{
  "abstract": "Objectives: Coronavirus disease 2019 outbreaks in long-term care facilities can spread rapidly, but evidence on whether delayed outbreak-triggered unit-wide screening is associated with outbreak size is limited.\n\nMethods: We conducted a retrospective observational study using outbreak-support records from long-term care and related social welfare facilities in Okinawa Prefecture, Japan, from April to September 2022. We included outbreaks with documented unit-wide screening. The outcome was the final outbreak size. The exposure was the delay from outbreak recognition to the first unit-wide screening (same day, 1 day, 2 days, or ≥3 days). We used multivariable negative binomial regression, adjusting for index case type, facility type, recognition period, and facility-level resident vaccination coverage.\n\nResults: We analyzed 707 outbreaks. Compared with same-day screening, the adjusted incidence rate ratios for outbreak size were 0.95 (95% confidence interval 0.72-1.26) for a 1-day delay, 1.16 (0.87-1.54) for a 2-day delay, and 1.44 (1.09-1.91) for delays of ≥3 days. The association was attenuated after adjustment for on-site infection prevention and control visit timing.\n\nConclusion: Delays of ≥3 days from outbreak recognition to the first unit-wide screening were associated with a larger final outbreak size. Earlier outbreak-triggered screening may support outbreak control in long-term care facilities, although causal interpretation is limited by the observational design.",
  "abstract_shown": true,
  "affiliations": [
    "Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Kyoto, Kyoto, Japan",
    "Emergency Medical Center, Urasoe General Hospital, Urasoe, Okinawa, Japan",
    "The Okinawa Prefecture Commission for Epidemiological and Statistical Analysis, Naha, Okinawa, Japan",
    "Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Université Paris Cité, Paris, France",
    "Pasteur International Unit at Kumamoto University/Japan Institute for Health Security, Tokyo, Japan",
    "Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan",
    "Department of Emergency Medicine, Nakagami Hospital, Okinawa, Okinawa, Japan",
    "Okinawa Prefectural Government, Naha, Okinawa, Japan",
    "Division of Infectious Diseases, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yining S. Xu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kuniko Takahashi"
    },
    {
      "affs": [
        2,
        3,
        4,
        5
      ],
      "name": "Yusuke Shimakawa"
    },
    {
      "affs": [
        6
      ],
      "name": "Takashi Nakamura"
    },
    {
      "affs": [
        7
      ],
      "name": "Toru Itokazu"
    },
    {
      "affs": [
        2,
        8
      ],
      "name": "Yoshihiro Takayama"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Kenji Mizumoto"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0zgj6vkjng0sg.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ijregi.2026.101042",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13744804/",
  "id": "0zgj6vkjng0sg",
  "issns": [
    "2772-7076"
  ],
  "landing_url": "https://doi.org/10.1016/j.ijregi.2026.101042",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Report"
    ],
    [
      "openalex",
      "2717|Geriatric Care and Nursing Homes"
    ]
  ],
  "openalex": "W7221595907",
  "pdf_url": null,
  "pmcid": "PMC13744804",
  "pmid": "43001209",
  "published": "2026-10-13",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/0zgj6vkjng0sg.ris",
  "sources": [
    {
      "first_seen": "2026-11-11T12:22:17Z",
      "native_id": "PMC13744804",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.ijregi.2026.101042"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2717|Geriatric Care and Nursing Homes",
      "subfield": "general"
    }
  ],
  "title": "Timing of outbreak-triggered unit-wide screening and COVID-19 outbreak size in long-term care and related social welfare facilities in Okinawa, Japan",
  "title_text": "Timing of outbreak-triggered unit-wide screening and COVID-19 outbreak size in long-term care and related social welfare facilities in Okinawa, Japan",
  "type": "peer-reviewed",
  "updated_at": "2026-11-12T12:21:14Z",
  "url": "https://research.draconitic.com/paper/0zgj6vkjng0sg",
  "venue": "IJID Regions",
  "versions": []
}