - Christin Linderkamp
- Department of Pediatric Hematology and Oncology, Hannover Medical School (MHH), Hannover, Germany
| | - Andreas Beilken
- Department of Pediatric Hematology and Oncology, Hannover Medical School (MHH), Hannover, Germany
| | - Felicitas Thol
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School (MHH), Hannover, Germany
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School (MHH), Hannover, Germany
| | - Ella Ebadi
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany
| | | | - Albert Heim
- Institute of Virology, Hannover Medical School (MHH), Hannover, Germany
| | - Franz-Christoph Bange
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH), Hannover, Germany
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Sapienza A, Barrat A, Cattuto C, Gauvin L. Estimating the outcome of spreading processes on networks with incomplete information: A dimensionality reduction approach. Phys Rev E 2018; 98:012317. [PMID: 30110805 DOI: 10.1103/physreve.98.012317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Indexed: 11/07/2022]
Abstract
Recent advances in data collection have facilitated the access to time-resolved human proximity data that can conveniently be represented as temporal networks of contacts between individuals. While the structural and dynamical information revealed by this type of data is fundamental to investigate how information or diseases propagate in a population, data often suffer from incompleteness, which possibly leads to biased estimations in data-driven models. A major challenge is thus to estimate the outcome of spreading processes occurring on temporal networks built from partial information. To cope with this problem, we devise an approach based on non-negative tensor factorization, a dimensionality reduction technique from multilinear algebra. The key idea is to learn a low-dimensional representation of the temporal network built from partial information and to use it to construct a surrogate network similar to the complete original network. To test our method, we consider several human-proximity networks, on which we perform resampling experiments to simulate a loss of data. Using our approach on the resulting partial networks, we build a surrogate version of the complete network for each. We then compare the outcome of a spreading process on the complete networks (nonaltered by a loss of data) and on the surrogate networks. We observe that the epidemic sizes obtained using the surrogate networks are in good agreement with those measured on the complete networks. Finally, we propose an extension of our framework that can leverage additional data, when available, to improve the surrogate network when the data loss is particularly large.
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Affiliation(s)
- Anna Sapienza
- Information Sciences Institute, Viterbi School of Engineering, University of Southern California, Marina del Rey, California 90292, USA and Data Science Laboratory, ISI Foundation, 10126 Turin, Italy
| | - Alain Barrat
- Aix Marseille Univ, Université de Toulon, CNRS, CPT, Marseille, France and Data Science Laboratory, ISI Foundation, Turin, Italy
| | - Ciro Cattuto
- Data Science Laboratory, ISI Foundation, 10126 Turin, Italy
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Ozella L, Gesualdo F, Tizzoni M, Rizzo C, Pandolfi E, Campagna I, Tozzi AE, Cattuto C. Close encounters between infants and household members measured through wearable proximity sensors. PLoS One 2018; 13:e0198733. [PMID: 29879196 PMCID: PMC5991752 DOI: 10.1371/journal.pone.0198733] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/24/2018] [Indexed: 11/25/2022] Open
Abstract
Describing and understanding close proximity interactions between infant and family members can provide key information on transmission opportunities of respiratory infections within households. Among respiratory infections, pertussis represents a public health priority. Pertussis infection can be particularly harmful to young, unvaccinated infants and for these patients, family members represent the main sources of transmission. Here, we report on the use of wearable proximity sensors based on RFID technology to measure face-to-face proximity between family members within 16 households with infants younger than 6 months for 2–5 consecutive days of data collection. The sensors were deployed over the course of approximately 1 year, in the context of a national research project aimed at the improvement of infant pertussis prevention strategies. We investigated differences in close-range interactions between family members and we assessed whether demographic variables or feeding practices affect contact patterns between parents and infants. A total of 5,958 contact events were recorded between 55 individuals: 16 infants, 4 siblings, 31 parents and 4 grandparents. The aggregated contact networks, obtained for each household, showed a heterogeneous distribution of the cumulative time spent in proximity with the infant by family members. Contact matrices defined by age and by family role showed that most of the contacts occurred between the infant and other family members (70%), while 30% of contacts was among family members (infants excluded). Many contacts were observed between infants and adults, in particular between infant and mother, followed by father, siblings and grandparents. A larger number of contacts and longer contact durations between infant and other family members were observed in families adopting exclusive breastfeeding, compared to families in which the infant receives artificial or mixed feeding. Our results demonstrate how a high-resolution measurement of contact matrices within infants’ households is feasible using wearable proximity sensing devices. Moreover, our findings suggest the mother is responsible for the large majority of the infant’s contact pattern, thus being the main potential source of infection for a transmissible disease. As the contribution to the infants’ contact pattern by other family members is very variable, vaccination against pertussis during pregnancy is probably the best strategy to protect young, unvaccinated infants.
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Affiliation(s)
- Laura Ozella
- Data Science Laboratory, ISI Foundation, Turin, Italy
- * E-mail:
| | - Francesco Gesualdo
- Innovation and Clinical Pathways Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | | | - Caterina Rizzo
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Pandolfi
- Innovation and Clinical Pathways Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Ilaria Campagna
- Innovation and Clinical Pathways Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Alberto Eugenio Tozzi
- Innovation and Clinical Pathways Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Ciro Cattuto
- Data Science Laboratory, ISI Foundation, Turin, Italy
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Probable transmission routes of the influenza virus in a nosocomial outbreak. Epidemiol Infect 2018; 146:1114-1122. [DOI: 10.1017/s0950268818001012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AbstractInfluenza is a long-standing public health concern, but its transmission remains poorly understood. To have a better knowledge of influenza transmission, we carried out a detailed modelling investigation in a nosocomial influenza outbreak in Hong Kong. We identified three hypothesised transmission modes between index patient and other inpatients based on the long-range airborne and fomite routes. We considered three kinds of healthcare workers’ routine round pathways in 1140 scenarios with various values of important parameters. In each scenario, we used a multi-agent modelling framework to estimate the infection risk for each hypothesis and conducted least-squares fitting to evaluate the hypotheses by comparing the distribution of the infection risk with that of the attack rates. Amongst the hypotheses tested in the 1140 scenarios, the prediction of modes involving the long-range airborne route fit better with the attack rates, and that of the two-route transmission mode had the best fit, with the long-range airborne route contributing about 94% and the fomite route contributing 6% to the infections. Under the assumed conditions, the influenza virus was likely to have spread via a combined long-range airborne and fomite routes, with the former predominant and the latter negligible.
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Liu J, Jiang H, Zhang H, Guo C, Wang L, Yang J, Nie S. Use of social network analysis and global sensitivity and uncertainty analyses to better understand an influenza outbreak. Oncotarget 2018; 8:43417-43426. [PMID: 28177887 PMCID: PMC5522157 DOI: 10.18632/oncotarget.15076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/11/2017] [Indexed: 11/25/2022] Open
Abstract
In the summer of 2014, an influenza A(H3N2) outbreak occurred in Yichang city, Hubei province, China. A retrospective study was conducted to collect and interpret hospital and epidemiological data on it using social network analysis and global sensitivity and uncertainty analyses. Results for degree (χ2=17.6619, P<0.0001) and betweenness(χ2=21.4186, P<0.0001) centrality suggested that the selection of sampling objects were different between traditional epidemiological methods and newer statistical approaches. Clique and network diagrams demonstrated that the outbreak actually consisted of two independent transmission networks. Sensitivity analysis showed that the contact coefficient (k) was the most important factor in the dynamic model. Using uncertainty analysis, we were able to better understand the properties and variations over space and time on the outbreak. We concluded that use of newer approaches were significantly more efficient for managing and controlling infectious diseases outbreaks, as well as saving time and public health resources, and could be widely applied on similar local outbreaks.
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Affiliation(s)
- Jianhua Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Department of Infectious Diseases, Center for Disease Control and Prevention, Yichang City, Hubei, China
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Hao Zhang
- Department of Infectious Diseases, Center for Disease Control and Prevention, Yichang City, Hubei, China
| | - Chun Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Department of Infectious Diseases, Center for Disease Control and Prevention, Yichang City, Hubei, China
| | - Jing Yang
- Department of Infectious Diseases, Center for Disease Control and Prevention, Yichang City, Hubei, China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Measuring dynamic social contacts in a rehabilitation hospital: effect of wards, patient and staff characteristics. Sci Rep 2018; 8:1686. [PMID: 29374222 PMCID: PMC5786108 DOI: 10.1038/s41598-018-20008-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 01/10/2018] [Indexed: 11/21/2022] Open
Abstract
Understanding transmission routes of hospital-acquired infections (HAI) is key to improve their control. In this context, describing and analyzing dynamic inter-individual contact patterns in hospitals is essential. In this study, we used wearable sensors to detect Close Proximity Interactions (CPIs) among patients and hospital staff in a 200-bed long-term care facility over 4 months. First, the dynamic CPI data was described in terms of contact frequency and duration per individual status or activity and per ward. Second, we investigated the individual factors associated with high contact frequency or duration using generalized linear mixed-effect models to account for inter-ward heterogeneity. Hospital porters and physicians had the highest daily number of distinct contacts, making them more likely to disseminate HAI among individuals. Conversely, contact duration was highest between patients, with potential implications in terms of HAI acquisition risk. Contact patterns differed among hospital wards, reflecting varying care patterns depending on reason for hospitalization, with more frequent contacts in neurologic wards and fewer, longer contacts in geriatric wards. This study is the first to report proximity-sensing data informing on inter-individual contacts in long-term care settings. Our results should help better understand HAI spread, parameterize future mathematical models, and propose efficient control strategies.
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Abstract
PURPOSE OF REVIEW The prevalence and incidence of viral nosocomial influenza infections in healthcare settings are underestimated. Nosocomial influenza outbreaks are frequent, and control remains challenging in acute care and long-term healthcare settings. This review examines recent publications on the determinants of nosocomial influenza prevention and control. RECENT FINDINGS Nosocomial influenza outbreaks occur in various healthcare settings, especially among the frail and elderly. The correct diagnosis is commonly missed because a substantial proportion of asymptomatic cases can transmit infections. Rapid diagnosis will facilitate rapid identification of cases and the implementation of control measures but needs confirmation in some circumstances, such as the description of transmission chains. Links between patients and healthcare personnel (HCP) have been well explored by phylogenetic virus characterization and need additional refinement and study. The preventive role of HCP vaccination in influenza incidence among patients should be investigated further in various settings to take into account different strategies for vaccination (i.e. voluntary or mandatory vaccination policies). Indeed, in Europe, influenza vaccination remains modest, whereas in North America hospitals and some states and provinces are now mandating influenza vaccination among HCP. The variability of vaccine effectiveness by seasonal epidemics is also an important consideration for control strategies. SUMMARY When influenza cases occur in the community, the risk of transmission and nosocomial cases increase in healthcare settings requiring vigilance among staff. Surveillance and early warning systems should be encouraged. Outbreak control needs appropriate identification of cases and transmission chains, and rapid implementation of control measures. Vaccination policies in conjunction with appropriate infection control measures could reduce virus spreading in hospitals. HCP vaccination coverage must be improved.
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Yoo JH. Principle and perspective of healthcare-associated infection control. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.1.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jin-Hong Yoo
- Division of Infectious Diseases, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
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Preventing Respiratory Viral Transmission in Long-Term Care: Knowledge, Attitudes, and Practices of Healthcare Personnel. Infect Control Hosp Epidemiol 2017; 38:1449-1456. [DOI: 10.1017/ice.2017.232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVETo examine knowledge and attitudes about influenza vaccination and infection prevention practices among healthcare personnel (HCP) in a long-term-care (LTC) setting.DESIGNKnowledge, attitudes, and practices (KAP) survey.SETTINGAn LTC facility in St Louis, Missouri.PARTICIPANTSAll HCP working at the LTC facility were eligible to participate, regardless of department or position. Of 170 full- and part-time HCP working at the facility, 73 completed the survey, a 42.9% response rate.RESULTSMost HCP agreed that respiratory viral infections were serious and that hand hygiene and face mask use were protective. However, only 46% could describe the correct transmission-based precautions for an influenza patient. Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary for HCP with more direct patient contact versus less patient contact. Furthermore, 42% of respondents reported working while sick, and 56% reported that their coworkers did. In addition, 54% reported that facility policies made staying home while ill difficult. Some respondents expressed concerns about the safety (22%) and effectiveness (27%) of the influenza vaccine, and 28% of respondents stated that they would not get the influenza vaccine if it was not required.CONCLUSIONSThis survey of staff in an LTC facility identified several areas for policy improvement, particularly sick leave, as well as potential targets for interventions to improve infection prevention knowledge and to address HCP concerns about influenza vaccination to improve HCP vaccination rates in LTCs.Infect Control Hosp Epidemiol 2017;38:1449–1456
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Lansbury LE, Brown CS, Nguyen‐Van‐Tam JS. Influenza in long-term care facilities. Influenza Other Respir Viruses 2017; 11:356-366. [PMID: 28691237 PMCID: PMC5596516 DOI: 10.1111/irv.12464] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 01/13/2023] Open
Abstract
Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence.
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Affiliation(s)
- Louise E. Lansbury
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
| | - Caroline S. Brown
- Influenza & Other Respiratory Pathogens ProgrammeDivision of Communicable Diseases and Health SecurityWHO Regional Office for EuropeUN CityCopenhagenDenmark
| | - Jonathan S. Nguyen‐Van‐Tam
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
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Estimating the epidemic risk using non-uniformly sampled contact data. Sci Rep 2017; 7:9975. [PMID: 28855718 PMCID: PMC5577035 DOI: 10.1038/s41598-017-10340-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/08/2017] [Indexed: 11/09/2022] Open
Abstract
Many datasets describing contacts in a population suffer from incompleteness due to population sampling and underreporting of contacts. Data-driven simulations of spreading processes using such incomplete data lead to an underestimation of the epidemic risk, and it is therefore important to devise methods to correct this bias. We focus here on a non-uniform sampling of the contacts between individuals, aimed at mimicking the results of diaries or surveys, and consider as case studies two datasets collected in different contexts. We show that using surrogate data built using a method developed in the case of uniform population sampling yields an improvement with respect to the use of the sampled data but is strongly limited by the underestimation of the link density in the sampled network. We put forward a second method to build surrogate data that assumes knowledge of the density of links within one of the groups forming the population. We show that it gives very good results when the population is strongly structured, and discuss its limitations in the case of a population with a weaker group structure. These limitations highlight the interest of measurements using wearable sensors able to yield accurate information on the structure and durations of contacts.
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Contacts between health care workers and patients in a short-stay geriatric unit during the peak of a seasonal influenza epidemic compared with a nonepidemic period. Am J Infect Control 2016; 44:905-9. [PMID: 27040566 DOI: 10.1016/j.ajic.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patterns of contacts between health care workers and patients during seasonal epidemics are unknown. Our study objective was to compare the number and duration of contacts between health care workers and patients during a nonepidemic period versus a community influenza epidemic, and to identify supercontactors. METHODS Our observational study was conducted in a short-stay geriatric unit of a university hospital. Contacts between individuals were recorded by active radio frequency identification devices. Contact patterns were compared between 2 periods according to contact number and duration. Each care period lasted 5 days in the nonepidemic and influenza epidemic periods. RESULTS The study included 21 medical doctors, 43 nurses, and 56 patients. In total, 3,200 contacts (61.4%; 152,700 seconds) were recorded during the nonepidemic period, with 2,013 contacts (38.6%; 92,740 seconds) in the epidemic period (P = .007). More cumulative contacts occurred during the nonepidemic period between nurses and patients (n = 2,638 [82%] vs n = 1,599 [79%]), but not between patients (n = 56 [18%] vs n = 414 [21%]). Contact duration between nurses and patients lasted longer during the nonepidemic period (P = .04). During the epidemic period, 6 nurses (15%) considered to be supercontactors accounted for 44.3% of the total number of contacts with patients. CONCLUSION The pattern of contacts between individuals differed according to the presence or not of the community influenza peak that might have influenced the risk of nosocomial influenza.
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Smieszek T, Castell S, Barrat A, Cattuto C, White PJ, Krause G. Contact diaries versus wearable proximity sensors in measuring contact patterns at a conference: method comparison and participants' attitudes. BMC Infect Dis 2016. [PMID: 27449511 DOI: 10.1186/s12879-016-1676-y/figures/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Studies measuring contact networks have helped to improve our understanding of infectious disease transmission. However, several methodological issues are still unresolved, such as which method of contact measurement is the most valid. Further, complete network analysis requires data from most, ideally all, members of a network and, to achieve this, acceptance of the measurement method. We aimed at investigating measurement error by comparing two methods of contact measurement - paper diaries vs. wearable proximity sensors - that were applied concurrently to the same population, and we measured acceptability. METHODS We investigated the contact network of one day of an epidemiology conference in September 2014. Seventy-six participants wore proximity sensors throughout the day while concurrently recording their contacts with other study participants in a paper-diary; they also reported on method acceptability. RESULTS There were 329 contact reports in the paper diaries, corresponding to 199 contacts, of which 130 were noted by both parties. The sensors recorded 316 contacts, which would have resulted in 632 contact reports if there had been perfect concordance in recording. We estimated the probabilities that a contact was reported in a diary as: P = 72 % for <5 min contact duration (significantly lower than the following, p < 0.05), P = 86 % for 5-15 min, P = 89 % for 15-60 min, and P = 94 % for >60 min. The sets of sensor-measured and self-reported contacts had a large intersection, but neither was a subset of the other. Participants' aggregated contact duration was mostly substantially longer in the diary data than in the sensor data. Twenty percent of respondents (>1 reported contact) stated that filling in the diary was too much work, 25 % of respondents reported difficulties in remembering contacts, and 93 % were comfortable having their conference contacts measured by sensors. CONCLUSION Reporting and recording were not complete; reporting was particularly incomplete for contacts <5 min. The types of contact that both methods are capable of detecting are partly different. Participants appear to have overestimated the duration of their contacts. Conducting a study with diaries or wearable sensors was acceptable to and mostly easily done by participants. Both methods can be applied meaningfully if their specific limitations are considered and incompleteness is accounted for.
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Affiliation(s)
- Timo Smieszek
- NIHR Health Protection Research Unit in Modelling Methodology and MRC Outbreak Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz-Centre for Infection Research, Braunschweig, Germany.
| | - Alain Barrat
- Aix Marseille Université, Université de Toulon, CNRS, CPT, UMR 7332, Marseille, 13288, France
- Data Science Laboratory, ISI Foundation, Torino, Italy
| | - Ciro Cattuto
- Data Science Laboratory, ISI Foundation, Torino, Italy
| | - Peter J White
- NIHR Health Protection Research Unit in Modelling Methodology and MRC Outbreak Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Gérard Krause
- Department for Epidemiology, Helmholtz-Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
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Smieszek T, Castell S, Barrat A, Cattuto C, White PJ, Krause G. Contact diaries versus wearable proximity sensors in measuring contact patterns at a conference: method comparison and participants' attitudes. BMC Infect Dis 2016; 16:341. [PMID: 27449511 PMCID: PMC4957345 DOI: 10.1186/s12879-016-1676-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 06/10/2016] [Indexed: 11/27/2022] Open
Abstract
Background Studies measuring contact networks have helped to improve our understanding of infectious disease transmission. However, several methodological issues are still unresolved, such as which method of contact measurement is the most valid. Further, complete network analysis requires data from most, ideally all, members of a network and, to achieve this, acceptance of the measurement method. We aimed at investigating measurement error by comparing two methods of contact measurement – paper diaries vs. wearable proximity sensors – that were applied concurrently to the same population, and we measured acceptability. Methods We investigated the contact network of one day of an epidemiology conference in September 2014. Seventy-six participants wore proximity sensors throughout the day while concurrently recording their contacts with other study participants in a paper-diary; they also reported on method acceptability. Results There were 329 contact reports in the paper diaries, corresponding to 199 contacts, of which 130 were noted by both parties. The sensors recorded 316 contacts, which would have resulted in 632 contact reports if there had been perfect concordance in recording. We estimated the probabilities that a contact was reported in a diary as: P = 72 % for <5 min contact duration (significantly lower than the following, p < 0.05), P = 86 % for 5-15 min, P = 89 % for 15-60 min, and P = 94 % for >60 min. The sets of sensor-measured and self-reported contacts had a large intersection, but neither was a subset of the other. Participants’ aggregated contact duration was mostly substantially longer in the diary data than in the sensor data. Twenty percent of respondents (>1 reported contact) stated that filling in the diary was too much work, 25 % of respondents reported difficulties in remembering contacts, and 93 % were comfortable having their conference contacts measured by sensors. Conclusion Reporting and recording were not complete; reporting was particularly incomplete for contacts <5 min. The types of contact that both methods are capable of detecting are partly different. Participants appear to have overestimated the duration of their contacts. Conducting a study with diaries or wearable sensors was acceptable to and mostly easily done by participants. Both methods can be applied meaningfully if their specific limitations are considered and incompleteness is accounted for. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1676-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Timo Smieszek
- NIHR Health Protection Research Unit in Modelling Methodology and MRC Outbreak Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz-Centre for Infection Research, Braunschweig, Germany.
| | - Alain Barrat
- Aix Marseille Université, Université de Toulon, CNRS, CPT, UMR 7332, Marseille, 13288, France.,Data Science Laboratory, ISI Foundation, Torino, Italy
| | - Ciro Cattuto
- Data Science Laboratory, ISI Foundation, Torino, Italy
| | - Peter J White
- NIHR Health Protection Research Unit in Modelling Methodology and MRC Outbreak Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Gérard Krause
- Department for Epidemiology, Helmholtz-Centre for Infection Research, Braunschweig, Germany.,Hannover Medical School, Hannover, Germany
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Hagel S, Ludewig K, Moeser A, Baier M, Löffler B, Schleenvoigt B, Forstner C, Pletz MW. Characteristics and management of patients with influenza in a German hospital during the 2014/2015 influenza season. Infection 2016; 44:667-72. [PMID: 27380386 DOI: 10.1007/s15010-016-0920-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
Abstract
The objective of this study was to review the management of patients with influenza during the influenza season 2014/2015 (n = 197). Our study revealed a high rate of healthcare-associated influenza infection (35.5 %) and a correlation between the total number of patients with HA influenza and the number of nurses on sick leave. The results of the study underline the importance of strict hygiene management. Furthermore, widespread influenza vaccination for both high-risk patients and health care workers is recommended.
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Affiliation(s)
- Stefan Hagel
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany. .,Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany.
| | - Katrin Ludewig
- Clinic of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany
| | - Anne Moeser
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany.,Clinic of Medicine, Division of Pneumology and Allergology, University Hospital of Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Michael Baier
- Institute of Medical Microbiology, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany
| | - Benjamin Schleenvoigt
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany
| | - Christina Forstner
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany.,Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Mathias W Pletz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany
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