An outbreak of human metapneumovirus in a rehabilitation center for alcoholics in Tampere, Finland

Abstract

Reports of respiratory tract infections in a rehabilitation center for alcoholics triggered the epidemiological investigations in Tampere, Finland. Twenty-nine out of 40 residents (attack rate 73%) and four members of staff fulfilled the case criteria: cough; worsening of dyspnea; or rhinitis with or without fever. Ten cases were hospitalized, one needed treatment in the intensive care unit. All cases recovered. Serum hMPV antibody titer was high (10 240 or more) in 20 (69%) of the 29 tested cases and the difference was significant when compared with the titer measured from the voluntary laboratory personnel (n = 14, p < 0.001). The titers were rising in three out of the five cases from whom coupled samples could be obtained. Rt-PCR for hMPV was positive in three out of the eight tested cases. No other causative agent for the outbreak was detected. The outcome of hMPV infection among institutionalized smoking alcoholics was good with no mortality.

Outbreak of Human Metapneumovirus in a Nursing Home: A Clinical Perspective

“…Outbreaks have been described in other institutionalized adult populations, such as psychiatric inpatients, with infection rates from 25% 21 to 56%, 22 and in a rehabilitation center for alcoholics with an incidence rate of 73%. 20 Such high rates of infection can be explained by the particular living conditions in institutions such as NHs. Indeed, this closed environment, as well as the often dependent and multipathologic profile of the residents, and possibly the short incubation period are factors favoring the transmission of infectious agents.…”

“…The median total Cumulative Illness Rating Scale for Geriatrics score was 14 (IQR [12][13][14][15][16][17][18][19][20], and the severity index was 1.82 (IQR 1.67-2). The most common underlying medical conditions were heart (n ¼ 36, 48.7 %), kidney (n ¼ 33,44.6%), respiratory (n ¼ 18,24.3%), malignancy (n ¼ 12, 16.2%), diabetes (n ¼ 10, 13.5%), and chronic liver diseases (n ¼ 3, 4.1%).…”

“…Hypoalbuminemia <30 g/L was present in 23 (29.5%) residents, a sign of severe malnutrition. Most patients displayed cognitive impairment (median Mini-Mental State Examination score ¼ 18, IQR [14][15][16][17][18][19][20]. Thirty (30.1%) residents had an ADL score of 3 or lower.…”

Rethinking Assessment: The Future of Examinations in Higher Education

“…For example, in mathematical calculations, students might need to transfer the paperwork to the computer in an online setup. This will require more time than simply deriving the answer on paper [14]. They note that teachers also have to master the necessary IT skills for online delivery in a creative manner, in which their preparation time shall be longer (2013) and this may be true in the case of (online) marking of online examinations too.…”