Infection Control & Hospital Epidemiology
components of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCATS or NIH.
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
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Affected healthcare workers during outbreaks: A report from the German consulting center for infection control (BZH) outbreak registry
Sebastian Schulz-Stübner Privatdozent Dr. med., Marcus Reska Dr. rer. nat., and Reiner Schaumann Privatdozent
Dr. med. habil. Deutsches Beratungszentrum für Hygiene (BZH GmbH), Schnewlinstr. 4, 79098 Freiburg im Breisgau
To the Editor—In 2013, the outbreak registry of the German consulting center for infection control and prevention (Deutsches Beratungszentrum für Hygiene, BZH GmbH, Freiburg, Germany) was instituted as a quality assurance project to analyze outbreak situations to gain epidemiological data and to generate practical advice for the affected institutions. After 5 years, the registry now contains data for 96 outbreaks plus final analyses. Here, we focused on outbreaks affecting healthcare workers (HCWs) as part of the infected or colonized outbreak cohort.
Material and Methods
In contrast to the German legal definition (German infection prevention law, Infektionsschutzgesetz), which defines 2 or more cases of infection with a presumed epidemiological link as an outbreak, our registry only includes “major” outbreaks, which are defined as 5 or more cases of infection or colonization with an epidemiological link or, in cases of special organisms like multidrug-resistant organisms (MDROs), highly contagious dis- eases with 2 or more cases or sentinel cases of special interest.1 The definition was chosen to limit the analytical effort on com- mon outbreaks (eg, with norovirus) to major events but to include
Author for correspondence: Privatdozent Dr. Sebastian Schulz-Stübner, Deutsches
Beratungszentrum für Hygiene (BZH GmbH), Schnewlinstr. 4, 79098 Freiburg im Breisgau Germany. E-mail:
Schulz-stuebner@bzh-freiburg.de
Cite this article: Schulz-Stübner S, et al. (2019). Affected healthcare workers during
outbreaks: A report from the German consulting center for infection control (BZH) outbreak registry. Infection Control & Hospital Epidemiology 2019, 40, 113–115. doi: 10.1017/ice.2018.274
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved.
colonization outbreaks without infections if they required com- prehensive infection control interventions. Data from the outbreak analysis were entered without personal
identifiers in an anonymized database according to European Union’s (EU) General Data Protection Regulation (GDPR). This was not human research, and data analysis does not require review by our institutional review board. Overall, 94 outbreaks were ana- lyzed regarding information related to involvement of HCWs.
Results
The 94 screened outbreaks involved 464 people with infections and 168 with colonization only. The duration of the outbreak management ranged from 1 day to 185 days; the number of affected people ranged from 1 to 66 per outbreak. Figure 1 shows the distribution of organisms involved and their relation to outbreaks of infections (59%), combined outbreaks with infections and colonizations (20%), and colonization only (21%). Overall, 192 HCWs became sick as part of an outbreak: 162
had norovirus infections, 22 had influenza infections, 8 had scabies infections. Furthermore, 2 HCWs were found to be colonized with MRSA in the screenings performed during an outbreak. No clear epidemiological link was identified between MRSA colonization status and the outbreak in 1 case, whereas an HCW was identified as superspreader during an upper respiratory tract infection in the other. In 5 outbreaks with gram-negative MDROs and 1 VRE outbreak, rectal screening of staff was performed without any meaningful results.
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