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How is everyone handling those who are turning up positive more than 3 months after their initial infection/positive? This has been problematic especially in long term care facilities with serial testing. Are decisions being made solely if clinical symptoms are present or anyone with a positive after 3 months is treated as a new case - even if asymptomatic.
Comments & Events
Lauren Stockman
CA is NOT considering these new cases.
Notified 219 people
Lynn Sosa
Thanks for posting this Lisa! This is also problematic in CT! I think our intent was to treat them as new cases for the purposes of public health action eg. contact tracing etc but nursing homes might challenge that idea, so I'm interested in hearing how others are handling this. I think the best we could come up with was do a risk and clinical assessment to decide how to handle next? That said, we are not officially counting these as *new* cases in our case counts/surveillance.
Notified 219 people
Brian Erly
For surveillance purposes, we consider a positive PCR after 90 days to be evidence of a new infection, and we are counting them twice, and initiating public health actions like quarantine and isolation. For inpatients, we defer to their own infection prevention policies, but use our surveillance definitions for case counting.
So, now that it has been another 3 months and CDC just posted their guidance, I'm wondering how you are handling reinfection? In light of the fact that having initial and subsequent illness specimens on persons is rare, are you counting second infections as a new case for counting purposes? I realize you may still be conducting the same I & Q and Contact Tracing as appropriate? Do you make any distinction between confirmed or probable cases if you count reinfection as a case?
Notified 251 people
Sherri Davidson
We conduct an investigation, but assign the case status as Unknown. Even our SPHL ran out of capacity to store specimens and we learned last week that they had discarded the older samples. As for marking them as Unknown, as more information becomes available about the virus, I hope a set timeframe will emerge for assuming a reinfection and these can later be reclassified accordingly.
Below is an algorithm from a HAN sent out 7/31