Nosocomial influenza A outbreak among HIV-infected patients in a tertiary-care hospital. Kyaw, W. M., Lin, C., Shiau Pheng, P., Chow, A., Ang, B., & Leo, Y. S. International Journal of Infectious Diseases, 16(SUPPL.1):e377, 2012. ![Nosocomial influenza A outbreak among HIV-infected patients in a tertiary-care hospital [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background: Nosocomial infection associated with respiratory viruses can lead to devastating complications in immunocompromised patients. In spite of long-standing recommendations for healthcare workers (HCWs) vaccination against seasonal influenza, vaccine uptake among HCWs remains lower than 45% worldwide. In June 2010, an influenza A outbreak occurred among HIV-infected patients admitted to a tertiary care hospital in Singapore. The study objective was to examine clinical information and vaccination coverage against influenza in infected patients and HCWs, and determine the possible reason for the outbreak. Method(s): A retrospective study was conducted on infected patients and staff from the ward who presented with respiratory illness and/or had exposure to these symptomatic patients, and/or a 4-fold increase in antibody titre by HI (hemagglutinin inhibition) testing from paired serum samples taken from HCWs two weeks apart. Epidemiologic, clinical, laboratory and vaccination data were collected. Result(s): Of 10 patients and 30 staff from the ward, four patients (clinical attack rate 40%) and four staff (clinical attack rate 13.3%) fulfilled our case definitions. All infected patients and HCWs had mild illness. All infected patients had positive A/H3N2 results. Only two affected patients received 2009 H1N1 influenza vaccine and the 2009-2010 seasonal influenza vaccines. Among 21 HCWs who provided paired sera, the influenza vaccine coverage for the 2009 H1N1 and the 2009-2010 seasonal influenza were 23.8% and 76.2%, respectively. Seroconversion against the A/Wisconsin/15/2009 H3N2 and the A/Calinfornia/7/2009 H1N1 pandemic viruses were found in 2 (9.5%) HCWs who had not been vaccinated previously with 2009-2010 seasonal influenza vaccines. Genetic studies on all the positive specimens from patients showed their probable common source, and all viruses were close to the local circulating strain. Conclusion(s): Unvaccinated HCWs when exposed to cases of influenza can acquire infection and pass the virus to the other patients. Since the efficacy of vaccination among these highly vulnerable patients may be lower, attempts should also be aimed at reducing chances of influenza transmission in healthcare settings by mandatory seasonal influenza vaccination of HCWs. Influenza vaccination should be the primary tool to decrease the frequency of nosocomial influenza outbreaks.
@article{kyaw_nosocomial_2012,
title = {Nosocomial influenza {A} outbreak among {HIV}-infected patients in a tertiary-care hospital},
volume = {16},
issn = {1201-9712},
url = {http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed13&NEWS=N&AN=70869339},
doi = {10.1016/j.ijid.2012.05.486},
abstract = {Background: Nosocomial infection associated with respiratory viruses can lead to devastating complications in immunocompromised patients. In spite of long-standing recommendations for healthcare workers (HCWs) vaccination against seasonal influenza, vaccine uptake among HCWs remains lower than 45\% worldwide. In June 2010, an influenza A outbreak occurred among HIV-infected patients admitted to a tertiary care hospital in Singapore. The study objective was to examine clinical information and vaccination coverage against influenza in infected patients and HCWs, and determine the possible reason for the outbreak. Method(s): A retrospective study was conducted on infected patients and staff from the ward who presented with respiratory illness and/or had exposure to these symptomatic patients, and/or a 4-fold increase in antibody titre by HI (hemagglutinin inhibition) testing from paired serum samples taken from HCWs two weeks apart. Epidemiologic, clinical, laboratory and vaccination data were collected. Result(s): Of 10 patients and 30 staff from the ward, four patients (clinical attack rate 40\%) and four staff (clinical attack rate 13.3\%) fulfilled our case definitions. All infected patients and HCWs had mild illness. All infected patients had positive A/H3N2 results. Only two affected patients received 2009 H1N1 influenza vaccine and the 2009-2010 seasonal influenza vaccines. Among 21 HCWs who provided paired sera, the influenza vaccine coverage for the 2009 H1N1 and the 2009-2010 seasonal influenza were 23.8\% and 76.2\%, respectively. Seroconversion against the A/Wisconsin/15/2009 H3N2 and the A/Calinfornia/7/2009 H1N1 pandemic viruses were found in 2 (9.5\%) HCWs who had not been vaccinated previously with 2009-2010 seasonal influenza vaccines. Genetic studies on all the positive specimens from patients showed their probable common source, and all viruses were close to the local circulating strain. Conclusion(s): Unvaccinated HCWs when exposed to cases of influenza can acquire infection and pass the virus to the other patients. Since the efficacy of vaccination among these highly vulnerable patients may be lower, attempts should also be aimed at reducing chances of influenza transmission in healthcare settings by mandatory seasonal influenza vaccination of HCWs. Influenza vaccination should be the primary tool to decrease the frequency of nosocomial influenza outbreaks.},
language = {English},
number = {SUPPL.1},
journal = {International Journal of Infectious Diseases},
author = {Kyaw, W. M. and Lin, C. and Shiau Pheng, P. and Chow, A. and Ang, B. and Leo, Y. S.},
year = {2012},
keywords = {*Human immunodeficiency virus, *Human immunodeficiency virus infected patient, *hospital, *human, *infection, *influenza A, *tertiary health care, Singapore, antibody titer, clinical laboratory, diseases, exposure, health care, health care personnel, hemagglutinin, hospital infection, immunocompromised patient, influenza, influenza vaccination, influenza vaccine, pandemic, patient, respiratory tract disease, respiratory virus, retrospective study, seasonal influenza, seroconversion, serum, vaccination, virus, ward},
pages = {e377},
}
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In June 2010, an influenza A outbreak occurred among HIV-infected patients admitted to a tertiary care hospital in Singapore. The study objective was to examine clinical information and vaccination coverage against influenza in infected patients and HCWs, and determine the possible reason for the outbreak. Method(s): A retrospective study was conducted on infected patients and staff from the ward who presented with respiratory illness and/or had exposure to these symptomatic patients, and/or a 4-fold increase in antibody titre by HI (hemagglutinin inhibition) testing from paired serum samples taken from HCWs two weeks apart. Epidemiologic, clinical, laboratory and vaccination data were collected. Result(s): Of 10 patients and 30 staff from the ward, four patients (clinical attack rate 40%) and four staff (clinical attack rate 13.3%) fulfilled our case definitions. All infected patients and HCWs had mild illness. All infected patients had positive A/H3N2 results. Only two affected patients received 2009 H1N1 influenza vaccine and the 2009-2010 seasonal influenza vaccines. Among 21 HCWs who provided paired sera, the influenza vaccine coverage for the 2009 H1N1 and the 2009-2010 seasonal influenza were 23.8% and 76.2%, respectively. Seroconversion against the A/Wisconsin/15/2009 H3N2 and the A/Calinfornia/7/2009 H1N1 pandemic viruses were found in 2 (9.5%) HCWs who had not been vaccinated previously with 2009-2010 seasonal influenza vaccines. Genetic studies on all the positive specimens from patients showed their probable common source, and all viruses were close to the local circulating strain. Conclusion(s): Unvaccinated HCWs when exposed to cases of influenza can acquire infection and pass the virus to the other patients. Since the efficacy of vaccination among these highly vulnerable patients may be lower, attempts should also be aimed at reducing chances of influenza transmission in healthcare settings by mandatory seasonal influenza vaccination of HCWs. Influenza vaccination should be the primary tool to decrease the frequency of nosocomial influenza outbreaks.","language":"English","number":"SUPPL.1","journal":"International Journal of Infectious Diseases","author":[{"propositions":[],"lastnames":["Kyaw"],"firstnames":["W.","M."],"suffixes":[]},{"propositions":[],"lastnames":["Lin"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Shiau","Pheng"],"firstnames":["P."],"suffixes":[]},{"propositions":[],"lastnames":["Chow"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["Ang"],"firstnames":["B."],"suffixes":[]},{"propositions":[],"lastnames":["Leo"],"firstnames":["Y.","S."],"suffixes":[]}],"year":"2012","keywords":"*Human immunodeficiency virus, *Human immunodeficiency virus infected patient, *hospital, *human, *infection, *influenza A, *tertiary health care, Singapore, antibody titer, clinical laboratory, diseases, exposure, health care, health care personnel, hemagglutinin, hospital infection, immunocompromised patient, influenza, influenza vaccination, influenza vaccine, pandemic, patient, respiratory tract disease, respiratory virus, retrospective study, seasonal influenza, seroconversion, serum, vaccination, virus, ward","pages":"e377","bibtex":"@article{kyaw_nosocomial_2012,\n\ttitle = {Nosocomial influenza {A} outbreak among {HIV}-infected patients in a tertiary-care hospital},\n\tvolume = {16},\n\tissn = {1201-9712},\n\turl = {http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed13&NEWS=N&AN=70869339},\n\tdoi = {10.1016/j.ijid.2012.05.486},\n\tabstract = {Background: Nosocomial infection associated with respiratory viruses can lead to devastating complications in immunocompromised patients. In spite of long-standing recommendations for healthcare workers (HCWs) vaccination against seasonal influenza, vaccine uptake among HCWs remains lower than 45\\% worldwide. In June 2010, an influenza A outbreak occurred among HIV-infected patients admitted to a tertiary care hospital in Singapore. The study objective was to examine clinical information and vaccination coverage against influenza in infected patients and HCWs, and determine the possible reason for the outbreak. Method(s): A retrospective study was conducted on infected patients and staff from the ward who presented with respiratory illness and/or had exposure to these symptomatic patients, and/or a 4-fold increase in antibody titre by HI (hemagglutinin inhibition) testing from paired serum samples taken from HCWs two weeks apart. Epidemiologic, clinical, laboratory and vaccination data were collected. Result(s): Of 10 patients and 30 staff from the ward, four patients (clinical attack rate 40\\%) and four staff (clinical attack rate 13.3\\%) fulfilled our case definitions. All infected patients and HCWs had mild illness. All infected patients had positive A/H3N2 results. Only two affected patients received 2009 H1N1 influenza vaccine and the 2009-2010 seasonal influenza vaccines. Among 21 HCWs who provided paired sera, the influenza vaccine coverage for the 2009 H1N1 and the 2009-2010 seasonal influenza were 23.8\\% and 76.2\\%, respectively. Seroconversion against the A/Wisconsin/15/2009 H3N2 and the A/Calinfornia/7/2009 H1N1 pandemic viruses were found in 2 (9.5\\%) HCWs who had not been vaccinated previously with 2009-2010 seasonal influenza vaccines. Genetic studies on all the positive specimens from patients showed their probable common source, and all viruses were close to the local circulating strain. 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