Fatal influenza outbreak aboard a sport fishing vessel in San Diego, California

Adam, Jessica K.; Varan, Aiden K.; Kao, Annie S.; McDonald, Eric; Waterman, Stephen H.

doi:10.1016/j.tmaid.2014.12.002

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…In the case of bites sustained by rats, NPs need to be aware of the rare, but fatal systemic illness of rat-bite fever (RBF) that is caused by Streptobacillus or Spirillum species. Of the nearly 20,000 cases of rat bites reported each year, less than 20 cases RBF are documented each year; however, the true incidence is not known as the disease state is not reportable (Adam et al, 2014). Little attention will be devoted to this serious disease as only 17 cases were identified over a period of 12 years in the state of California (Adam et al, 2014).…”

Section: Further Considerationmentioning

confidence: 99%

“…Of the nearly 20,000 cases of rat bites reported each year, less than 20 cases RBF are documented each year; however, the true incidence is not known as the disease state is not reportable (Adam et al, 2014). Little attention will be devoted to this serious disease as only 17 cases were identified over a period of 12 years in the state of California (Adam et al, 2014). However, NPs should be suspicious of patients who enter the ED with flu-like symptoms, fevers, migratory arthralgias, and have recently sustained a rat bite or scratch that may or not have already healed; symptoms tend to hit rather abruptly during or immediately after the bite (Stehle, Dubuis, So, Dudler, 2003).…”

Section: Further Considerationmentioning

confidence: 99%

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All the Better to Taste You With, My Dear

Holley-Mallo

2024

Advanced Emergency Nursing Journal

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Mammal bites account for over 5 million visits to Emergency Departments (EDs) annually. Nurse Practitioners (NPs) need to stay abreast of current guidelines, changes to antibiotic regimens that are now most effective, and understand in what circumstances collaboration with other specialists is indicated. It is not enough to care for the wound, itself, but rather understand in what presentations additional care may be needed despite the fact that there is no clear evidence at the time of evaluation of the need for advanced care. Additionally, NPs should understand what resources are available within their community for wound care that may exceed the scope and ability of the facility in which they practice. Health departments may need to be utilized in the care of ED patients who present with wounds that are suspicious for rabies. Finally understanding what constitutes a high, medium, and low risk bite will aide NPs in delivering optimal care within the communities they serve while also minimizing patient morbidity.

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Section: Further Considerationmentioning

confidence: 99%

Section: Further Considerationmentioning

confidence: 99%

All the Better to Taste You With, My Dear

Holley-Mallo

2024

Advanced Emergency Nursing Journal

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“…42 While quarantine (Q) -"the restriction of activities of or the separation of persons who are not ill but who may have been exposed to an infectious agent or disease" 43 has been a cornerstone for controlling infectious disease outbreaks for centuries, 44 additional measures such as isolation and sanitation on board vessels are mandated under the International Health Regulations. 8,17,20,34,40,[45][46][47][48][49][50][51][52] Quarantining decreased the transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) during vessels' outbreaks, 40,45 but it did not completely control the event, with further cases occurring after release from Q. 40,46,[53][54][55] The containment measures, travel restrictions, and border closures 2 continue to make it increasingly difficult for ship operators world-wide to be granted pratique -"permission for a ship to enter a port, embark or disembark, discharge or load cargo or stores," 34,56 conduct trade, and change crew.…”

Section: Introductionmentioning

confidence: 99%

The Healthy Crew, Clean Vessel, and Set Departure Date Triad: Successful Control of Outbreaks of COVID-19 On Board Four Cargo Vessels

Codreanu

Pingault

O’Loughlin

et al. 2021

Prehosp. Disaster med.

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Background: A variety of infectious diseases can cause outbreaks on board vessels, with both health and economic effects. Internationally, Coronavirus Disease 2019 (COVID-19) outbreaks have occurred on numerous cruise and cargo vessels and the containment measures, travel restrictions, and border closures continue to make it increasingly difficult for ship operators world-wide to be granted pratique, effect crew changes, and conduct trade. An effective outbreak management strategy is essential to achieve the outcome triad – healthy crew, clean vessel, and set departure date – while maintaining the safety of the on-shore workers and broader community and minimizing disruption to trade. This report describes the principles of COVID-19 outbreak responses on four cargo vessels, including the successful use of one vessel as a quarantine facility. Methods: Established principles of management and the experiences of COVID-19 outbreaks on cruise ships elsewhere informed a health-lead, multi-agency, strict 14-day quarantine (Q) regime based on: population density reduction on board; crew segregation; vessel cleaning and sanitation; infection risk zones, access, and control measures; health monitoring; case identification and management; food preparation and delivery; waste management control; communication; and welfare and security. Findings: Sixty-five crew were diagnosed with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection (range 2-25; attack rate 10%-81%; 15 asymptomatic). No deaths were recorded, and only one crew was hospitalized for COVID-19-related symptoms but did not require intensive care support. Catering crew were among the cases on three vessels. All non-essential crew (n-EC) and most of the cases were disembarked. During the vessel’s Q period, no further cases were diagnosed on board, and no crew became symptomatic after completion of Q. The outbreak response duration was 15-17 days from initial decision. No serious health issues were reported, no response staff became infected, and only two Q protocol breaches occurred among crew. Interpretation: Despite increasing risk of outbreaks on cargo vessels, maritime trade and crew exchanges must continue. The potential consequences of COVID-19 outbreaks to human life and to trade necessitate a balanced response. The principles described can offer health, financial, operational, and safety advantages.

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