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Data from the National Healthcare Safety Network were analyzed to assess the impact of COVID-19 on the incidence of healthcare-associated infections (HAI) during 2021. Standardized infection ratios were significantly higher than those during the prepandemic period, particularly during 2021-Q1 and 2021-Q3. The incidence of HAI was elevated during periods of high COVID-19 hospitalizations.

Background A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. Conclusion MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.

The intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates the Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute-Care Hospitals published in 2014. It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission.

All viral haemorrhagic fever laboratory confirmatory testing is done at UVRI and results are available within 24-48 h after sample reception.Since 2010, the viral haemorrhagic fever laboratory has tested over 11 000 clinical samples from serosurveys, surveillance programmes, and outbreaks.In addition to the success of the viral haemorrhagic fever programme in Uganda, direct technical assistance and support for response to viral haemorrhagic fever outbreaks throughout Africa has been provided, including for the west Africa Ebola outbreak in 2014-16.8 Materials developed for the Uganda viral haemorrhagic fever programme, including standardised case reporting forms, case definitions, health education and risk communication materials, and the Epi-Info viral haemorrhagic fever application,9 were used in 2014 to the three west African countries affected by Ebola virus disease to aid in outbreak management and control since the region had no previous experience with filovirus outbreaks.Rift valley fever response-Kabale District, Uganda, March 2016, MMWR Morb Mortal Wkly Rep, Vol. 65, 2016, 1200-1201 6 JF Wamala, L Lukwago, M Malimbo, Ebola hemorrhagic fever associated with novel virus strain, Uganda, 2007-2008, Emerg Infect Dis, Vol. 16, 2010, 1087-1092 7 SI Okware, FG Omaswa, S Zaramba, An outbreak of Ebola in Uganda, Trop Med Int Health, Vol. 7, 2002, 1068-1075 8 S Bagcchi, Ebola haemorrhagic fever in west Africa, Lancet Infect Dis, Vol. 14, 2014, 375 9 IJ Schafer, E Knudsen, LA McNamara, S Agnihotri, PE Rollin, A Islam, The Epi Info Viral hemorrhagic fever (VHF) application: a resource for outbreak data management and contact tracing in the 2014-2016 West Africa Ebola epidemic, J Infect Dis, Vol. 214, Iss. suppl 3, 2016, S122-S136 10 JN Borchert, JW Tappero, R Downing, Rapidly building global health security capacity-Uganda demonstration project, 2013, MMWR Morb Mortal Wkly Rep, Vol. 63, 2014, 73-76

[...]we analysed available incubation period data of 512 confirmed cases from five EVD outbreaks from the last ten years and found that the mean and median incubation periods of the gamma distributions fitted to the cases was 10 days (SD 5·3 days). [...]we performed a literature review of experimental infection in non-human primates, which found that 103 (98%) of 105 non-human primates injected with lethal doses of EBOV showed initial signs of illness 3 or more days after injection (appendix pp 5–6). [...]epidemiological investigations of EVD outbreaks that encounter cases where the incubation period is suspected to be shorter than 4 days should clarify whether these cases and their suspected source patients share a common origin of infection (eg, common source patient) that had not been previously identified.

Hantavirus is endemic in the Four Corners region of Arizona, Colorado, New Mexico, and Utah, and hantavirus cardiopulmonary syndrome (HCPS) disproportionately affects the Navajo Nation. We describe the application of a rapid screening tool for identification of HCPS. A rapid screening tool for HCPS was implemented at Tséhootsooí Medical Center (TMC) in collaboration with academic partners. Since its implementation in 2016, 20 TMC staff members have been trained to perform this test, and 189 screens for HCPS have been reported. Although hantavirus infection is rare even in high-risk areas, use of this tool resulted in the identification of 4 acute cases of hantavirus infection. The results demonstrate the successful implementation of a 5-point screening tool for hantavirus infection in an endemic setting by a laboratory in a small community hospital.

Abstract Objectives Navajo Nation is disproportionately affected by hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease that can quickly progress to respiratory failure and cardiogenic shock. The initial signs and symptoms of HCPS are indistinguishable from coronavirus disease 2019 (COVID-19). However, this distinction is critical, as the disease course differs greatly, with most patients with COVID-19 experiencing mild to moderate illness. We set out to determine if the evaluation of peripheral blood smears for five hematopathologic criteria previously identified as hallmarks of hantavirus infection, or “the hantavirus 5-point screen,” could distinguish between COVID-19 and HCPS. Methods The hantavirus 5-point screen was performed on peripheral blood smears from 139 patients positive for COVID-19 seeking treatment from Tséhootsooí Medical Center and two Emory University hospitals. Results Of these 139 individuals, 136 (98%) received a score of 3/5 or below, indicating low suspicion for HCPS. While thrombocytopenia, one of the key signs of HCPS, was seen in the patients with COVID-19, it was generally mild and remained stable on repeat specimens collected 12 to 24 hours later. Conclusions Given these findings, the 5-point screen remains a useful rapid screening tool for potential HCPS cases and may be useful to distinguish early HCPS from COVID-19 in HCPS endemic regions.

Objectives: Navajo Nation is disproportionately affected by hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease that can quickly progress to respiratory failure and cardiogenic shock. The initial signs and symptoms of HCPS are indistinguishable from coronavirus disease 2019 (COVID-19). However, this distinction is critical, as the disease course differs greatly, with most patients with COVID-19 experiencing mild to moderate illness. We set out to determine if the evaluation of peripheral blood smears for five hematopathologic criteria previously identified as hallmarks of hantavirus infection, or \"the hantavirus 5-point screen,\" could distinguish between COVID-19 and HCPS. Methods: The hantavirus 5-point screen was performed on peripheral blood smears from 139 patients positive for COVID-19 seeking treatment from Tsehootsooi Medical Center and two Emory University hospitals. Results: Of these 139 individuals, 136 (98%) received a score of 3/5 or below, indicating low suspicion for HCPS. While thrombocytopenia, one of the key signs of HCPS, was seen in the patients with COVID-19, it was generally mild and remained stable on repeat specimens collected 12 to 24 hours later. Conclusions: Given these findings, the 5-point screen remains a useful rapid screening tool for potential HCPS cases and may be useful to distinguish early HCPS from COVID-19 in HCPS endemic regions. KEY WORDS Hantavirus; Hantavirus cardiopulmonary syndrome; COVID-19; Rapid screen; Peripheral blood smear; Thrombocytopenia

During an Ebola virus disease (EVD) outbreak, calculating the exposure window of a confirmed case can assist field investigators in identifying the source of infection and establishing chains of transmission. However, field investigators often have difficulty calculating this window. We developed a bilingual (English/French), smartphone-based field application to assist field investigators in determining the exposure window of an EVD case. The calculator only requires the reported date of symptoms onset and the type of symptoms present at onset or the date of death. Prior to the release of this application, there was no similar electronic capability to enable consistent calculation of EVD exposure windows for field investigators. The Democratic Republic of the Congo Ministry of Health endorsed the application and incorporated it into trainings for field staff. Available for Apple and Android devices, the calculator continues to be downloaded even as the eastern DRC outbreak resolved. We rapidly developed and implemented a smartphone application to estimate the exposure window for EVD cases in an outbreak setting

A healthcare provider unknowingly treated a patient with mpox and subsequently developed ocular mpox without rash. She breastfed during illness; her infant was not infected. This report addresses 3 challenges in mpox management and control: diagnosis in the absence of rash, exposures in healthcare settings, and management of lactating patients.