On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from ...Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.
To evaluate the quality of corneal donor tissue from pseudophakic eyes for transplantation.
Only capsular-supported posterior chamber pseudophakia was studied. Forty-five pairs of donor eyes were ...assessed and evaluated by standard Minnesota Lions Eye Bank (MLEB) protocol. Thirty-three pairs were unilaterally pseudophakic with the unoperated phakic eye used as a control eye. Twelve donors were bilaterally pseudophakic. All corneas were rated for corneal clarity, epithelial defects, stromal edema, Descemet's membrane folding, endothelial cell density (ECD), and cell damage by slit-lamp examination and specular microscopy. If the corneas were not transplanted, the endothelium was vital stained with trypan blue and counterstained with alizarin red S for quantitation, localization, and visualization of cell morphology and damage.
Sixty-eight of the 90 corneas in this study did not meet transplantation criteria. A significant difference in ECD (>22%) and in overall corneal rating was found in seven (21%) of 33 pairs of unilateral pseudophakic donors. Fourteen corneal transplants were performed using corneas from the donors in this study. Nine corneas from pseudophakic donor eyes were transplanted, resulting in one primary graft failure reported.
Corneas from pseudophakic donor eyes may need more extensive evaluation for endothelial viability than is currently required by eye bank standards.
Between May 1983 and December 1989, 2,921 donor eyes received by the Minnesota Lions Eye Bank underwent a decontamination protocol using 10% Betadine (1% povidone-iodine) solution. Positive ...pretreatment limbal cultures were obtained on 52.1% of donor eyes. Posttreatment limbal cultures demonstrated a 76.1% reduction in microbial growth, including an 85.7% reduction in Candida species. Streptococcus species were reduced by 76.7% and coagulase-negative Staphylococcus were reduced by 76.1%. In addition, of 250 donor rims obtained at the time of surgery, two had coagulase-negative. Staphylococcus present that were also present after the decontamination procedure. In no cases did endophthalmitis occur during this study. This study demonstrates that this protocol using 10% Betadine solution is extremely effective in decontaminating donor globes of aerobic bacteria and fungi. However, gentamicin-resistant organisms survived this protocol, emphasizing the need to develop storage media containing a broader-spectrum antibiotic agent then gentamicin.
Twenty-four pair of eyes donated to the Minnesota Lions Eye Bank were studied to determine the effect of corneal procurement methods on tissue quality. Eyes studied were ineligible for ...transplantation because of a preexisting medical condition other than sepsis or age of > 75 years. The procurement technique was randomized for each donor. One cornea was procured in situ (IS), whereas the fellow eye was enucleated and processed in the laboratory (EN). Procurement protocols were standard Eye Bank Association of America methods. Tissue characteristics were scored according to standard eye bank protocols. Cultures were performed at the time of tissue procurement and following storage for 7 days in Dexol media. With the exception of endothelial striae, no statistical difference was found between groups for any tissue characteristics. The average score for endothelial striae in the IS group was greater than twice that of the EN group. Initial cultures were positive in 10 of 24 in the IS group and four of 24 in the EN group. Each group had three positive end-storage cultures. These results demonstrate superior tissue decontamination after initial processing and less endothelial cell trauma with standard enucleation when compared to in situ corneal excisions.
In this laboratory study, several commercially available household bathroom and kitchen cleaning products, with and without EPA registered disinfectant properties, were compared to several ..."alternative" products (lemon juice, vinegar, ammonia, baking soda and borax). High pressure decorative laminate tiles were cleaned mechanically using a Gardner Abrasion Tester. Test criteria included microbial reduction, based on remaining colony forming units of a tracer organism (Serrada marcescens), and soil reduction (of simulated bathroom and kitchen soil formulations) based on subjective grading by a panel of individuals. Among bathroom cleaners, the commercial cleaners and vinegar gave the most effective microbial reduction while a commercial cleaner without disinfectant was most effective at soil removal. Among kitchen cleaners, again the commercial products and vinegar were most effective at microbial reduction while the commercial cleaners and ammonia were most effective at soil removal.
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