Residents of long-term care facilities (LTCFs), particularly those in skilled nursing facilities (SNFs), have experienced disproportionately high levels of COVID-19-associated morbidity and mortality and were prioritized for early COVID-19 vaccination (1,2). However, this group was not included in COVID-19 vaccine clinical trials, and limited postauthorization vaccine effectiveness (VE) data are available for this critical population (3). It is not known how well COVID-19 vaccines protect SNF residents, who typically are more medically frail, are older, and have more underlying medical conditions than the general population (1). In addition, immunogenicity of the Pfizer-BioNTech vaccine was found to be lower in adults aged 65-85 years than in younger adults (4). Through the CDC Pharmacy Partnership for Long-Term Care Program, SNF residents and staff members in Connecticut began receiving the Pfizer-BioNTech COVID-19 vaccine on December 18, 2020 (5). Administration of the vaccine was conducted during several on-site pharmacy clinics. In late January 2021, the Connecticut Department of Public Health (CT DPH) identified two SNFs experiencing COVID-19 outbreaks among residents and staff members that occurred after each facility's first vaccination clinic. CT DPH, in partnership with CDC, performed electronic chart review in these facilities to obtain information on resident vaccination status and infection with SARS-CoV-2, the virus that causes COVID-19. Partial vaccination, defined as the period from >14 days after the first dose through 7 days after the second dose, had an estimated effectiveness of 63% (95% confidence interval [CI] = 33%-79%) against SARS-CoV-2 infection (regardless of symptoms) among residents within these SNFs. This is similar to estimated effectiveness for a single dose of the Pfizer-BioNTech COVID-19 vaccine in adults across a range of age groups in noncongregate settings (6) and suggests that to optimize vaccine impact among this population, high coverage with the complete 2-dose series should be recommended for SNF residents and staff members.

Candida auris is an emerging fungus that poses a considerable threat to US healthcare facilities and their patients. Patients exposed to C. auris can develop invasive infection, which can be fatal,Reference Lockhart, Etienne and Vallabhaneni 1 or can become colonized, which poses long-term transmission risks. Once introduced into a healthcare facility, C. auris can spread through contact with affected patients and contaminated surfaces.Reference Tsay, Welsh and Adams 2 The organism can persist in the environment,Reference Welsh, Bentz and Shams 3 and quaternary ammonium disinfectants demonstrate poor activity against it.Reference Cadnum, Shaikh, Piedrahita and Sankar 4 Candida auris is often multidrug-resistant,Reference Lockhart, Etienne and Vallabhaneni 1 , Reference Cadnum, Shaikh, Piedrahita and Sankar4 and its detection is challenging because it can be misidentified by some biochemically based identification methods. For example, the API 20 C (bioMerieux, Marcy-l’Etoile, France) can misidentify C. auris as C. sake or Rhodotorula glutinis, and the Vitek 2 (bioMerieux) can misidentify C. auris as C. haemulonii or C. duobushaemulonii.Reference Mizusawa, Miller and Green 5 Rapid and accurate C. auris detection would help hospitals to guide infection control activities intended to prevent the spread of the fungus within and between facilities and to properly plan antifungal treatment. We surveyed laboratories that serve Connecticut’s acute-care hospitals to assess their capability to identify C. auris. The information was collected to guide statewide hospital prevention efforts.

In September 2016, the Connecticut Department of Public Health was notified of a cluster of gastrointestinal illnesses among persons who shared a catered lunch. The Connecticut Department of Public Health worked with the local health department to investigate the outbreak and recommend control measures. Information about symptoms and foods eaten was gathered using an online survey. A case was defined as the onset of abdominal pain or diarrhea in a lunch attendee <24 hours after the lunch. Risk ratios (RRs), 95% confidence intervals (CIs), and Fisher’s exact p-values were calculated for all food and beverages consumed. Associations of food exposures with illness were considered statistically significant at p<0.05. | Among approximately 50 attendees, 30 (60%) completed the survey; 19 (63%) respondents met the case definition. The majority of commonly reported symptoms included diarrhea (17 of 18), abdominal pain (15 of 16), and headache (7 of 15). The median interval from lunch to illness onset was 5.3 hours (range = 0.4–15.5 hours) for any symptom and 7 hours (range = 2.5–13 hours) for diarrhea. Analysis of food exposures reported by 16 ill and 10 well respondents (four respondents did not provide food exposure information) found illness to be associated with the beef dish (RR = undefined; CI = 1.06–∞; p = 0.046) (Table). All 16 ill respondents reported eating the beef. Coffee was also associated with illness; however, all 13 coffee drinkers who became ill also ate the beef. Eating cake approached significance (p = 0.051); all 10 cake eaters who became ill also ate the beef.