Abstract:
CONTEXT:Preventing nosocomial transmission of influenza is essential to reduce the morbidity and mortality associated with this infection. In October 2009, an outbreak of the 2009 influenza A (H1N1) virus occurred in a hematology ward of a children's hospital over a 21-day period and involved two patients and four healthcare workers. OBJECTIVE:To investigate nosocomial transmission of the 2009 influenza A (H1N1) virus in patients and healthcare workers. DESIGN, SETTING, AND PARTICIPANTS:An outbreak investigation was initiated in response to suspected nosocomial transmission of the 2009 influenza A (H1N1) virus during the peak of the 2009 pandemic. Cases were confirmed using a polymerase chain reaction (PCR) test specific for the 2009 H1N1 influenza A virus. Viruses isolated from nasopharyngeal swabs were genetically characterized using Sanger sequencing of uncloned "bulk" PCR products. MAIN OUTCOME MEASURES:Virus sequencing to investigate nosocomial transmission. RESULTS:Two immunocompromised patients and four healthcare workers were found to be part of a nosocomial outbreak of the 2009 influenza A (H1N1) virus. One immunocompromised patient had a second episode of clinical influenza infection after isolation precautions had been discontinued, resulting in additional exposures. Strain-specific PCR showed that all cases were caused by infection of the 2009 H1N1 virus. Sequencing of viral genes encoding hemagglutinin and polymerase basic subunit 2 (PB2) revealed that all viruses isolated were genetically identical at these loci, including the two episodes occurring in the same immunocompromised patient. CONCLUSIONS:Prompt institution of isolation precautions is essential in preventing nosocomial outbreaks of the 2009 novel influenza A (H1N1) virus. Our data suggest that isolation precautions may need to be continued for a prolonged period of time in immunocompromised patients with influenza infection.
journal_name
Influenza Other Respir Virusesjournal_title
Influenza and other respiratory virusesauthors
Bearden A,Friedrich TC,Goldberg TL,Byrne B,Spiegel C,Schult P,Safdar Ndoi
10.1111/j.1750-2659.2011.00322.xsubject
Has Abstractpub_date
2012-09-01 00:00:00pages
374-9issue
5eissn
1750-2640issn
1750-2659journal_volume
6pub_type
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