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Outbreak Investigations in Healthcare Settings

CDC works with health departments and federal agencies, such as the United States Food and Drug Administration (FDA), to protect patients and stop outbreaks from spreading in healthcare facilities. Often, these outbreaks are the result of either failures in infection control practices or contaminated equipment or medications.

During some outbreak situations, CDC sends experts to work side-by-side with facility and health department staff. For example, state health departments may contact CDC and request assistance through a process known as an Epi-Aid. Typically, these efforts include on-site assistance, laboratory support and additional consultation with experts at CDC headquarters. CDC advises the public about what they can do to protect themselves, provides recommendations to the medical and public health community about how to prevent future infections, and works closely with policymakers, regulatory agencies and industry to learn how to prevent similar outbreaks in the future.

In addition to formal Epi-Aid investigations, CDC routinely provides consultation and laboratory assistance to healthcare facilities and health departments that are working to solve outbreaks or investigate infection control breaches and other adverse events.

2014-2015 Epi-Aid Investigations Supported by CDC’s Division of Healthcare Quality Promotion

Blood and Wound Infections in Nursing Home Patients

Summary: A cluster of bloodstream infections identified in residents of a nursing home
Facility Type: Nursing home
Infection Type: Bloodstream and wound infections
Pathogen: Group A Streptococcus
When: March 2015
Where: South Carolina
Related Education/Training Materials:
www.cdc.gov/HAI/prevent/prevent_pubs.html
www.cdc.gov/groupastrep/index.html

Hepatitis Infections Among Patients at an Outpatient Facility

Summary: Hepatitis cases after unsafe injections
Facility Type: Outpatient clinic
Infection Type: Systemic
Pathogen: Hepatitis C
When: March 2015
Where: California

Related Education/Training Materials: 
www.cdc.gov/injectionsafety
www.cdc.gov/HAI/prevent/prevention_tools.html

Bloodstream Infections in a Nursing Home

Summary: A cluster of bloodstream infections identified in residents of a nursing home.
Facility Type: Nursing home
Infection Type: Bloodstream infections
Pathogen: Salmonella
When: January 2014
Where: New York
Related Education/Training Materials: www.cdc.gov/HAI/prevent/prevention_tools.html

Infections Among Cancer Patients

Summary: A cluster of infections identified in hospital patients with myeloid leukemia.
Facility Type: Hospital
Infection Type: Central nervous system symptoms
Pathogen: Bacillus cereus
When: February 2014
Where: Massachusetts

Related Education/Training Materials: 
www.cdc.gov/cancer/preventinfections

Rare CRE Found in Hospital Patients

Summary: A cluster of patients carrying a bacteria with a rare form of carbapenem resistance.
Facility Type: Hospital
Infection Type: N/A – colonization only
Pathogen: Plasmid-mediated AmpC-producing E. coli
When: February 2014
Where: Washington

Related Education/Training Materials: 
www.cdc.gov/HAI/organisms/cre/index.html
www.ncbi.nlm.nih.gov/pubmed/25817743

First U.S. Case of Middle East Respiratory Syndrome Coronavirus – MERS-CoV

Summary: A patient tested positive for MERS-CoV infection and was hospitalized.
Facility Type: Hospital
Infection Type: Respiratory virus
Pathogen: MERS-CoV
When: May 2014
Where: Indiana

Related Education/Training Materials: 
www.cdc.gov/coronavirus/mers/index.html

Bloodstream Infections in Patients Undergoing Dialysis Treatment

Summary: A cluster of bloodstream infections among patients undergoing hemodialysis
Facility Type: Outpatient dialysis facilities
Infection Type: Bloodstream infections
Pathogen: Burkholderia cepacia and Stenotrophomonas maltophilia
When: September 2014
Where: California
Related Education/Training Materials: 
www.cdc.gov/dialysis/

Infections in NICU patients

Summary: Deaths and infections among babies in a neonatal intensive care unit
Facility Type: Hospital
Infection Type: Bloodstream and respiratory
Pathogen: Pseudomonas aeruginosa
When: September 2014
State: California
Related Education/Training Materials: http://www.cdc.gov/HAI/organisms/Pseudomonas.html

Ebola Importation and Transmission in the United States

Summary: Healthcare workers contracted Ebola while caring for a patient with the disease
Facility Type: Hospital
Infection Type: Ebola virus disease
Pathogen: Ebola Virus
When: October 2014
Where: Texas

Related Education/Training Materials: 
www.cdc.gov/ebola/
www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1114a5.htm

Fungal Infections among Hematologic Cancer Patients

Summary: A cluster of mucormycosis among hematologic cancer patients
Facility Type: Hospital
Infection Type: Infections in the lungs, and rhinocerebral area (sinuses, oral and nasal cavities, or brain)
Pathogen: multiple mucormycete species
When: December 2014
Where: Kansas

Related Education/Training Materials: 
www.cdc.gov/hicpac/

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