Ambulance dispatch calls attributable to influenza A and other common respiratory viruses in the Netherlands (2014‐2016)

Abstract

Background: Ambulance dispatches could be useful for syndromic surveillance of severe respiratory infections. We evaluated whether ambulance dispatch calls of highest urgency reflect the circulation of influenza A virus, influenza B virus, respiratory syncytial virus (RSV), rhinovirus, adenovirus, coronavirus, parainfluenzavirus and human metapneumovirus (hMPV). Methods:We analysed calls from four ambulance call centres serving 25% of the population in the Netherlands (2014)(2015)(2016). The chief symptom and urgency level is recorded during triage; we restricted our analysis to calls with the highest urgency and identified those compatible with a respiratory syndrome. We modelled the relation between respiratory syndrome calls (RSC) and respiratory virus trends using binomial regression with identity link function. Results:We included 211 739 calls, of which 15 385 (7.3%) were RSC. Proportion of RSC showed periodicity with winter peaks and smaller interseasonal increases.Overall, 15% of RSC were attributable to respiratory viruses (20% in out-of-office hour calls). There was large variation by age group: in <15 years, only RSV was associated and explained 11% of RSC; in 15-64 years, only influenza A (explained 3% of RSC); and in ≥65 years adenovirus explained 9% of RSC, distributed throughout the

Syndromic surveillance to detect disease outbreaks using time between emergency department presentations

“…21 Others have observed the overwhelming quantity of information ('infodemics') associated with pandemics, coupled with the potential of political biases/propaganda, and the absence of expectations that user-generated content is subject to fact-checking, raises concerns about the credibility of information about pandemics on social media. 22 Other related surveillance includes online questionnaires, 23 temperature monitoring, 4 ambulance dispatch calls 24 and hybrid systems that cover a range of data sources including Facebook surveys and Google search trends. 3,25 An advantage of having technology companies deploy surveys is the high sample sizes that result.…”

Bacteria Associated with Healthcare-Associated Infections on Environmental Samples Obtained from Two Fire Departments

“…Gram -Nosocomial transmission [40,41] E. coli Gram -Contaminates surfaces and textiles [42,43] P. aeruginosa Gram -Contaminates surfaces in ambulances [44,45] E. faecalis Gram + Contaminates surfaces and textiles [42,43] C. difficile Gram + Contaminates surfaces and textiles [42,43] and resistant to laundering [43] MRSA Gram + Present in EMS workers and on EMS equipment [6,46] S. pneumoniae Gram + Present in EMS workers and on EMS equipment [6,46] Viruses Influenza Enveloped Highly contagious, vaccine available but many refuse [47] Adenovirus Non-Enveloped Highly contagious, major cause of emergencies in elderly [48] Norovirus Non-Enveloped Highly contagious, spread by contact and aerosol, environmentally stable [49,50] Disinfection standard operating protocols (SOPs) in place may not be sufficient in high-touch, high-use areas or against environmentally stable pathogens. The primary objective of this study was to document evidence of the HAI (see Table 1) on surfaces at fire stations and engines to inform disinfection procedures and identify which pathogens might contribute to occupational exposures.…”

“…A study evaluating 65 high-touch surfaces in 11 vehicles (ambulances and fire engines) and common areas of two fire stations found that bacterial, yeast, and mold contamination of the surfaces was significant [44]. Reports on surface contamination of ambulances and occupational exposures of EMS show that several drug-resistant bacteria and highly contagious viruses are of concern, especially in iatrogenic and nosocomial infections (Table 1) [44][45][46][47][48]. Low concentrations of enveloped respiratory viruses have been found to retain infectivity on common environmental surfaces, such as Teflon, polyvinyl chloride (PVC), ceramic tiles, glass, silicon rubber, and stainless steel [49].…”