Exposure to Influenza Virus Aerosols During Routine Patient Care

Bischoff, Werner; Swett, Katrina; Leng, Iris; Peters, Timothy R.

doi:10.1093/infdis/jis773

Cited by 215 publications

(224 citation statements)

References 21 publications

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“…112,113 Since publication of the 2003 Infection Control Guideline for CF, several studies conducted in people with and without CF who are infected with viral or bacterial pathogens have expanded our understanding of droplet transmission and now challenge the 3-foot rule. These studies include epidemiologic data collected during outbreaks of influenza 114,115 and SARS in non-CF individuals, [116][117][118] experimental and observational studies performed in people with CF, [119][120][121] and studies of the dynamics of infectious aerosols. 119,122,123 …”

Section: Iia Contact and Droplet Transmissionmentioning

confidence: 99%

“…Infectious droplets containing influenza virus and SARS-CoV traveled 3-6 feet. 6,114,116,118 Aerosols of droplet nuclei from patients infected with influenza can be generated during intubation and suctioning. Droplet size and distance traveled can be affected by (1) environmental factors (eg, humidity, temperature, air currents, and number of air changes per hour in a room), (2) agent factors (eg, infectious load, transferability, survivability, infectivity, and contagiousness), and (3) host factors (eg, susceptibility and behavior).…”

Section: Iic Emerging View Of Droplet Transmissionmentioning

confidence: 99%

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Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

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Section: Iia Contact and Droplet Transmissionmentioning

confidence: 99%

Section: Iic Emerging View Of Droplet Transmissionmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

View full text Add to dashboard Cite

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“…An influenza case was defined as a patient who had laboratory confirmed influenza during the influenza season (11 June -26 August, weeks [24][25][26][27][28][29][30][31][32][33][34]2012), and was either admitted to an hospital ward or discharged after clinical assessment in the Emergency Department (ED) or Children's Acute Assessment Unit (CAA) of CDHB.…”

Section: Influenza Case Definitionmentioning

confidence: 99%

“…30 The recommendations of several infection control advisory groups are to draw privacy curtains as a precaution. 31,32 The reliance on the use of privacy curtains for aerosol protection has been challenged by Bischoff (2013) who has shown that small-particle aerosols containing influenza virus can be measured 1.829 m or 6 feet from an infected patient. 33 It is difficult to assess the CDHB infection control approach for multi-bed rooms used in this review, as patients were also given either Oseltamivir treatment or prophylaxis.…”

Section: Nosocomial Infectionmentioning

confidence: 99%

“…31,32 The reliance on the use of privacy curtains for aerosol protection has been challenged by Bischoff (2013) who has shown that small-particle aerosols containing influenza virus can be measured 1.829 m or 6 feet from an infected patient. 33 It is difficult to assess the CDHB infection control approach for multi-bed rooms used in this review, as patients were also given either Oseltamivir treatment or prophylaxis. An interesting observation was the low number of nosocomial influenza infections in the designated influenza wards.…”

Section: Nosocomial Infectionmentioning

confidence: 99%

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A review of the winter influenza strategy for hospitals within a major district health board in New Zealand following the 2012 Influenza season

Schousboe

Jennings

2013

Int. j. infect. control

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Winter influenza planning is an integral part of a health services preparation for the annual increase in respiratory virus infections and associated hospital admissions in New Zealand.A moderate to severe influenza A (H3N2) outbreak occurred in the winter of 2012 resulting in an unprecedented number of attendances at ED and admission of patients with influenza-like illness to the Canterbury District Health Board (CDHB) hospitals. A review of the hospital winter influenza management strategy following this outbreak, included the use of dedicated influenza wards, extensive diagnostic testing of patients, infection control advice, staff influenza vaccination and the use of Oseltamivir for treatment of patients and prophylaxis of their contacts. The review found that 534 patients were assessed and laboratory confirmed to have influenza, 347 patients were admitted and 40 nosocomial influenza infections recorded over an 11 weeks period. The strategy contributed to the management of the hospital admission of patients with influenza, a relatively low number of nosocomial influenza infections in the dedicated admission wards and low in-hospital mortality. The use of diagnostic testing for influenza with planned escalation of services supported the clinical decision to treat patients with confirmed influenza and prophylaxis of contacts with Oseltamivir probably facilitated appropriate discharge of patients.

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Emerging infections

Wilson

2017

Infectious Diseases

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Exposure to Influenza Virus Aerosols During Routine Patient Care

Abstract: HCPs within 1.829 m of patients with influenza could be exposed to infectious doses of influenza virus, primarily in small-particle aerosols. This finding questions the current paradigm of localized droplet transmission during non-aerosol-generating procedures.

Cited by 215 publications

References 21 publications

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

A review of the winter influenza strategy for hospitals within a major district health board in New Zealand following the 2012 Influenza season

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