پیش‌گیری از همه‌گیری بیماری‌های واگیردار

1⃣Duration of Isolation & Precautions for Adults
CDC
July 22, 2020

1. Concentrations of SARS-CoV-2 RNA measured in upper respiratory specimens decline after onset of symptoms.

2. The likelihood of recovering replication-competent virus also declines after onset of symptoms. For patients with mild to moderate COVID-19, replication-competent virus has not been recovered after 10 days following symptom onset.

Recovery of replication-competent virus between 10 and 20 days after symptom onset has been documented in some persons with severe COVID-19 that, in some cases, was complicated by immunocompromised state.

However, in this series of patients, it was estimated that 88% and 95% of their specimens no longer yielded replication-competent virus after 10 and 15 days, respectively, following symptom onset.

3. A large contact tracing study demonstrated that high-risk household and hospital contacts did not develop infection if their exposure to a case patient started 6 days or more after the case patient’s illness onset.

4. Although replication-competent virus was not isolated 3 weeks after symptom onset, recovered patients can continue to have SARS-CoV-2 RNA detected in their upper respiratory specimens for up to 12 weeks.
Investigation of 285 “persistently positive” persons, which included 126 persons who had developed recurrent symptoms, found no secondary infections among 790 contacts attributable to contact with these case patients. Efforts to isolate replication-competent virus from 108 of these case patients were unsuccessful.

5. Specimens from patients who recovered from an initial COVID-19 illness and subsequently developed new symptoms and retested positive by RT-PCR did not have replication-competent virus detected.

The risk of reinfection may be lower in the first 3 months after initial infection, based on limited evidence from another betacoronavirus (HCoV-OC43), the genus to which SARS-CoV-2 belongs

6. Currently, 6 months after the emergence of SARS-CoV-2, there have been no confirmed cases of SARS-CoV-2 reinfection. However, the number of areas where sustained infection pressure has been maintained, and therefore reinfections would be most likely observed, remains limited

7. Serologic or other correlates of immunity have not yet been established.

2⃣Ending Home Isolation
Interim Guidance
CDC
July 20, 2020
Summary of Recent Changes:

A test-based strategy is no longer recommended to determine when to discontinue home isolation, except in certain circumstances.
Symptom-based criteria were modified as follows:
Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications.
Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19.
For patients with severe illness, duration of isolation for up to 20 days after symptom onset may be warranted. Consider consultation with infection control experts.
For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.

3⃣Return-to-Work Criteria
CDC
July 17, 2020
Summary of Recent Changes:

Except for rare situations, a test-based strategy is no longer recommended to determine when to allow HCP to return to work.
For HCP with severe to critical illness or who are severely immunocompromised1, the recommended duration for work exclusion was extended to 20 days after symptom onset (or, for asymptomatic severely immunocompromised1 HCP, 20 days after their initial positive SARS-CoV-2 diagnostic test).
Other symptom-based criteria were modified as follows:
Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications
Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19

4⃣WHO
Criteria for releasing COVID-19 patients from isolation

🆘 @nouritazeh
❤️ @HealthNotes

www.group-telegram.com/it/nouritazeh.com/3072

2.1K viewsedited  Jul 24, 2020 at 06:27

1⃣Duration of Isolation & Precautions for Adults
CDC
July 22, 2020

1. Concentrations of SARS-CoV-2 RNA measured in upper respiratory specimens decline after onset of symptoms.

2. The likelihood of recovering replication-competent virus also declines after onset of symptoms. For patients with mild to moderate COVID-19, replication-competent virus has not been recovered after 10 days following symptom onset.

Recovery of replication-competent virus between 10 and 20 days after symptom onset has been documented in some persons with severe COVID-19 that, in some cases, was complicated by immunocompromised state.

However, in this series of patients, it was estimated that 88% and 95% of their specimens no longer yielded replication-competent virus after 10 and 15 days, respectively, following symptom onset.

3. A large contact tracing study demonstrated that high-risk household and hospital contacts did not develop infection if their exposure to a case patient started 6 days or more after the case patient’s illness onset.

4. Although replication-competent virus was not isolated 3 weeks after symptom onset, recovered patients can continue to have SARS-CoV-2 RNA detected in their upper respiratory specimens for up to 12 weeks.
Investigation of 285 “persistently positive” persons, which included 126 persons who had developed recurrent symptoms, found no secondary infections among 790 contacts attributable to contact with these case patients. Efforts to isolate replication-competent virus from 108 of these case patients were unsuccessful.

5. Specimens from patients who recovered from an initial COVID-19 illness and subsequently developed new symptoms and retested positive by RT-PCR did not have replication-competent virus detected.

The risk of reinfection may be lower in the first 3 months after initial infection, based on limited evidence from another betacoronavirus (HCoV-OC43), the genus to which SARS-CoV-2 belongs

6. Currently, 6 months after the emergence of SARS-CoV-2, there have been no confirmed cases of SARS-CoV-2 reinfection. However, the number of areas where sustained infection pressure has been maintained, and therefore reinfections would be most likely observed, remains limited

7. Serologic or other correlates of immunity have not yet been established.

2⃣Ending Home Isolation
Interim Guidance
CDC
July 20, 2020
Summary of Recent Changes:

A test-based strategy is no longer recommended to determine when to discontinue home isolation, except in certain circumstances.
Symptom-based criteria were modified as follows:
Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications.
Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19.
For patients with severe illness, duration of isolation for up to 20 days after symptom onset may be warranted. Consider consultation with infection control experts.
For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.

3⃣Return-to-Work Criteria
CDC
July 17, 2020
Summary of Recent Changes:

Except for rare situations, a test-based strategy is no longer recommended to determine when to allow HCP to return to work.
For HCP with severe to critical illness or who are severely immunocompromised1, the recommended duration for work exclusion was extended to 20 days after symptom onset (or, for asymptomatic severely immunocompromised1 HCP, 20 days after their initial positive SARS-CoV-2 diagnostic test).
Other symptom-based criteria were modified as follows:
Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications
Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19

4⃣WHO
Criteria for releasing COVID-19 patients from isolation

🆘 @nouritazeh
❤️ @HealthNotes

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