September/October 2022 · Volume 13, Issue 93

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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 VDH HAI/AR Program Members
• Spotlight on Regional Infection Preventionists
• Influenza Updates
• Monkeypox Updates
• Candida auris Alerts in EDCC Platform
• COVID-19 Updates
• NHSN Updates
• Training & Education
  
  • Updates to Enhanced Barrier Precautions Implementation Guidance
  • Project Firstline 
  • Virginia Infection Prevention Training Center (VIPTC) 
  • APIC Virginia Educational Conference
  • Centers for Medicare & Medicaid Services Updates
• Research
  • Ensuring Widespread and Equitable Access to Treatments for COVID-19
• Awareness Events
  • Global Handwashing Day - October 15, 2022
  • International Infection Prevention Week - October 16-22, 2022
  • National Health Education Week - October 17-21, 2022

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News in Virginia

New VDH HAI/AR Program Members: We are excited to welcome Ryan Lohr, MPH as the HAI data analyst and Victoria Nichols, MPH as the assistant HAI data analyst. We would also like to welcome Debra Bennett as the HAI/AR contract monitor, Jessica Caggiano, MPH as the Long-Term Care Coordinator, and Marsha Kemp as a Central Regional Infection Preventionist.

Spotlight on Regional Infection Preventionists, Eastern Region: As part of a CDC grant, the VDH regional infection preventionists (IPs) are partnering with healthcare facilities such as nursing homes, dialysis centers, outpatient facilities, and long-term acute care hospitals (LTACHs) to conduct on-site visits. The purpose of the visit is to proactively assess, strengthen, and maintain infection prevention and control (IPC) infrastructure to support residents, patients, staff, and visitors of the healthcare facility. 

Recently, the Eastern Region IPs, Dana Chapman and Dee Winston, collaborated with several outpatient clinics, long-term care facilities, outpatient dialysis centers, and one of the largest LTACHs in the state to improve and sustain these facilities’ capacity to detect and respond to infectious diseases and emerging pathogens, including COVID-19. The Eastern Region IPs have continued to build strong partnerships with the local health departments, HQI, Quality Insights, and IPs from other agencies including the Department of Social Services to ensure the health and safety of the healthcare community. During a recent proactive IPC assessment, the facility IP expressed gratitude to have another set of eyes look over the facility and to learn that she can reach out any time she has questions. She was excited to hear that the Eastern Region IPs are available to assist her with fit-testing needs.

Interested in receiving free infection prevention expertise from the VDH IP team?  Request a free consultative visit on the VDH HAI/AR website.

Influenza Updates: 

• Flu Virus Found in Pigs Spreads to Humans: The CDC recently reported a total of five human infections with influenza (flu) A(H3N2)v, which is usually associated with exposure to infected pigs. All five infections were reported in people younger than 18 years who attended the same West Virginia agricultural fair in August 2022, where pigs tested positive for swine flu A(H3N2) virus.  None of the patients were hospitalized and all have recovered from their illness. Outside of the traditional influenza season, clinicians should ask patients with suspected influenza if they have any recent exposure to swine; check the CDC H3N2v for Clinicians webpage for more information. 
• Composition of the 2022–23 Influenza Vaccines: Seasonal flu vaccines are designed to protect against the flu viruses that research suggests will  most likely be circulating during the upcoming flu season. All U.S. flu vaccines are quadrivalent vaccines, meaning they protect against four different flu viruses: flu A(H1N1), flu A(H3N2), and two flu B viruses. Vaccine strains for the 2022–23 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee based on WHO’s recommended Northern Hemisphere 2022–23 influenza vaccine composition. 

Monkeypox Updates: 

• CDC Infection Prevention and Control of Monkeypox in Healthcare Settings (updated 8/11/2022)
• VDH key messages: 
  • Please continue to check the VDH monkeypox website for updates. Information for healthcare professionals (HCPs) is on the VDH monkeypox website for HCPs. Recently posted information includes:
    • VDH Monkeypox Information Sheet for Healthcare Providers (8/22/2022)
    • VDH Tool for Assessing and Managing Exposed Healthcare Personnel (updated 8/25/2022)
    • VDH What Long-Term Care Facilities Need to Know About Monkeypox (8/31/2022)
  • When monkeypox exposures occur in the healthcare setting, healthcare facilities should continue to share a linelist of monitored individuals with the local health department for awareness, even if the healthcare facility is monitoring those who are exposed. 

Candida auris Alerts in the EDCC Platform:  Starting September 1, 2022, multidrug-resistant (MDRO) alerts for C. auris will appear in the electronic medical record of facilities participating in the EDCC Program. Alerts will appear indefinitely for patients/residents with previous C. auris clinical or colonization diagnosis reported to VDH. Notification of patients with C. auris will help ensure the patient/resident is placed on appropriate transmission-based precautions to prevent further spread, as well as help inform the optimal antimicrobial therapy regimen, if necessary.

To prepare, facilities should:

1. Update facility-specific C. auris guidance and align guidance with CDC recommendations
2. Create process to ensure patients/residents with a C. auris flag will be promptly placed in the appropriate transmission-based precautions
3. Notify and educate appropriate staff about new C. auris flag
4. Continue to communicate C. auris status directly with other transferring facilities due to any potential lag in data transfer

We are working to add carbapenemase-producing organism (CPO) alerts into the same portal by the end of 2022. This project is a collaborative effort between VDH, Virginia Health Information (VHI), and Collective Medical.  

Please email the below addresses for more information:

• About this enhancement and to participate in the EDCC Program: EDCCSupport@vhi.org
• About direct support with the EDCC portal and this enhancement (for existing EDCC participants): suppor@collectivemedicaltech.com
• About the C. auris alert, C. auris infection prevention, or C. auris surveillance: hai@vdh.virginia.gov (VDH’s Healthcare-Associated Infections & Antimicrobial Resistance Program)

COVID-19 Updates: 

• VDH COVID-19 websites have now been updated to reflect current CDC guidance. VDH policy leaves masking as a personal choice in most circumstances; exceptions are high-risk settings, including healthcare delivery, and as part of an isolation protocol, where masking is still recommended.
• VDH Interim Guidance for COVID-19 Prevention for Students, Teachers, and Staff in Child Care, K-12 Schools, and Day Camp Settings
  • Notable revisions to the updated Virginia guidance include:
    • Updated testing guidance for persons who test positive for COVID-19 and are unable or choose not to wear a mask through day 10. Recommendations to either isolate for 10 full days (including children under age 2) or use the CDC's test-based strategy that includes two negative tests 48 hours apart.
    • Updated testing guidance for persons who have had recent or suspected exposure to an infected person. Guidance for exposed persons is no longer based on vaccination status. Persons who have had recent exposure may consider testing for COVID-19 ≥5 days after exposure (or sooner, if they are symptomatic), irrespective of their vaccination status. “Test to Stay”  is no longer routinely recommended. Schools that choose to implement Test to Stay programs can contact VDH for more information on available testing resources and/or guidance.
• 2022-2023 Communicable Disease Reference Chart for School and Child Care Facility Personnel 
  • Major changes include the following: Now applies to both K-12 schools and child care and includes COVID-19 and Monkeypox
• Updated CDC Guidance: Interim Clinical Considerations for use of COVID-19 Vaccines. CDC has updated its vaccination recommendations to include: 
  • New booster recommendation for people ages 12 years and older to receive 1 bivalent mRNA booster after completion of a monovalent primary series; it replaces all prior booster recommendations for this age group.
  • Updated guidance for observation periods following COVID-19 vaccination
  • Updated guidance on COVID-19 vaccination and Multi-system Inflammatory Syndrome in children (MIS-C) and adults (MIS-A)
• Quick Links 
  • Data
    • Virginia COVID-19 Community Levels Map
    • VDH COVID-19 Data In Virginia
    • CDC COVID Data Tracker 
    • Hopkins COVID-19 Data Dashboard
  • Other Updates
    • MMWR COVID-19 Reports
    • CDC’s COVID What’s New & Updated

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