key: cord-1038632-aqc3d7ln authors: Greenky, David; Linam, Matt; Yaffee, Anna; Costello, Brian; Murray, Brittany title: Response to “Prevalence of SARS-CoV-2 Antibodies in Pediatric Healthcare Workers (pHCWs)” date: 2021-04-03 journal: Int J Infect Dis DOI: 10.1016/j.ijid.2021.03.092 sha: 79326f6854aa43d0e948e97f68b43df6dea7f2f4 doc_id: 1038632 cord_uid: aqc3d7ln nan We read with interest the recently published article by Morris et al. , "Prevalence of SARS-CoV-2 Antibodies in Pediatric Healthcare Workers (pHCWs) ." The study demonstrated pHCWs in the pediatric emergency department (ED) had a higher prevalence of anti-SARS-CoV-2-IgG than pHCWs outside the ED. It also points to universal personal protective equipment (PPE) for pHCWs in the pediatric ED until communicable disease can be definitively ruled out (Morris et al., 2021) . While the personal travel of pHCWs was not associated with increased seropositivity in this study, an association between pHCW seropositivity and patient travel was not discussed. This is a potentially vital piece of information considering this investigation encompassed a time early in the COVID-19 pandemic when history of patient travel was thought to be an important factor in identifying patients at risk of infection. Understanding the effectiveness of current ED triage travel screening and providertaken travel history to identify patients with travel-related risk for COVID-19 could inform our overall understanding of these processes to detect travel-related infections and interrupt transmission. Most patients with travel-related illness present to the hospital through the ED (Burkholder et al., 2019) . Consequently, ED healthcare providers are at particular risk for exposure to travel-related disease. During the Ebola epidemic in 2014, a triage travel screen was implemented in EDs across the United States at the direction of the Centers for Disease Control and Prevention (CDC) to detect persons under investigation and prevent outbreaks (Identify, Isolate, Inform, 2019) (Schwedhelm et al., 2020) . Since then, it has become a de facto screen for travel-related illness. The screen is not intended to replace a formal travel history, but instead to identify patients at risk for travel-related illness, allowing for appropriate isolation and to alert clinicians to information that may impact management. Most ED triage travel screens ask about international travel in the 21 days prior to presentation as part of the CDC's "Identify, Isolate, Inform" strategy for travel-related illness (Identify, Isolate, Inform, 2019) . However, initial studies have suggested these screens may not adequately detect travel-related illness, and could be improved by implementing an algorithm that combines travel history, origin of travel, and symptoms to make smarter travel alerts (Greenky et al., 2020; Yaffee et al., 2019) . The COVID-19 pandemic has highlighted the importance of conducting further research to identify how interventions such as an improved ED triage travel screen algorithms and PPE could better protect HCWs from communicable illness. J o u r n a l P r e -p r o o f Adherence to Universal Travel Screening in the Emergency Department During Epidemic Ebola Virus Disease The Utility of a Travel Screen at Triage in Pediatric Emergency Medicine Inform: Emergency Department Evaluation and Management for Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) | Emergency Services | Clinicians | Ebola (Ebola Virus Disease) | CDC Prevalence of SARS-CoV-2 antibodies in pediatric healthcare workers Can You Catch It? Lessons Learned and Modification of ED Triage Symptom-and Travel-Screening Strategy How Can Emergency Departments Better Prepare for Emerging Infectious Disease Threats? A Returned Traveler With Fever Walks Into Triage… The authors declare no conflict of interest in this study. There were no animal or human subjects in this study, no ethical approval was obtained or needed.There was no funding for this study. ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.