HAI High Sign Newsletter MAR/APRIL 2022

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March/April · Volume 13, Issue 90

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

In this Newsletter:

News in Virginia

New Team Members. The VDH HAI/AR Program would like to welcome Carolyn Kiefer, RN, BSN, CIC as the Southwest and Northwest Regional Infection Prevention Coordinator. 

VDH Regional IPs. Did you know that VDH has eight regional infection preventionists (IPs) throughout the Commonwealth who are available to provide consultation and education on infection prevention and control (IPC)? These experienced IPs are an excellent resource to healthcare facilities across the continuum of care as well as to health department teams. For example, regional IPs work with healthcare facilities during proactive IPC assessments to help facilities identify IPC strengths and areas for improvement. Facilities can request a proactive IPC assessment on the VDH HAI/AR website. Future issues of the HAI High Sign will spotlight the work and impact of our regional IPs!

NACCHO IPC Champions Series: NACCHO recently published the latest installation of their IPC Champion series featuring the Fairfax County Health Department. Read the full member spotlight for more.

VDH Tuberculosis (TB) Program. The VDH TB Program has updated the High Burden TB Countries List and MDR TB High Burden Countries List 

2021-2022 Influenza Season. While sporadic cases continue in Virginia and across the country, influenza activity is declining. However, this season has seen more activity than last; CDC estimates that so far this season there have been at least 2.3 million flu illnesses, 22,000 hospitalizations, and 1,300 deaths from flu. Flu activity is still being observed in long-term care facilities (LTCFs).  According to the CDC, in the week of February 12th, (MMWR Week 6), 57 (0.4%) of 14,248 reporting LTCFs reported at least one influenza positive test among their residents. The majority of influenza viruses detected so far have been A(H3N2), which are genetically closely related to the vaccine virus. However, there are some antigenic differences that have developed as H3N2 viruses continue to evolve. The best way to prevent flu infection is to get vaccinated. According to the CDC, vaccination rates this year are lower than last year; it is not too late to get your vaccine!

Coinfections with COVID and flu were relatively rare last flu season because of reduced flu activity. Despite the fact that flu activity has declined globally since it reached its peak at the end of 2021, the importance of coinfection cannot be overemphasized. Vaccination with both COVID-19 and flu vaccine can help reduce the severity of illness caused by COVID-19, flu, or a coinfection of both viruses. Testing should be considered for both influenza and SARS-CoV-2 viruses in patients with influenza-like illness (ILI).

Increased Norovirus Activity in Virginia. Have you seen an increasing number of patients with nausea, vomiting, and diarrhea lasting approximately 1-2 days? 

  • Noroviruses are highly contagious and are found in the feces and vomitus of infected people. These viruses can spread rapidly through congregate facilities (e.g., long-term care, daycare and school). Mitigation measures such as cleaning, disinfection, and hand washing for at least 20 seconds after using the bathroom, between seeing patients and before preparing or serving foods and medications prevents transmission via person-person or contaminated surfaces. Stay home from work or school if you are ill.
  • Norovirus infections are usually diagnosed based on symptoms. However, the state public health laboratory will test stool specimens to identify the virus and confirm a suspected 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.
  • In the last norovirus season (August 1, 2020 - July 31, 2021), 48 norovirus or norovirus-like outbreaks were reported in Virginia, whereas 103  were reported  during the previous season (August 1, 2019 - July 31, 2020). Most of these outbreaks were spread through person-person transmission and occurred in long-term care facilities. So far this season, there have been 36 norovirus outbreaks reported in Virginia, and over half were in long-term care and restaurant settings.
  • Norovirus Resources: Norovirus Infection Fact SheetKey Infection Control Recommendations for the Control of Norovirus Outbreaks in Healthcare SettingsNorovirus in Healthcare Facilities Fact Sheet 

COVID-19 Updates. 

  • CDC COVID-19 Guidance: Below is a list of healthcare IPC and other related guidance documents that have been recently published or updated by CDC. For additional updates, CDC’s What’s New & Updated tool is a helpful way to stay up-to-date with new and updated content on CDC’s COVID-19 webpages. Users can filter by date, webpage type, audience, and topic.
  • CDC Updated Clinical Considerations for COVID-19 Vaccination:  
    • For people who are moderately or severely immunocompromised: 
      • People who have completed a primary series of Pfizer-BioNTech or Moderna are recommended to receive an mRNA booster dose 3 months (previously 5 months) after completing the primary series
      • People who have received a single J&J vaccine should receive one additional dose of an mRNA (Pfizer-BioNTech or Moderna) vaccine and one booster dose (preferably mRNA) for a total of 3 vaccine doses
      • Clarification to confirm that those who have completed their primary series of 3 mRNA doses should then receive an mRNA booster dose (total of 4 doses)
    • Added considerations for an 8-week interval between the first and second doses of a primary mRNA vaccine schedule
  • New Monoclonal Antibody: Bebtelovimab
    • FDA granted emergency use authorization for bebtelovimab on February 11, 2022
    • Shown in lab testing that it has activity against: Omicron variant and BA.2 subvariant
    • Indicated for the treatment of patients with mild to moderate COVID-19 in adults and pediatric patients (12 years of age and older who weigh at least 40 kg): 
      • Who have a positive SARS-CoV-2 viral test and are at high-risk for progression to severe COVID-19, and who are not hospitalized
      • When alternative treatment options approved or authorized by FDA are not accessible or clinically appropriate
    • Administered as a single intravenous infusion and given as soon as possible after diagnosis and within 7 days of symptom onset
  • VDH Resources
    • Therapeutics
      • Updated VDH resource to outline steps to request immediate deployment of COVID-19 therapeutics for patients in congregate care settings (including long-term care facilities) in response to a COVID-19 outbreak
        • May include monoclonal antibody and/or oral antiviral treatment
    • Infection Prevention and Control
      • COVID-19 Long-Term Care Task Force page
        • Updated resources under Nursing Homes/Skilled Nursing Facilities and Guidance for all LTCFs (general infection prevention recommendations, outbreak response recommendations, PPE and cohorting guidance, and more)
      • Healthcare Professionals page
        • Resources on IPC best practices in emergency departments and an updated healthcare personnel risk assessment tool

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Reminder - HHS Point of Care (POC) Test Results Reporting Requirements. CMS-certified nursing homes may use NHSN or the VDH Portal to report COVID-19 POC test results. Facilities will only need to report to one system, as results from NHSN will be directly sent to state and local health departments. If facilities choose to report to NHSN, they must first upgrade their SAMS access to Level 3. Facilities should report individual COVID-19 POC test results (positive and negative) within 24 hours regardless of the system that is utilized. Information on reporting in NHSN, including POC Testing Reporting Tool FAQs, can be found on the NHSN LTCF website.

Training & Education

Project Firstline (PFL). The VDH PFL team is conducting multiple webinars in the upcoming weeks! 

  • Anyone can attend PFL training sessions to build their infection prevention and control (IPC) practice.  These basic training sessions can empower all staff including activities teams, environmental services, dietary services, aides, nurses, etc.  
  • If you are looking for easy to use training resources for your staff, check out PFL training sessions to gain comfort in using PFL materials in your own facility. 
  • Visit the VDH HAI/AR PFL web page for more information.
  • Join VDH and CDC’s Project Firstline for the third session in the Infection Prevention & Control and COVID-19 webinar series. Register for Gloves & Gowns webinar on March 10, 2022 from 1:00 - 2:00 PM.

                                                    PFL Webinar Series: Gloves&Gowns

  • It’s easy to use PFL materials to conduct your own training at your workplace!  Join us at the PFL Facilitator Guide Training Session to learn more. Details coming soon to the VDH PFL website
  • Join VDH HAI/AR Program for the PFL Watch Party Series.  Come participate in a livestream and discussion of PFL content. Details coming soon to the VDH PFL website.  

                          PFL Watch Part flyer

Virginia Infection Prevention Training Center (VIPTC). Looking to broaden your knowledge of infection prevention? Want to refine your infection prevention and control program? The Virginia Infection Prevention Training Center is pleased to announce a FREE virtual Intermediate Level Course in Infection Prevention.

VIPTC March Webinars

Intended for proficient or becoming-proficient infection preventionists, this course will cover:

  • Intermediate principles of infection prevention and control
  • The role of infection prevention in meeting best practice standards and regulatory requirements
  • The relationship between public health and healthcare across the continuum
  • How to develop, implement, and optimize a Champions of Infection Prevention program

This is a four-day virtual course featuring both local and nationally-recognized content experts. Days 1 & 2 will offer six 1-hour, pre-recorded modules for self-study. Days 3 & 4 will be live-streamed learning with breakout sessions from 7:45am – 4:45pm ET. Please visit our website for links to course description and agenda. Register now for the Intermediate Course in Infection Prevention

Thanks to funding from the Virginia Department of Health (VDH), this course is free. CE credits offered, click here for details.

VIPTC More information

Highlights from the CDC COVID-19 Updated Guidance for Healthcare Facilities Webinar: On February 23, the VDH HAI/AR team presented a webinar containing highlights from the CDC COVID-19 updated guidance for healthcare facilities. Webinar slides and recording are available on the VDH HAI/AR Education & Training page.

NACCHO’S LIVING LEARNING NETWORK: NACCHO is developing a new Living Learning Network (LLN) to support local health department staff looking to build subject matter expertise related to infection prevention and control (IPC) training and education for healthcare workers. Learn more about NACCHO’s LLN and sign up to participate.  

Research Corner
Future of HAI/AR Response in the Face of COVID-19: Dawn Terashita, Associate Director of the Acute Communicable Disease Control Program at the Los Angeles County Department of Public Health (LACDPH), and Zachary Rubin, Chief of Healthcare Outreach Unit at the LACDPH, discuss their experiences on the COVID-19 pandemic response and the future of HAI/AR outbreak response across the healthcare continuum. Click here to read the blog. 

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Awareness Events

March 13 - 19, 2022 - National Patient Safety Awareness Week: Patient Safety Awareness Week is an annual recognition event intended to encourage everyone to learn more about health care safety. During this week, the Institute for Healthcare Improvement seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce. Click here to learn more. 

March 24, 2022 - World Tuberculosis Day! #WorldTBDay is an opportunity to recognize our achievements in tuberculosis (TB) prevention and control and renew our commitment to eliminating this devastating disease in the United States. This year’s slogan is Invest to End TB. Save Lives.” 

                           World Health Day 2022

April 4 - 10, 2022 - National Public Health Week! “Public Health is Where You Are” is the 2022 NPHW theme. Where we live impacts our communities’ health. We can make our communities healthier, stronger and safer. For ways you can participate, check out the National Public Health page. #NPHW

                                                              National Public Health Week 2022

April 7, 2022 - World Health Day The World Health Day 2022 theme is “Our planet, our health”. On April 7, 2022, WHO will focus global attention on the interconnectedness between the planet and our health. To learn more check out the World Health Campaign page. 

April 30, 2022 - National Prescription Drug Take Back Day: The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications. To learn more check out the DEA page. 

                                                   Prescription Drug Take Back day

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.
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