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A SARS-CoV-2 Outbreak Investigation: Two Rehabilitation Units in a Pennsylvania Tertiary Care Facility

Keck, Taylor (2021) A SARS-CoV-2 Outbreak Investigation: Two Rehabilitation Units in a Pennsylvania Tertiary Care Facility. Master Essay, University of Pittsburgh.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for coronavirus disease 2019 (COVID-19) pandemic, created surges in hospitals around the United States. Infection prevention surveillance in a tertiary care facility detected clusters of healthcare workers (HCWs) and inpatients testing positive for COVID-19 on two separate rehabilitation units, named Unit 1 and Unit 2. As a result of the rehabilitation population requiring extended close-contact care from medical professionals, there is an increased risk of transmission of the highly contagious SARS-CoV-2 virus. Whole genome sequencing (WGS) was used to analyze the relationship between the cases within both units.

Infection preventionists (IPs) contact traced COVID-19 positive HCWs and patients on the afflicted rehabilitation units. Positive HCWs were isolated at home and positive patients were isolated to private rooms to prevent further transmission on the units. Intervention measures included staff education on proper personal protective equipment (PPE) donning and doffing techniques, implementing universal contact/droplet precautions, second staff screening, enhanced unit cleaning, closing staff lunch areas on the units, lowering symptom-threshold testing for the patients, and closing new patient admissions onto the units. Viral samples from the outbreaks were sent to the University of Pittsburgh’s School of Medicine’s Microbial Genomic Epidemiology Laboratory (MiGEL) to analyze the relationship between the cases on each unit.

Between both rehabilitation units, a total of 24 HCWs and 12 inpatients tested positive for COVID-19 within a 3.5-week timeframe.
Based on the data from the MiGEL lab, there were distinct outbreaks of SARS-CoV-2 on each unit that were not related to each other in any way.

Conclusion and Discussion:
The COVID-19 pandemic has strained healthcare systems globally and created a new challenge for IP teams to manage. Individuals in hospitals are susceptible to infections and the contagious nature of SARS-CoV-2 creates a highly transmissible environment in rehabilitation settings even with preventative measures in place. The infection preventionist, along with a multidisciplinary team was utilized to disrupt the chain of transmission.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Keck, TaylorTRK57@pitt.eduTRK57
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairYassin, Mohamedyassinm@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee ChairFrank, Lindafrankie@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 14 May 2021
Date Type: Completion
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 38
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: No
Date Deposited: 14 May 2021 18:57
Last Modified: 14 May 2023 05:15


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