HAI High Sign Newsletter JAN/FEB 2021

HAI High Sign Newsletter Header

January/February 2021 · Volume 12, Issue 83

Antimicrobial Resistance (AR)   Healthcare-Associated Infection (HAI)
Virginia Department of Health (VDH)     United States (US)
Centers for Disease Control & Prevention (CDC)

In this Newsletter:

News in Virginia

Welcome New Team Members! We would like to welcome and introduce VDH Infection Prevention Coordinators Lisa Sollot, MPH and Sandra Sebestin, BS, MT, CIC, and Regional Infection Preventionists (IPs) Betsy Allbee, RN, BSN, CIC, FAPIC, Melisa Hobbs, RN, BSN, CIC, Kirsten Simpkins, BSN, MPH, CIC, and Stuart Hutter, MS, MPH.  The regional IPs will be positioned across Virginia to provide infection prevention and control consultation in healthcare and congregate settings.  We're thankful to have such amazing talent join our HAI/AR Program! Additional hiring is ongoing, and regional IPs will be announced as they are onboarded (see additional information below).

Project Firstline Banner
Dear Frontline Healthcare Workers,
Infection prevention and control is a team effort and we need your help!
The Centers for Disease Control and Prevention (CDC) and the Virginia Department of Health (VDH) are collaborating on Project Firstline, an initiative aimed at providing innovative and effective infection prevention and control training for all frontline healthcare workers. 
VDH is asking all frontline healthcare workers to participate in a 10 minute survey designed to inform future CDC training materials and guide VDH training sessions. 
Please visit the VDH Project Firstline website for a full list of frontline worker types, including, but not limited to:
  • Non-clinical support staff & environmental services
  • Behavioral & mental health professionals & social services
  • Clinical professionals
  • Healthcare administrators
  • Laboratorians
  • Pharmacists
  • Public health personnel

Your valuable input will help shape Project Firstline!  If you have any questions, please reach out to the VDH Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Program at hai@vdh.virginia.gov.
Go to the Survey!

Please Share this Survey with all Frontline Healthcare Workers

Update: VDH Outbreak Dashboard. HB 5048, signed by Governor Northam on October 21, 2020, requires VDH to share a public-facing dashboard of COVID-19 outbreaks reported to our agency. Long-term care facilities (LTCFs) are part of this legislation and these outbreaks have already been shared publicly. A new dashboard has been created to include data from LTCFs in addition to other facilities. This dashboard was posted on the COVID-19 Data Insights page on Friday, December 18, 2020 and contains the same information that was presented in the previous LTC Outbreak Dashboard. The dashboard is updated once a week so that the data can stabilize and appropriate communications can occur before information is publicly posted. If you notice an error, please contact your local health department. Information will be corrected on the next weekly dashboard update.

2020-21 Flu Season Update. In entering what would normally be peak flu season, influenza activity remains low in all regions of Virginia. Emergency department and urgent care visits for influenza-like illness (ILI) have generally remained below 2% for all regions. Flu activity also remains low nationwide. During the week of December 12, 2020, ILI accounted for 1.6% of medical visits in the U.S. Flu activity updates for the Commonwealth can be found in the VDH Weekly Influenza Activity Report, located here, or on the VDH Epidemiology webpage. Nationwide weekly flu updates can be found at the CDC FluView page, located here.
As the COVID-19 pandemic continues to impact Virginia, VDH recognizes the importance of transparency and dissemination of information regarding both flu and COVID-19 surveillance. In order to answer inquiries related to surveillance and what the data tells about the current flu season, VDH has published a post in the COVID-19 blog, “COVID-19 and Influenza Surveillance.” The link to the blog post can be found here.
As a reminder, the flu season isn’t over! It is not too late to get a flu vaccine if you have not already done so. 
Atypical Norovirus Season. An increase in the number of patients with nausea, vomiting and diarrhea due to norovirus would typically be observed by this time of year. However, like much of this year, norovirus season has not been like previous seasons. 
Noroviruses are found in the feces and vomit of infected people and are highly contagious. Mitigation measures such as cleaning and disinfection and hand washing after using the bathroom, between seeing patients and prior to preparing or serving foods/medications prevents transmission via person to person or contaminated surfaces.
Norovirus infections are usually diagnosed based on symptoms but during an outbreak, the state public health laboratory will test stool specimens to identify the virus and confirm the outbreak. Although individual cases of norovirus infection are not reportable to VDH, it is important to report suspected and confirmed outbreaks of norovirus to your local VDH health district.
During the last Norovirus Season (August 1, 2019- July 31, 2020) 103 norovirus or norovirus-like outbreaks were reported in Virginia. The majority of these outbreaks were spread through person to person transmission, and occurred in long-term care facilities. So far this season, there have been 4 norovirus outbreaks reported in Virginia.
Norovirus Resources: Norovirus Infection Fact SheetKey Infection Control Recommendations for the Control of Norovirus Outbreaks in Healthcare SettingsNorovirus in Healthcare Facilities Fact Sheet

Hiring Continues to Bolster Infection Prevention Resources in Virginia. The VDH Division of Clinical Epidemiology continues to seek Regional Infection Preventionists that will be positioned across Virginia to provide infection prevention and control consultation for healthcare-associated infections both proactively and in response to outbreaks in hospitals, long-term care facilities, and other healthcare and congregate settings. These positions will support implementation of numerous patient safety initiatives for COVID-19 and other emerging pathogens by performing on site infection prevention and control assessments, providing health education to public health staff, and serving as experts in infection control issues. Positions are being advertised through Indeed, Emory University, and the Virginia Chapter of the Association for Professionals in Infection Control and Epidemiology (APIC). These are contract positions with 22 months of funding. To apply send your cover letter and/or resume to lindsey.lambert@vdh.virginia.gov.

HAI/AR Narrow Microbe Banner

Interim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities. CDC recently published updated interim recommendations for outpatient hemodialysis settings. Patients who undergo dialysis are at increased risk for healthcare-associated infections. These patients are also more likely to experience severe consequences of an infection, given their weakened immune systems. It is critical that providers who care for dialysis patients understand this risk and the need for enacting appropriate prevention strategies. CDC has infection prevention tools, clinician educational materials, and guidelines specific to the treatment and care of dialysis patients.

Training & Education
  • SHEA Prevention Course in HAI Knowledge and Control. The Society of Healthcare Epidemiology of America (SHEA) is offering a Prevention Course in Healthcare-Associated Infection Knowledge and Control. The course is designed to train frontline healthcare personnel (those “responsible for direct patient care”) in best practices to prevent and control HAIs and pathogens that can spread in the healthcare setting. The training will educate frontline personnel to successfully execute best practices in topics that include:
    • Prevention of CLABSI, CAUTI, SSI, VAP/VAE
    • Prevention of C. difficile and MRSA
    • Prevention strategies:
      • Methods for appropriate performance and timing of hand hygiene in the healthcare setting
      • Disinfection and environmental controls

One Health
One Health & Antimicrobial Resistance. Did you know that One Health issues span many topics such as, antimicrobial resistance, zoonotic diseases, food safety/security, vector-borne diseases, and environmental contamination? Health threats shared by people, animals, and the environment benefit from a One Health approach involving communication, coordination and collaboration across disciplines and sectors. 
According to the CDC, each year in the U.S., at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die.  It is essential to recognize our place in combatting antimicrobial resistance within the global context and across people, animals and the environment. Check out One Health—Its Importance in Helping to Better Control Antimicrobial Resistance to learn more about One Health considerations and strategies.   

  • Reminder: Nursing Homes Should Confer Rights to VDH in NHSN. Per the Code of Virginia (§32.1-35.1), data required to be reported to NHSN to meet CMS requirements should be shared with VDH through the NHSN system. In order for VDH to view data from nursing homes reporting in NHSN, VDH is requesting that each facility join the VDH NHSN group. You can find instructions on how to do that here. Licensed but not certified nursing homes are not required to report data to CMS, but they may report to NHSN and are encouraged to confer rights to VDH. Please refer to the June 5 memo for additional information. 
    As of December 28, 61 certified nursing homes still need to confer rights to VDH in NHSN. Facilities can email HAI@vdh.virginia.gov for assistance.


  • CDC 2019 HAI Progress Report. The CDC 2019 HAI Progress Report was published December, 2020 and highlights important improvements in national CLABSI, CAUTI, and C. difficile rates.

Research Corner
  • Antimicrobial Stewardship. A national survey found that physicians view antimicrobial resistance as an abstract problem with little that they can personally do to combat it. Though a majority of physicians view antimicrobial resistance as an imminent threat, less than 40% believe that their own prescribing practices contribute to it. Additionally, most physicians view antimicrobial stewardship programs as critical, but nearly half indicated that they needed substantial help in implementing these activities within their own practices. The CDC recently underscored the importance of implementing and maintaining stewardship activities during the COVID-19 pandemic. The HAI/AR team has several resources that can help acute care, outpatient, and long-term care providers establish antimicrobial stewardship programs.


  • Increase in Hospital-Acquired Carbapenem-Resistant Acinetobacter baumannii (CRAB) Infection and Colonization in an Acute Care Hospital During a Surge in COVID-19 Admissions— New Jersey, February–July 2020. Infection prevention and control (IPC) measures such as extended ventilator and catheter usage, personal protective equipment (PPE) conservation, less frequent patient bathing, and reduced CRAB screening tests  were employed in response to pandemic-related challenges.  These changes likely contributed to a CRAB cluster in a hospital. It is important that facilities managing surges of patients with COVID-19 remain vigilant regarding changes in practice that may increase vulnerability to outbreaks of multidrug-resistant organism (MDRO) infections.  Read more here


  • Disinfectant wipes transfer Clostridioides difficile spores from contaminated surfaces to uncontaminated surfaces during the disinfection process. In this study, cross contamination was observed on hard non-porous surfaces and spores were recovered from used disinfectant towelettes.  Cross-contamination may be affected by wipe material and the liquid load of disinfectant on the wipe. 

HAI/AR Narrow Microbe Banner

Save the Date for Upcoming Events & Recognition Weeks
  • January 2021 - One Health Awareness Month. Help raise awareness about One Health and take action to inspire more people to become One Health advocates and leaders!  Check out the the One Health Awareness Month Campaign materials. #OneHealth #OneHealthAwarenessMonth


  • January 2021 - National Blood Donor Month. The American Red Cross (ARC) has a critical need for blood. Encourage those around you to consider becoming a donor during National Blood Donor Month.  For more information or to find a blood drive near you, please visit the ARC website.


  • February 25, 2021 - Virginia Patient Safety Summit. The 2021 Summit will be a virtual event on Thursday, February 25, from 9:30AM - 2:30PM. In celebration of the 10th anniversary of this statewide event and in recognition of the tremendous and extraordinary efforts in response to the COVID-19 pandemic, there will be NO registration fee for the 2021 Summit! Advanced registration is required, however, in order to receive a participant link for the virtual event and to access the meeting content after the event. Register here.

We Want To Hear From You!
We would like to thank all facilities across Virginia for their continued efforts to reduce antimicrobial resistance.  We know there are programs across Virginia doing great work to reduce antimicrobial resistance and we want to hear about it! If you would like to have your facility spotlighted in a future edition of the HAI High Sign, please email hai@vdh.virginia.gov.