With an average of only 0.1 secondary infections per case after the public health responses began, the outbreaks terminated rapidly.
In the present case, antibiotic treatment with cefepime did not prove very effective for controlling the outbreak which terminated only following the reinforcement of handwashing and isolation contact precautions.
It is unclear why some outbreaks reached clinical awareness and prompted targeted interventions and, given that numerous outbreaks did self-terminate, to what extent such interventions influenced the time to outbreak termination.
Enhanced hygiene measures, particular hand hygiene, terminated the outbreak.
In an outbreak in Jeddah, Saudi Arabia, in 2014 involving multiple health care facilities, 255 laboratory-confirmed MERS cases were documented during a 2-month period, but intensified infection prevention measures in hospitals terminated that outbreak (6, 7 ).
Although terminal cleaning within our BU terminated an MDR- Acinetobacter baumannii outbreak six years previously, repeated attempts at cleaning interventions targeting structural plumbing components have not resulted in elimination of MBLs from the environment.
Additionally, the VSD outbreaks appear to have been terminated by viral extinctions, possibly from reducing the local cat density (Radford et al. 2007).
If these are terminated too early, the outbreak may simply be shifted to a later date but if the measures are stopped too late, resources may be wasted.
Two recent reports highlight the efficacy of mupirocin decolonization to terminate outbreaks of skin infections in the community (12, 13 ).
We did not change the guidelines of empirical antibacterial treatment at a time of the outbreak, because in similar studies its significance in terminating the outbreak has remained unclear [ 16].
