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<title xml:lang="en">Outbreak column 18: The undervalued work of outbreak: prevention, preparedness, detection and management</title>
<author>
<name sortKey="Curran, Evonne T" sort="Curran, Evonne T" uniqKey="Curran E" first="Evonne T" last="Curran">Evonne T. Curran</name>
<affiliation>
<nlm:aff id="aff1-1757177415599592">Consultant Nurse Infection Control, Health Protection Scotland, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dalziel, Catherine E" sort="Dalziel, Catherine E" uniqKey="Dalziel C" first="Catherine E" last="Dalziel">Catherine E. Dalziel</name>
<affiliation>
<nlm:aff id="aff2-1757177415599592">Healthcare Scientist, Health Protection Scotland, UK</nlm:aff>
</affiliation>
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<idno type="pmid">28989442</idno>
<idno type="pmc">5074162</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074162</idno>
<idno type="RBID">PMC:5074162</idno>
<idno type="doi">10.1177/1757177415599592</idno>
<date when="2015">2015</date>
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<title xml:lang="en" level="a" type="main">Outbreak column 18: The undervalued work of outbreak: prevention, preparedness, detection and management</title>
<author>
<name sortKey="Curran, Evonne T" sort="Curran, Evonne T" uniqKey="Curran E" first="Evonne T" last="Curran">Evonne T. Curran</name>
<affiliation>
<nlm:aff id="aff1-1757177415599592">Consultant Nurse Infection Control, Health Protection Scotland, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dalziel, Catherine E" sort="Dalziel, Catherine E" uniqKey="Dalziel C" first="Catherine E" last="Dalziel">Catherine E. Dalziel</name>
<affiliation>
<nlm:aff id="aff2-1757177415599592">Healthcare Scientist, Health Protection Scotland, UK</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Journal of Infection Prevention</title>
<idno type="ISSN">1757-1774</idno>
<idno type="eISSN">1757-1782</idno>
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<date when="2015">2015</date>
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<p>There are oft-quoted studies which advise that between 1% and 10% of healthcare-associated infections (HAIs) present as healthcare-associated outbreaks (HAOs). Examination of these studies showed they lacked validity due to a low sensitivity to detect HAO, and because they pre-date both advanced healthcare systems and the emergence of recent nosocomial pathogen challenges. The accepted inference: that as there are so few HAOs the focus of surveillance programmes should be on endemic and not epidemic infections (outbreaks), is therefore called into question.</p>
<p>Current estimates of HAI burden are derived from Point Prevalence Surveys (PPS) which are neither designed to nor are capable of detecting HAOs. We considered the extensive Infection Prevention and Control Team (IPCT) work to prevent and prepare for perennial and novel HAOs and suggest that at present this endeavour is largely unseen, underestimated and undervalued.</p>
<p>Any HAI burden estimate needs to comprise a more complete HAI summary than PPS data. This can only be done with a more inclusive surveillance system that has a wider focus than just prevalent infections. There is a real risk of redirection of the IPCT resource from outbreak prevention and preparedness work towards HAI that are counted: such a change could only further increase HAO risks.</p>
</div>
</front>
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<pmc article-type="other">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Infect Prev</journal-id>
<journal-id journal-id-type="iso-abbrev">J Infect Prev</journal-id>
<journal-id journal-id-type="publisher-id">BJI</journal-id>
<journal-id journal-id-type="hwp">spbji</journal-id>
<journal-title-group>
<journal-title>Journal of Infection Prevention</journal-title>
</journal-title-group>
<issn pub-type="ppub">1757-1774</issn>
<issn pub-type="epub">1757-1782</issn>
<publisher>
<publisher-name>SAGE Publications</publisher-name>
<publisher-loc>Sage UK: London, England</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28989442</article-id>
<article-id pub-id-type="pmc">5074162</article-id>
<article-id pub-id-type="doi">10.1177/1757177415599592</article-id>
<article-id pub-id-type="publisher-id">10.1177_1757177415599592</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Commentary</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Outbreak column 18: The undervalued work of outbreak: prevention, preparedness, detection and management</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Curran</surname>
<given-names>Evonne T</given-names>
</name>
<xref ref-type="aff" rid="aff1-1757177415599592">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dalziel</surname>
<given-names>Catherine E</given-names>
</name>
<xref ref-type="aff" rid="aff2-1757177415599592">2</xref>
</contrib>
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<aff id="aff1-1757177415599592">
<label>1</label>
Consultant Nurse Infection Control, Health Protection Scotland, UK</aff>
<aff id="aff2-1757177415599592">
<label>2</label>
Healthcare Scientist, Health Protection Scotland, UK</aff>
<author-notes>
<corresp id="corresp1-1757177415599592">Evonne T Curran, Consultant Nurse Infection Control, Health Protection Scotland, NHS National Services Scotland, 4th Floor, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK. Email:
<email>evonne.curran@ntlworld.com</email>
</corresp>
<fn fn-type="COI-statement">
<p>
<bold>Declaration of conflicting interests:</bold>
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>12</day>
<month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub">
<month>11</month>
<year>2015</year>
</pub-date>
<volume>16</volume>
<issue>6</issue>
<fpage>266</fpage>
<lpage>272</lpage>
<permissions>
<copyright-statement>© The Author(s) 2015</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder content-type="sage">Infection Prevention Society</copyright-holder>
</permissions>
<abstract>
<p>There are oft-quoted studies which advise that between 1% and 10% of healthcare-associated infections (HAIs) present as healthcare-associated outbreaks (HAOs). Examination of these studies showed they lacked validity due to a low sensitivity to detect HAO, and because they pre-date both advanced healthcare systems and the emergence of recent nosocomial pathogen challenges. The accepted inference: that as there are so few HAOs the focus of surveillance programmes should be on endemic and not epidemic infections (outbreaks), is therefore called into question.</p>
<p>Current estimates of HAI burden are derived from Point Prevalence Surveys (PPS) which are neither designed to nor are capable of detecting HAOs. We considered the extensive Infection Prevention and Control Team (IPCT) work to prevent and prepare for perennial and novel HAOs and suggest that at present this endeavour is largely unseen, underestimated and undervalued.</p>
<p>Any HAI burden estimate needs to comprise a more complete HAI summary than PPS data. This can only be done with a more inclusive surveillance system that has a wider focus than just prevalent infections. There is a real risk of redirection of the IPCT resource from outbreak prevention and preparedness work towards HAI that are counted: such a change could only further increase HAO risks.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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