Prevention of respiratory outbreaks in the rehabilitation setting

Corpus, Carla; Williams, Victoria; Salt, Natasha; Agnihotri, Tanya; Morgan, Wendy; Robinson, Lawrence; Maze Dit Mieusement, Lorraine; Cobbam, Sonja; Leis, Jerome A

The RV season was defined as 1 October to 30 April during baseline (2016/2017), intervention (2017/2018) and postintervention (2018/2019) seasons. Patients with respiratory symptoms were prospectively identified through active surveillance based on unit reporting and tracking of laboratory specimens. Mid-turbinate (MT) swabs were collected from all patients with new or worsening onset of one or more respiratory symptom (rhinorrhoea, cough, sore throat, wheeze or dyspnoea). A case was considered nosocomial if symptoms developed >72 hours after admission. A RV outbreak was defined as two nosocomial cases (non-roommates) in a designated unit with symptom onset within 48 hours and a lab-confirmed respiratory virus detected in a least one case. In the absence of laboratory confirmation of a respiratory virus, three nosocomial cases (non-roommates) within 48 hours in one unit was considered a RV outbreak. 7 RV outbreaks were declared over on day 8 following the onset of the last nosocomial RV case, in accordance with local public health guidelines. 7 Any unit where a RV outbreak was declared was immediately closed to new admissions. Accordingly, the census on the unit decreased throughout each outbreak as patients were discharged without new patient admissions. Reducing the number of bed-closure days due to outbreak was thus chosen as the primary aim of this study because it reflected the impact of these outbreaks on our facility's ability to fulfil its mission of providing inpatient rehabilitation.