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Foodborne and waterborne infections in elderly community and long-term care facility residents,Victoria, Australia.

ABSTRACT: We calculated rates of foodborne and waterborne infections reported to the health department in Victoria, Australia, during 2000-2009 for elderly residents of long-term care facilities (LTCFs) and the community. We used negative binomial regression to estimate incidence rate ratios, adjusting for age, sex, and reporting period. We analyzed 8,277 infections in elderly persons. Rates of campylobacteriosis, legionellosis, listeriosis, toxigenic Escherichia coli infections, and shigellosis were higher in community residents, and rates of Salmonella infection were higher in LTCF residents. Each year, 61.7 Campylobacter infections were reported per 100,000 LTCF residents, compared with 97.6 per 100,000 community residents. LTCF residents were at higher risk for S. enterica serotype Typhimurium associated with outbreaks. Rates of foodborne infections (except salmonellosis) were similar to or lower for LTCF residents than for community residents. These findings may indicate that food preparation practices in LTCFs are safer than those used by elderly persons in the community.

SUBMITTER: Kirk MD

PROVIDER: S-EPMC3309568 | biostudies-literature | 2012 Mar

REPOSITORIES: biostudies-literature

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Foodborne and waterborne infections in elderly community and long-term care facility residents,Victoria, Australia.

Kirk Martyn D MD Gregory Joy J Lalor Karin K Hall Gillian V GV Becker Niels N

Emerging infectious diseases 20120301 3

We calculated rates of foodborne and waterborne infections reported to the health department in Victoria, Australia, during 2000-2009 for elderly residents of long-term care facilities (LTCFs) and the community. We used negative binomial regression to estimate incidence rate ratios, adjusting for age, sex, and reporting period. We analyzed 8,277 infections in elderly persons. Rates of campylobacteriosis, legionellosis, listeriosis, toxigenic Escherichia coli infections, and shigellosis were high ...[more]

PMID: 22377177

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Project description:Background/objectivesTo determine the associations of nursing home registered nurse (RN) staffing, overall quality of care, and concentration of Medicaid or racial and ethnic minority residents with 2019 coronavirus disease (COVID-19) confirmed cases and deaths by April 16, 2020, among Connecticut nursing home residents.DesignCross-sectional analysis on Connecticut nursing home (n = 215) COVID-19 report, linked to other nursing home files and county counts of confirmed cases and deaths. Multivariable two-part models determined the associations of key nursing home characteristics with the likelihood of at least one confirmed case (or death) in the facility, and with the count of cases (deaths) among facilities with at least one confirmed case (death).SettingAll Connecticut nursing homes (n = 215).ParticipantsNone.InterventionNone.MeasurementsNumbers of COVID-19 confirmed cases and deaths among residents.ResultsThe average number of confirmed cases was eight per nursing home (zero in 107 facilities), and the average number of confirmed deaths was 1.7 per nursing home (zero in 131 facilities). Among facilities with at least one confirmed case, every 20-minute increase in RN staffing (per resident day) was associated with 22% fewer confirmed cases (incidence rate ratio [IRR] = .78; 95% confidence interval [CI] = .68-.89; P < .001); compared with one- to three-star facilities, four- or five-star facilities had 13% fewer confirmed cases (IRR = .87; 95% CI = .78-.97; P < .015), and facilities with high concentration of Medicaid residents (IRR = 1.16; 95% CI = 1.02-1.32; P = .025) or racial/ethnic minority residents (IRR = 1.15; 95% CI = 1.03-1.29; P = .026) had 16% and 15% more confirmed cases, respectively, than their counterparts. Among facilities with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths (IRR = .74; 95% CI = I .55-1.00; P = .047). Other focused characteristics did not show statistically significant associations with deaths.ConclusionNursing homes with higher RN staffing and quality ratings have the potential to better control the spread of the novel coronavirus and reduce deaths. Nursing homes caring predominantly for Medicaid or racial and ethnic minority residents tend to have more confirmed cases.

Project description:Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak in a long-term care skilled nursing facility (SNF) in King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents of these types of facilities (2). On March 1, a health care provider at a second long-term care skilled nursing facility (facility A) in King County, Washington, had a positive test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, after working while symptomatic on February 26 and 28. By March 6, seven residents of this second facility were symptomatic and had positive test results for SARS-CoV-2. On March 13, CDC performed symptom assessments and SARS-CoV-2 testing for 76 (93%) of the 82 facility A residents to evaluate the utility of symptom screening for identification of COVID-19 in SNF residents. Residents were categorized as asymptomatic or symptomatic at the time of testing, based on the absence or presence of fever, cough, shortness of breath, or other symptoms on the day of testing or during the preceding 14 days. Among 23 (30%) residents with positive test results, 10 (43%) had symptoms on the date of testing, and 13 (57%) were asymptomatic. Seven days after testing, 10 of these 13 previously asymptomatic residents had developed symptoms and were recategorized as presymptomatic at the time of testing. The reverse transcription-polymerase chain reaction (RT-PCR) testing cycle threshold (Ct) values indicated large quantities of viral RNA in asymptomatic, presymptomatic, and symptomatic residents, suggesting the potential for transmission regardless of symptoms. Symptom-based screening in SNFs could fail to identify approximately half of residents with COVID-19. Long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2 (3). Once a confirmed case is identified in an SNF, all residents should be placed on isolation precautions if possible (3), with considerations for extended use or reuse of personal protective equipment (PPE) as needed (4).

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Foodborne and waterborne infections in elderly community and long-term care facility residents,Victoria, Australia.

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Foodborne and waterborne infections in elderly community and long-term care facility residents,Victoria, Australia.

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