The syndromes included here represent a variety of clinically relevant infections that can occur in the LTCF population. Surveillance should be performed for infections for which there are clear strategies that can be implemented for prevention and control of transmission ( Table 1 ). However, for completeness and consistency with the original surveillance definitions, 1 several infections that may occur because of underlying host factors rather than transmission within the facility have also been included in this document, so that both infection prevention programs and research studies have a standard set of criteria. Given the limited infection prevention and control resources that are currently available in most LTCFs, surveillance activities may need to target those infections in a facility that have the most potential for prevention. In addition, some infections are associated with a high likelihood of transmission and development of outbreaks (eg, norovirus, influenza, group A Streptococcus , acute viral hepatitis). For these infections, identification of even a single case in a LTCF should trigger a more intensive investigation. 6 , 7
While a psychotic reaction can occur following any method of use, emergency room responders have seen an increasing number of cases involving marijuana edibles. Some people (especially preteens and teens) who know very little about edibles don't realize that it takes longer for the body to feel marijuana’s effects when eaten rather than smoked. So they consume more of the edible, trying to get high faster or thinking they haven't taken enough. In addition, some babies and toddlers have been seriously ill after ingesting marijuana or marijuana edibles left around the house.