November/December 2021 · Volume 12, Issue 88

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

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• New Team Members
• Tuberculosis Program Updates
• 2021-2022 Influenza Season
• Measles Outbreak
• Norovirus Season
• NHSN Updates
• Training & Education
  • Virginia Infection Prevention Training Center (VIPTC) 
  • Project Firstline Facilitator Toolkit 
  • NACCHO-Project Firstline Report on Local Health Districts
  • Regional Containment Webinar Series led by CDC: C. auris & CPO Colonization Screening 101
  • Antibiotics Awareness Week Webinar
• Research
  • Protecting Nursing Home Residents from COVID-19: Federal Strike Team Findings and Lessons
  • Federal Action Needed to Address Antibiotic Resistance in Older Americans
• Save the Dates
  • One Health Day
  • Antibiotic Awareness Week
  • National Influenza Vaccination Week

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News in Virginia

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Welcome New Team Members! We would like to welcome and introduce VDH Regional Infection Preventionists (IPs) Scott Baumgartner, BSN, RN, OCN  and Rashidat Odeyale, BSN, RN, who will be positioned in the Northern Region of Virginia to provide infection prevention and control consultation in healthcare and congregate settings. We would also like to welcome our new Regional Infection Prevention Coordinator, Andrea Chapman, MPH, CHOP, CIC.  We are thankful to have such amazing talent join our HAI/AR Program! 

VDH Tuberculosis (TB) Program Updates. On August 31, CDC updated their Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States regarding the timing of TB testing. 

• COVID-19 vaccination should not be delayed because of testing for tuberculosis (TB) infection. Testing for TB infection with one of the immune-based methods, either the tuberculin skin test (TST) or an interferon release assay (IGRA), can be done before, after, or during the same encounter as COVID-19 vaccination.
• TSTs and IGRAs were previously recommended to be administered > 4 weeks after completion of COVID-19 vaccination to minimize potential theoretical interference between vaccination and TB testing. This was out of an abundance of caution during a period when these vaccines were new. However, given logistical challenges faced in delaying TB infection testing, the recommendation has been updated so that these tests may now be administered without regard to timing of COVID-19 vaccination.

Tuberculosis has been added to the list of underlying conditions for CDC’s COVID-19 Vaccines for People with Underlying Medical Conditions.

2021-2022 Influenza Season. We are still fighting a pandemic, but the 2021-22 flu season is here! It is critical this year to get your flu vaccine; it’s never too late to vaccinate!

There is a large amount of uncertainty regarding how this year’s flu season will look, as we do not have sufficient data from last year’s season to make predictions for the coming year. Before the 2020-21 flu season, we generally observed one peak of Influenza A or B or a combination of both. Throughout 2020-21 we saw little to no activity during flu season (usually October-May). However, increased activity was observed during the off-season. 

Seasonal influenza surveillance data from the Southern Hemisphere showed a mild flu season, and influenza activity remains lower than expected for this time of year for a number of countries. Data from the Southern Hemisphere are critical for understanding how the flu season will look in the Northern Hemisphere. As a result, there is more uncertainty regarding the current flu season. Mitigation measures that were adopted due to concerns of spreading COVID-19, such as hand washing, social distancing, and mask wearing, may have helped reduce the spread of flu as well as other respiratory pathogens last flu season. How well these measures are followed this year may have an impact on how much activity we see during this flu season. 

VDH will continue to publish the Weekly Influenza Report every Thursday based on the previous week’s data and will keep evaluating other reports that may be helpful in measuring effects of currently circulating respiratory pathogens in Virginia. Visit the VDH Influenza website for weekly influenza updates. 

Follow these steps to prevent the spread of flu:

1. Get vaccinated
2. Practice good hand hygiene, respiratory etiquette, and stay home if you are feeling sick
3. Take antivirals as prescribed

Measles Outbreak. VDH is working closely with local, state, and federal partners to respond to a measles outbreak among persons recently arriving from Afghanistan.  No community transmission has been identified at this time in Virginia.  Because measles is so contagious, it is likely that healthcare providers will find more cases; it is required to report measles cases to VDH.  Visit the measles web page to learn more about the current outbreak.

Norovirus Season. In Virginia, VDH is observing an increase in the number of patients with nausea, vomiting and diarrhea due to norovirus.  

• 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 and 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 required to report suspected and confirmed outbreaks of norovirus to your local VDH health district.
• During the last Norovirus Season (August 1, 2020- July 31, 2021) 48 norovirus or norovirus-like outbreaks were reported in Virginia, compared to 103 norovirus or norovirus-like outbreaks reported during the previous season (August 1, 2019- July 31, 2020). The majority of these outbreaks were spread through person-to-person transmission, and occurred in long-term care facilities. So far this season, 14 norovirus outbreaks have been reported in Virginia.
• Norovirus Resources: Norovirus Infection Fact Sheet, Key Infection Control Recommendations for the Control of Norovirus Outbreaks in Healthcare Settings, Norovirus in Healthcare Facilities Fact Sheet 

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Protecting Nursing Home Residents from COVID-19: Federal Strike Team Findings and Lessons Learned. A commentary from the June 2021 issue of the New England Journal of Medicine Catalyst focused on COVID-19’s toll in nursing homes by highlighting major shortcomings in how these facilities handle infection prevention and control. A federal strike team identified key challenges and promising practices to improve safety for residents and staff.  

Federal Action Needed to Address Antibiotic Resistance in Older Americans. According to the most recent antibiotic resistance report from the CDC, in 2017, six common antibiotic-resistant pathogens caused an estimated 30,000 deaths in the U.S. and resulted in $4.6 billion in health care costs. New research published by The Pew Charitable Trusts, University of Utah, and Infectious Diseases Society of America revealed that over one-third of those deaths and costs came from the Medicare-aged population (65 years and older)—a disproportionate figure given that Americans 65 and older made up 15% of the U.S. population that year.  Check out the full article for more data and a review of potential actions to combat antibiotic resistance. 

One Health Day: November 3, 2021. The COVID-19 pandemic is an example of a disease emerging as a result of close contact between animals and people.  One Health recognizes the close connection between the health of people, animals, and the environment and the role this connection plays in the emergence of new diseases.  A One Health approach can help address many kinds of public health threats, including zoonotic diseases, antibiotic resistance, vector-borne diseases, food safety and security, chronic disease, mental health, and more.  Celebrate One Health Day and learn more on the CDC One Health web page. 

 

Antibiotic Awareness Week: November 18-24, 2021. CDC is urging healthcare professionals to prescribe antibiotics only when necessary to help fight antibiotic resistance and to protect their patients from antibiotic-related adverse drug events. The Be Antibiotics Aware initiative provides resources to help improve antibiotic prescribing among healthcare professionals and use among consumers. Click here to view brief educational efforts you can use as healthcare professionals! 

 

National Influenza Vaccination Week: December 5-11, 2021. National Influenza Vaccination Week is a call to all Americans 6 months and older to get their annual flu vaccine if they have not already. Since COVID-19 and flu could spread simultaneously this winter, this week will serve to remind people that there is still time to get a flu vaccine to protect against flu illness and serious flu complications, such as worsening of chronic conditions or pneumonia. Check the CDC National Influenza Vaccination Week web page for more information and resources. To find a vaccination center near you click here.