A nosocomial outbreak of influenza during a period without influenza epidemic activity

Abstract

The objective of this study was to describe a nosocomial outbreak of influenza during a period without influenza epidemic activity in the community.Outbreak investigation was carried out in an infectious diseases ward of a tertiary hospital. Presence of two or more of the following symptoms were used to define influenza: cough, sore throat, myalgia and fever. Epidemiological survey, direct immunofluorescence, viral culture, polymerase chain reaction, haemagglutination-inhibition test in throat swabs and serology for respiratory viruses were performed.Twenty-nine of 57 healthcare workers (HCW) (51%) and eight of 23 hospitalised patients (34%) fulfilled the case definition. Sixteen HCW (55%) and three inpatients (37%) had a definitive diagnosis of influenza A virus infection (subtype H1N1). Among the symptomatic HCW, 93% had not been vaccinated against influenza that season. Affected inpatients were isolated and admissions in the ward were cancelled for 2 weeks. Symptomatic HCW were sent home for 1 week. On the seventeenth day of the outbreak the last case was declared.The incidence of cases in this outbreak of influenza, which occurred during a period without influenza epidemic activity in the community, was notably high. Epidemiological data suggest transmission from healthcare workers to inpatients. Most healthcare workers were not vaccinated against influenza. Vaccination programmes should be reinforced among healthcare workers.

Incidence of respiratory viruses in preterm infants submitted to mechanical ventilation

“…To our knowledge no systematic investigations into respiratory viruses among preterm infants with acute respiratory failure have been reported in Brazil. The confirmation of a viral infection diagnosis is important for rationalizing the prescription of antibiotics, thereby avoiding the appearance of multi-resistant bacteria and to control the dissemination of respiratory viruses in NICUs 7,15,19 .…”

Evaluation of 2009 pandemic influenza A (H1N1) exposures and illness among physicians in training

“…[3][4][5][6] The fact that HCP represent an estimated 9% of the entire US workforce 2 further magnifies the importance of preventing influenza in HCP to protect both themselves and their patients. Information on comprehensive prevention strategies for HCP during pandemics, when effective vaccination or treatment might not be available, is important.…”

“…2 Seasonal influenza has been shown to spread rapidly among patients and health care personnel (HCP) in health care settings. [3][4][5] HCP are among the occupational groups considered at highest risk for exposure to pandemic influenza virus, 6 and health care-associated pH1N1 infections were reported in HCP nationwide. 7 Strategies for prevention and control of seasonal influenza in health care facilities have included annual influenza vaccination of patients and HCP, standard and droplet precautions for infected patients, active surveillance for new illness cases, restriction of ill visitors and HCP, rapid administration of antiviral medications for treatment and prevention during outbreaks, and education and training of HCP in hand hygiene, respiratory hygiene, and cough etiquette.…”

Outbreak of influenza virus A/H1N1 in a hospital ward for immunocompromised patients

“…There might be different reasons for this. It is known that, even in acute influenza disease, the virus becomes undetectable in the respiratory tract within days after infection [7]. The pharyngeal lavages of the HCWs were collected from February 27 to March 5, 2008, i.e.…”

“…It is well known that especially the elderly, neonates and patients with underlying chronic diseases are at risk for influenza-associated morbidity and mortality [2,4]. Several outbreaks of nosocomial influenza have been described in recent years [7,9,12]. In these cases, unvaccinated health care workers (HCWs) have been identified as the main source of infection [11].…”