Pandemic (H1N1) 2009 Influenza in Hospitalized Children in Manitoba: Nosocomial Transmission and Lessons Learned from the First Wave

Fanella, Sergio; Pinto, Michelle A.; Bridger, Natalie; Bullard, Jared; Coombs, Jennifer; Crockett, Maryanne; Olekson, Karen; Poliquin, Philippe Guillaume; Caeseele, Paul G. Van; Embreé, Joanne

doi:10.1086/659401

Cited by 26 publications

(23 citation statements)

References 5 publications

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“…Enstone et al reported that 93% of UK children with nosocomial pH1N1 had serious underlying illnesses, while Fanella et al from Canada reported that all nosocomial cases had underlying medical conditions. 13,14 Both host and environmental factors could be responsible. Generalized immunosuppression, poor functioning of a specific organ/system (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…It is not clear if prompt antiviral therapy decreased the severity of illnesses in children with nosocomial influenza, but antiviral drug usage in this cohort was comparable with published data. 13,14 A limitation of this study is that contact tracing was not performed actively. Only five of 42 (12%) patients with nosocomial pH1N1 whose data were available knew of a contact.…”

Section: Discussionmentioning

confidence: 99%

“…Fanella et al reported that almost all patients with nosocomial pH1N1 acquired the illness from another patient on the ward in their hospital in Canada. 13 It is notable that HCWs are also important transmitters of the infection. 1,7 Molecular genotyping can help describe the outbreaks of nosocomial pH1N1, although its wider applicability requires further assessment.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case–control study

Khandaker

Rashid

Zurynski

et al. 2012

Journal of Hospital Infection

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case–control study

Khandaker

Rashid

Zurynski

et al. 2012

Journal of Hospital Infection

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“…1 Several studies from around the world have included children and adults admitted to hospital or intensive care units with pH1N1 infection. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, these data vary in format and emphasis, making direct comparison between studies difficult. Furthermore, data on severe outcomes (including death) and risk factors for severe outcomes are limited.…”

Section: Introductionmentioning

confidence: 99%

Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study

Dalziel

Thompson

Macias

et al. 2013

BMJ

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Objective To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness.Design Multicentre retrospective case-control study.Setting 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countries.Participants 265 children (<16 years), presenting between 16 April and 31 December 2009, who fulfilled Centers for Disease Control and Prevention criteria for influenza-like illness and developed severe outcomes from laboratory confirmed H1N1 infection. For each case, two controls presenting with influenza-like illness but without severe outcomes were included: one random control and one age matched control.Main outcome measures Severe outcomes included death or admission to intensive care for assisted ventilation, inotropic support, or both. Multivariable conditional logistic regression was used to compare cases and controls, with effect sizes measured as adjusted odds ratios.Results 151 (57%) of the 265 cases were male, the median age was 6 (interquartile range 2.3-10.0) years, and 27 (10%) died. Six factors were associated with severe outcomes in children presenting with influenza-like illness: history of chronic lung disease (odds ratio 10.3, 95% confidence interval 1.5 to 69.8), history of cerebral palsy/developmental delay (10.2, 2.0 to 51.4), signs of chest retractions (9.6, 3.2 to 29.0), signs of dehydration (8.8, 1.6 to 49.3), requirement for oxygen (5.8, 2.0 to 16.2), and tachycardia relative to age). ConclusionThese independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics. IntroductionIn June 2009 the World Health Organization declared the first global influenza pandemic in 41 years.1 From early in the pandemic, children-particularly those aged under 5 years 2 -were considered a population at higher risk of morbidity and mortality from pandemic H1N1 (pH1N1) infection. 1Several studies from around the world have included children and adults admitted to hospital or intensive care units with pH1N1 infection. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, these data vary in format andCorrespondence to: S R Dalziel sdalziel@adhb.govt.nzExtra material supplied by the author (see

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“…Visitors of visitors for acute illness has been efficacious in reducing the spread of influenza [7] and norovirus [8]. During the severe acute respiratory syndrome (SARS) epidemic, all hospital visitors were screened at hospital entry for acute illness using questionnaires and temperature assessment [9].…”

Section: General Infection Prevention Strategies and Healthcare Visitorsmentioning

confidence: 99%

Infection control precautions for visitors to healthcare facilities

Banach

Bearman

Morgan

et al. 2015

Expert Review of Anti-infective Therapy

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Infection transmission in healthcare facilities is a growing concern. Visitation to healthcare facilities is very common, though the potential role of visitors in the transmission of infection is unknown. Although transmission-based precautions are generally used to prevent the spread of organisms in healthcare settings by healthcare staff, the applicability of these precautions to visitors is unclear. Decisions regarding whether to implement transmission-based precautions among visitors should take into account the organism of concern and means of transmission as well as factors pertaining to the visitor and the healthcare setting. The role of visitors as vectors for organism transmission in the healthcare setting and the potential benefits and adverse consequences of visitor adherence with transmission-based precautions are important areas for additional research. BackgroundInfection transmission in healthcare settings has become an increasingly recognized threat to patients and healthcare providers. While visitation to healthcare settings is common, the potential role of visitors in the transmission of healthcareassociated infections (HAIs) remains unclear. Despite the frequency of healthcare setting visitation and heightened awareness and understanding of HAI transmission, little attention has been offered to understanding the significance of visitors in HAI transmission. The emergence of multidrug-resistant pathogens with limited treatment options highlights the need to address infection prevention strategies for visitors to healthcare facilities.Literature describing situations implicating visitors in the transmission of infections is limited. Guidelines have been issued addressing the prevention of transmission of infectious agents in healthcare, primarily focusing on healthcare staff [1]. The applicability of these guidelines to visitors is uncertain. Expert guidance was recently issued to assist healthcare epidemiology programs in formulating policies and practices

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Pandemic (H1N1) 2009 Influenza in Hospitalized Children in Manitoba: Nosocomial Transmission and Lessons Learned from the First Wave

Cited by 26 publications

References 5 publications

Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case–control study

Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case–control study

Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study

Infection control precautions for visitors to healthcare facilities

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