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1.
MMWR Morb Mortal Wkly Rep ; 64(45): 1267-70, 2015 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-26583915

RESUMO

On December 13, 2014, the emergency management system in Lake Delton, Wisconsin, was notified when a male hockey player aged 20 years lost consciousness after participation in an indoor hockey tournament that included approximately 50 hockey players and 100 other attendees. Elevated levels of carbon monoxide (CO) (range = 45 ppm-165 ppm) were detected by the fire department inside the arena. The emergency management system encouraged all players and attendees to seek medical evaluation for possible CO poisoning. The Wisconsin Department of Health Services (WDHS) conducted an epidemiologic investigation to determine what caused the exposure and to recommend preventive strategies. Investigators abstracted medical records from area emergency departments (EDs) for patients who sought care for CO exposure during December 13-14, 2014, conducted a follow-up survey of ED patients approximately 2 months after the event, and conducted informant interviews. Ninety-two persons sought ED evaluation for possible CO exposure, all of whom were tested for CO poisoning. Seventy-four (80%) patients had blood carboxyhemoglobin (COHb) levels consistent with CO poisoning; 32 (43%) CO poisoning cases were among hockey players. On December 15, the CO emissions from the propane-fueled ice resurfacer were demonstrated to be 4.8% of total emissions when actively resurfacing and 2.3% when idling, both above the optimal range of 0.5%-1.0%. Incomplete fuel combustion by the ice resurfacer was the most likely source of elevated CO. CO poisonings in ice arenas can be prevented through regular maintenance of ice resurfacers, installation of CO detectors, and provision of adequate ventilation.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Intoxicação por Monóxido de Carbono/etiologia , Monóxido de Carbono/análise , Exposição Ambiental/efeitos adversos , Hóquei , Adolescente , Adulto , Poluição do Ar em Ambientes Fechados/análise , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/estatística & dados numéricos , Exposição Ambiental/análise , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Wisconsin , Adulto Jovem
2.
Infect Control Hosp Epidemiol ; 33(2): 185-91, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22227989

RESUMO

OBJECTIVE: To detect an outbreak-related source of Legionella, control the outbreak, and prevent additional Legionella infections from occurring. DESIGN AND SETTING: Epidemiologic investigation of an acute outbreak of hospital-associated Legionnaires disease among outpatients and visitors to a Wisconsin hospital. PATIENTS: Patients with laboratory-confirmed Legionnaires disease who resided in southeastern Wisconsin and had illness onsets during February and March 2010. METHODS: Patients with Legionnaires disease were interviewed using a hypothesis-generating questionnaire. On-site investigation included sampling of water and other potential environmental sources for Legionella testing. Case-finding measures included extensive notification of individuals potentially exposed at the hospital and alerts to area healthcare and laboratory personnel. RESULTS: Laboratory-confirmed Legionnaires disease was diagnosed in 8 patients, all of whom were present at the same hospital during the 10 days prior to their illness onsets. Six patients had known exposure to a water wall-type decorative fountain near the main hospital entrance. Although the decorative fountain underwent routine cleaning and maintenance, high counts of Legionella pneumophila serogroup 1 were isolated from cultures of a foam material found above the fountain trough. CONCLUSION: This outbreak of Legionnaires disease was associated with exposure to a decorative fountain located in a hospital public area. Routine cleaning and maintenance of fountains does not eliminate the risk of bacterial contamination. Our findings highlight the need to evaluate the safety of water fountains installed in any area of a healthcare facility.


Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/epidemiologia , Microbiologia da Água , Abastecimento de Água , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Feminino , Fômites , Humanos , Controle de Infecções , Doença dos Legionários/prevenção & controle , Doença dos Legionários/transmissão , Masculino , Pessoa de Meia-Idade , Wisconsin
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