American Journal of Infection Control – June 2015

American Journal of Infection Control
June 2015 Volume 43, Issue 6, p547-662

What can we learn about the Ebola outbreak from tweets?
Michelle Odlum, Sunmoo Yoon
Twitter can address the challenges of the current Ebola outbreak surveillance. The aims of this study are to demonstrate the use of Twitter as a real-time method of Ebola outbreak surveillance to monitor information spread, capture early epidemic detection, and examine content of public knowledge and attitudes.

Healthcare worker influenza declination form program
Sherri L. LaVela, PhD, MPH, MBA, Jennifer N. Hill, MA, Bridget M. Smith, PhD, Charlesnika T. Evans, PhD, MPH, Barry Goldstein, MD, PhD, Richard Martinello, MD
Published Online: March 20, 2015
:: The declination form program was compatible, flexible, easy to use, and supported by leadership.
:: Declination form program facilitators included complementary ongoing strategies and leadership engagement.
:: One-on-one attention and education at the time of vaccination led to health care worker accountability.
:: An influenza declination form program is of minimal cost, but it requires some dedicated staff and resources.
:: Vaccination rate improved from 53.5% to 77.4% pre- to postdeclination form program implementation.
Health care worker (HCW) vaccination rates have been low for many years (approximately 50%). Our goal was to implement an influenza declination form program (DFP) to assess feasibility, participation, HCW vaccination, and costs.
This was a prospective interventional pilot study using mixed methods to evaluate the DFP implementation processes and outcomes. We conducted a formative evaluation and interviews; data were transcribed and coded into themes. Secondary outcomes included self-reported HCW influenza vaccine uptake (pre-/postsurvey) and program costs; data were evaluated using descriptive and bivariate analyses.
The DFP was compatible with ongoing strategies and unit culture. Barriers included multiple hospital shifts and competing demands. Facilitators included complementary ongoing strategies and leadership engagement. HCW vaccination rates were higher post- versus preimplementation (77.4% vs 53.5%, P =.01). To implement the DFP at site 1, using a mobile flu cart, 100% of declination forms were completed in 42.5 staff hours over <2 months. At site 2, using a vaccination table on all staff meeting days, 49% of forms were completed in 26.5 staff hours over 4.5 months. Average cost of staff time was $2,093 per site.
DFP implementation required limited resources and resulted in increased HCW influenza vaccine rates; this may have positive clinical implications for influenza infection control/prevention.
Increased reports of measles in a low endemic region during a rubella outbreak in adult populations
Takako Kurata, Daiki Kanbayashi, Hiroshi Nishimura, Jun Komano, Tetsuo Kase, Kazuo Takahashi
Published online: April 1, 2015
In 2013, a rubella outbreak was observed in Japan, Romania, and Poland. The outbreak in Japan was accompanied by an increase of measles reports, especially from a region where measles is highly controlled. This was attributed to the adult populations affected by this rubella outbreak, similarity of clinical signs between rubella and measles, sufficiently small impact of measles outbreaks from neighboring nations, and elimination levels of measles endemicity. Current and future concerns for measles control are discussed.