Virtual Training for Managing Emerging Zoonotic Diseases including COVID-19

The burden of zoonotic diseases is an important global issue affecting human and animal health, food value chains, international trade, and the environment. Two-thirds of the infectious diseases affecting human health are of animal origin. Information and knowledge of zoonotic diseases and associated effects is critical for managing these diseases. The World TAP at Michigan State University offered an online course in zoonotic diseases in March 2021, which a diverse group of 42 participants from 15 countries in Africa, Asia, Middle East, and Americas attended. Grounded on Experiential Leaning Theory this paper discusses the conceptualization, design, implementation, outcomes of, and lessons-learned from this course. Key contents of this comprehensive course included epidemiology of zoonotic diseases, zoonoses of wildlife origin, utilizing a One Health approach to managing zoonoses, and roles of regional/international organizations in strengthening zoonotic disease management capacities, and the lessons-learned from the pandemic on diagnosis, prevention, and prediction of zoonotic diseases. The paired t-test results using pre- and post-course survey data showed significant increases in the participants’ level of knowledge on zoonoses post-course. in comparison to their pre-course knowledge. During the interactive discussion, participants stressed the need for continuing information sharing, and networking. For future offerings, the participants suggested adding impacts of zoonoses on international trade, and effect of climate change on zoonoses., and increasing collaborations between national, regional, and international organizations working on zoonoses. With the success of the first offering, MSU will continue to offer this course in the future, may be in a hybrid mode

Screening Acute HIV Infections among Chinese Men Who Have Sex with Men from Voluntary Counseling & Testing Centers

Recent studies have shown the public health importance of identifying acute HIV infection (AHI) in the men who have sex with men (MSM) of China, which has a much higher risk of HIV transmission. However, cost-utility analyses to guide policy around AHI screening are lacking.An open prospective cohort was recruited among MSM living in Liaoning Province, Northeast China. Blood samples and epidemiological information were collected every 10 weeks. Third-generation ELISA and rapid test were used for HIV antibody screening, western blot assay (WB) served for assay validation. Antibody negative specimens were tested with 24 mini-pool nucleic acid amplification testing (NAAT). Specimens with positive ELISA but negative or indeterminate WB results were tested with NAAT individually without mixing. A cost-utility analysis of NAAT screening was assessed. Among the 5,344 follow-up visits of 1,765 MSM in 22 months, HIV antibody tests detected 114 HIV chronic infections, 24 seroconverters and 21 antibody indeterminate cases. 29 acute HIV infections were detected with NAAT from 21 antibody indeterminate and 1,606 antibody negative cases. The HIV-1 prevalence and incidence density were 6.6% (95% CI: 5.5–7.9) and 7.1 (95% CI: 5.4–9.2)/100 person-years, respectively. With pooled NAAT and individual NAAT strategy, the cost of an HIV transmission averted was $1,480. The addition of NAAT after HIV antibody tests had a cost-utility ratio of$3,366 per gained quality-adjusted life year (QALY). The input-output ratio of NAAT was about 1∶16.9.The HIV infections among MSM continue to rise at alarming rates. Despite the rising cost, adding pooled NAAT to the HIV antibody screening significantly increases the identification of acute HIV infections in MSM. Early treatment and target-oriented publicity and education programs can be strengthened to decrease the risk of HIV transmission and to save medical resources in the long run

Utilizing Pre-education Assessment and a Targeted Education Module to Enhance Nurse Knowledge of Standard and Transmissible Precautions

Abstract The aim of this project was to protect patient safety and prevent healthcare acquired infections by improving nurses’ knowledge of infection prevention practices. A second practical benefit was creating a pilot for an RN education program. I propose that the reason compliance with hand hygiene is low at any facility can be explained by Rosenstock’s Health Belief Model. Nurses may not believe that 1) There is a high chance of spreading or themselves contracting infectious illness, 2) That the illnesses they are exposed to would be just as serious in them as they are seeing in patients, 3) They have been told but may not actually believe that the simple act of hand hygiene protects everyone and 4) That barriers of time and memory can be overcome. Rosenstocks is the behavior change model for the individual nurses to change their behavior based on knowledge that I will give them that addresses each of those four points. The team was created from RN volunteers—16 of them—who liked that they were being assessed and recognized for what they knew and were not getting the same style of “education” that they had gotten from other facilities—cut and dried one size fits all. Vision and communication for buy-in was easy from the RN team, support in this project was also offered readily from Administration. The short term win was the post test score increases which showed that the RNs improved their test scores on all three components of infection prevention, standard precautions, transmissible precautions and organism specific knowledge

Shifting the Culture of Quarantine

Quarantine will likely never be a comfortable experience for anyone, but there are concrete steps that can be taken to improve the experience and help shift perceptions of quarantine in the United States from punishment to social responsibility. Changing perceptions, however, requires changing the reality of the quarantine experience, which must be done through a series of policies, regulations and tangible support to individuals who have had their freedom of movement curtailed. These actions must also be taken to reinforce the public’s trust in government. This paper looks at how quarantine has been used in recent history, assesses what we can learn from the experiences, and proposes a set of actions the United States could take to improve the quarantine experience, and eventually change perceptions