Becker's Hospital Review

10 INFECTION CONTROL & PATIENT SAFETY Humidifier tied to deadly mold at Seattle Children's, CDC says By Gabrielle Masson T he CDC identified an old humidifier as the cause of the mold outbreak at Seattle Children's Hospital that resulted in seven patient deaths, according to King 5. The humidifier had been turned off for more than 10 years and then was switched on again in 2018 and 2019. The CDC reported that the humidifier, part of an operating room's air handling unit, had been turned on before the two mold outbreaks, according to King 5. The report said the droplets produced by the humid- ifier were too large to be diffused by the hospital's air ventilation system, allowing for condensation and mold growth. The mold has infected 14 patients and resulted in seven deaths since 2001, with the most recent death on Feb. 12, 2020. The system that circulated air through the operating rooms was initially thought to be the cause of the outbreak, Jeff Sperring, MD, CEO of Seat- tle Children's Hospital, announced Nov. 18, according to The Seattle Times. Seattle Children's has been making "comprehensive improvements" to its ORs since receiving the CDC re- port, according to a Feb. 24 statement cited by King 5. "We have installed a new rooftop air handling system," the statement read. "We have also installed in-room [high-efficiency particulate air] filtration systems in our ORs that removes 99.97 percent of particles from the air passing through the filter; this is the highest level of filtration found in ORs today." In February, Seattle Children's Hospital filed a lawsuit to block the release of health department records regard- ing mold at its facility, according to court documents cited by King 5. n 'Hope for the best, prepare for the worst': UNMC infection control chief talks coronavirus By Gabrielle Masson M ark Rupp, MD, chief of the infectious disease division and medical director of infection control and epidemiology at Omaha-based University of Nebraska Medical Center, discussed the ongoing COVID-19 outbreak with Becker's. Editor's note: Responses were lightly edited for length and clarity. Question: UNMC treated evacuees from the Diamond Princess cruise ship in Japan, correct? Dr. Mark Rupp: Yes, UNMC is proud of the role we play as a national resource in caring for patients with highly communicable diseases. We screened and quarantined a lot of people who visited China, including 13 people from the Diamond cruise ship. Many of the passengers had positive test results in Japan, which we worked to confirm. Q: What's the most difficult part of handling an infection control outbreak such as coronavirus? MR: at depends on the nature of the outbreak, especially when a pathogen, such as the novel coronavirus, can spread very quickly. When an organism is spread primarily via respiratory droplets, such as the flu, the biggest challenge is getting people to pay attention and take the necessary precautions to protect themselves. Right now, we're working on informing the public of the main tools at our disposal. If the virus does take root in the U.S., there aren't medications or a vaccine yet, so we will have to depend on basic infection control practices. ese methods include social distancing, minimizing how oen people touch their eyes, mouths and nose, and good hand hygiene. Q: What should U.S. hospitals do to prepare for a nation- al spread of the virus? MR: Hospitals should use personal protective equipment when treating any patient who may be infected. We are screening anyone at our facilities who shows respiratory symptoms, has recently traveled to China or has had contact with anyone infected. A suspected coronavirus patient should be given a mask and taken to a private room, preferably a negative-pressure airborne isolation room, where they can be further screened. Q: Are surgical face masks effective against coronavirus? MR: Masks are most helpful preventing an infected person from spreading the droplets. If you're not infected and wear the mask, you still have a pretty good chance of breathing around the mask and potentially coming into contact with the virus. e masks may, however, remind people not to touch their nose, mouth, eyes. Ultimately, it is not a tight-fitting mask and therefore doesn't have as much filtration capacity or protection as a respirator. Q: What's one key action hospitals should take amid the outbreak? MR: Hope for the best, but prepare for the worst. Most hospitals have a pandemic influenza plan, used during the avian and H1N1 influenza scares. Hospitals should have contingency plans in place for what they would do if there was a large influx of patients with flu-like illness because we may face that in this country. I'm very hopeful in the measures taken by our public health agencies, and hope we won't face a pandemic, but starting to prepare for a pandemic would be prudent. Consider how to bring in these patients and care for them, protect healthcare workers, screen visitors, assess stocks of personal protective equipment. e emergency plan needs to be taken off the shelf, dusted off and examined carefully to prepare for this. n

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