Novel coronavirus outbreak - Updates

The etiologic agent responsible for the cluster of pneumonia cases in Wuhan has been identified as a novel betacoronavirus, (in the same family as SARS-CoV and MERS-CoV) via next generation sequencing (NGS) from cultured virus or directly from samples received from several pneumonia patients. Electron microscopy revealed a virus with a characteristic crown morphology: a coronavirus.

As information about the novel cornovirus causimg disease in the cluster of respiratory disease patients identified in Wuhan is evolving, HISI shall be providing updates on the news and resources available.

Surveillance case definitions for human infection with novel coronavirus (nCoV) by WHO. (updated Jan 23, 2020)

Epidemiological Update Novel coronavirus (2019-nCoV) 20 January 2020 by PAHO. (updated Jan 23, 2020)

Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. Interim guidance January 2020 by WHO. (updated Jan 23, 2020)

Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases - Interim guidance 14 January 2020 by WHO. (updated Jan 23, 2020)

Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. (WHO). (updated Jan 23, 2020)

Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts (WHO). (updated Jan 23, 2020)

Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV) by CDC-USA. (updated Jan 23, 2020)

Wuhan novel coronavirus (WN-CoV) infection prevention and control guidance - Public Health England, UK (updated Jan 23, 2020)

Government of India - Travel advisory to travelers visiting China.

Novel coronavirus outbreak in China. GOI releases Travel advisory to travelers visiting China

An infection with a novel coronavirus has been reported from China. As on 11th January, 2020, 41 confirmed cases have been reported so far, of which one has died. Only travel related cases have been reported (one each) in Thailand and Japan. The clinical signs and symptoms are mainly fever with a few patients having difficulty in breathing.

Mode of transmission is unclear as of now. However, so far there is little evidence of significant human- to-human transmission.

Although as per World Health Organization’s risk assessment the risk for global spread has been stated as low, as a matter of abundant precaution, the travellers to China are advised the following:

Travelers to China should follow simple public health measures at all times as under:
- Observe good personal hygiene
- Practice frequent hand washing with soap
- Follow respiratory etiquettes - cover your mouth when coughing or sneezing
- Avoid close contact with people who are unwell or showing symptoms of illness, such as cough, runny nose etc.
- Avoid contact with live animals and consumption of raw/undercooked meats
- Avoid travel to farms, live animal markets or where animals are slaughtered
- Wear a mask if you have respiratory symptoms such as cough or runny nose
All travellers to China (in particular Wuhan city) to monitor their health closely.
If you feel sick and have fever and cough:
Cover your mouth while coughing or sneezing
- Don’t plan travels if sick
- Seek medical attention promptly
If you feel sick on flight, while traveling back to India:
- Inform the airlines crew about illness
- Seek mask from the airlines crew
- Avoid close contact with family members or fellow travellers
- Follow the directions of airline crew while disembarking
If you feel sick on flight or at the time of disembarkation:
- Report to airport health authorities/immigration
- Follow the direction of the airport health officer
If you feel sick with in a span of one month after return from China:
- Report the illness to the nearest health facility and also inform the treating doctor regarding your travel history.

GOI travel advisory in response to New Corona Virus Outbreal in China.

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Novel coronavirus outbreak in China. GOI releases Travel advisory to travelers visiting China

Preventing infection from indwelling intravascular devices: HISI consensus recommendations

Introduction: Bloodstream infections (BSIs) are an important cause of morbidity and mortality in a healthcare facility. It is essential to follow standardised, evidence-based policies and protocols so as to prevent BSIs associated with indwelling intravascular medical devices. To address this issue, the Hospital Infection Society-India (HISI) took up the initiative to build up consensus on 'Infection Prevention aspects of Indwelling Intravascular Medical Devices'. The HISI is an association of medical professionals with a special interest in the prevention and control of healthcare-associated infections and antimicrobial stewardship. It is registered with the Registrar of Societies at Delhi. Founded in 1991, the Society presently has >1000 members. A HISI Educational and Awareness Initiative 'Vichar Goshthi' and Consensus Building were organised under the aegis of HISI Delhi NCR Chapter Meet on Saturday 7th July 2018 from 1:00 pm to 4:00 pm at the Auditorium, Indraprastha Apollo Hospitals, New Delhi.

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Preventing infection from indwelling intravascular devices: Hospital infection society India consens

Definitions

An antimicrobial is generally an agent that kills or stops the growth of bacteria, fungi, viruses or parasites. There are two major types of antimicrobial: antiseptic and antibiotic. Antiseptics, such as hand washes or surgical scrubs, destroy a range of micro-organisms on a surface or in living tissues, whereas antibiotics are administered in relatively small amounts with the aim of selective targeting of micro-organisms, especially bacteria
Central line: An intravascular catheter that terminates at, close to the heart, or in one of the great vessels that is used for infusion, withdrawal of blood, or hemodynamic monitoring. The great vessels include the aorta, pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic veins, internal jugular veins, subclavian veins, external iliac veins, common iliac veins, femoral veins and, in neonates, the umbilical artery/vein.
Central line-associated bloodstream infection (BSI): Primary BSI in a patient that had a central line within the 48-h period before the development of BSI and is not bloodstream related to an infection at another site.
Catheter-related BSI: It is defined as clinical manifestations and at least one positive blood culture from a peripheral vein and no other apparent source, with either positive semiquantitative (>15 colony-forming units [CFU]/catheter segment) or quantitative (103CFU/catheter segment) culture, whereby the same organism (species and antibiogram) is isolated from the catheter segment and a peripheral blood sample; simultaneous quantitative cultures of blood samples with a ratio of 3:1 (central venous catheter [CVC] vs. peripheral); differential period of CVC culture versus peripheral blood culture positivity of 2 h; or isolation of the same organism from semiquantitative or quantitative culture segment and from blood (preferably from a peripheral vein) of a patient with accompanying symptoms of BSI and no other apparent source of infection
Catheter dressing refers to a protective material applied to the site of catheter insertion with the major aim of securing the CVC in place and includes, for instance, gauze with tape or transparent dressing

Types of Intravascular Access Devices

Permanent central line: It includes tunnelled catheters, including tunnelled dialysis catheters or implanted catheters (including ports)
Temporary central line: It includes non-tunnelled or non-implanted catheter
Umbilical catheter: A vascular catheter inserted through the umbilical artery or vein in a neonate. All umbilical catheters are central lines
Non-tunnelled central venous catheter (CVC) is a single-, dual-, or triple-lumen catheter that is placed either in the internal jugular or subclavian vein with the distal tip lying in the superior vena cava
Tunnelled CVC is placed when the patient needs the device for long-term therapy. It is surgically inserted and literally tunnelled under the skin in a subcutaneous pocket
Peripherally inserted central catheter: A catheter which is inserted in a large peripheral vein such as cephalic or basilic vein and then advanced until the tip rests in the distal superior vena cava or cavoatrial junction
Peripheral venous catheter: A catheter inserted in the peripheral veins, usually of forearm or hand
Peripheral arterial catheter: A catheter usually inserted in radial artery and can also be placed in femoral, axillary, brachial, posterior tibial arteries.

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Journal of Patient Safety and Infection Control

Journal of Patient Safety and Infection Control, a publication of Hospital Infection Society India, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.jpsiconline.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository.

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