Health Care–Acquired Viral Respiratory Diseases

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Epidemiology

RSV is the most common cause of pneumonia and bronchiolitis in infants3 and is a common pathogen in older and high-risk adults.4 Outbreaks of RSV have occurred in a variety of pediatric and adult health care settings.5, 6, 7, 8, 9, 10, 11, 12 Secondary attack rates of 19% to 45% have been reported among patients when limited or no infection control measures are implemented.6, 7, 13 Similarly, 34% to 56% of personnel on infant wards may become infected.6, 7, 13 Most infected personnel are

Epidemiology

Influenza infects approximately 5% to 20% of the US population annually, resulting in 226,000 hospitalizations and 36000 deaths.36, 37 Transmission of influenza has been reported in a variety of pediatric and adult health care settings, and health care workers may be often implicated in the outbreaks.37 Health care workers are at an increased risk of acquiring influenza because of exposure to infection in both the health care and community settings,38 and they often fail to recognize that they

Pandemic influenza

Pandemic influenza results when a novel viral strain to which the population has little or no immunity achieves the ability to spread easily between humans, resulting in rapid spread across several continents. A novel virus emerges as a result of reassortment of human influenza genes with those of avian or swine strains. During the past century, there have been 4 major pandemics: 1918–1919 Spanish influenza (H1N1), 1957–1958 Asian influenza (H2N2), 1968–1969 Hong Kong influenza (H3N2), and 2009

Adenovirus

Health care–associated outbreaks of respiratory tract infections caused by adenovirus have been reported from pediatric and adult health care settings.101, 102, 103, 104 Attack rates among patients have ranged from 15% to 56%.101, 102 Health care workers were often infected, and many continued to provide patient care while ill.103 Similar to influenza, adenovirus is transmitted through large respiratory droplets. Transmission also occurs via self-inoculation after contact with contaminated

Summary

Transmission of viral respiratory infections occurs in a variety of pediatric and adult health care settings, resulting in increased patient morbidity and health care costs. Transmission may occur via aerosol, large respiratory droplets, or self-inoculation after touching contaminated fomites. Different viruses have different modes of transmission, and prevention of transmission requires early recognition of symptomatic patients and prompt institution of appropriate transmission-based

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References (108)

  • T.F. Feltes et al.

    Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease

    J Pediatr

    (2003)
  • C.D. Salgado et al.

    Influenza in the acute hospital setting

    Lancet Infect Dis

    (2002)
  • S. Weingarten et al.

    Barriers to influenza vaccine acceptance. A survey of physicians and nurses

    Am J Infect Control

    (1989)
  • G.A. Poland et al.

    Requiring influenza vaccination for health care workers: seven truths we must accept

    Vaccine

    (2005)
  • S.A. Boone et al.

    The occurrence of influenza A virus on household and day care center fomites

    J Infect

    (2005)
  • W.F. Carman et al.

    Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial

    Lancet

    (2000)
  • H. Wang et al.

    Probable limited person-to-person transmission of highly pathogenic avian influenza A (H5N1) virus in China

    Lancet

    (2008)
  • O.C. Tablan et al.

    Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee

    MMWR Recomm Rep

    (2004)
  • D.K. Shay et al.

    Bronchiolitis-associated hospitalizations among US children, 1980–1996

    JAMA

    (1999)
  • A.R. Falsey et al.

    Respiratory syncytial virus infection in elderly and high-risk adults

    N Engl J Med

    (2005)
  • P.S. Gardner et al.

    Virus cross-infection in paediatric wards

    Br Med J

    (1973)
  • C.B. Hall et al.

    Nosocomial respiratory syncytial virus infections

    N Engl J Med

    (1975)
  • C.B. Hall et al.

    Neonatal respiratory syncytial virus infection

    N Engl J Med

    (1979)
  • N.B. Halasa et al.

    Medical and economic impact of a respiratory syncytial virus outbreak in a neonatal intensive care unit

    Pediatr Infect Dis J

    (2005)
  • J.A. Englund et al.

    Nosocomial transmission of respiratory syncytial virus in immunocompromised adults

    J Clin Microbiol

    (1991)
  • U. Mathur et al.

    Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill

    Ann Intern Med

    (1980)
  • C.B. Hall et al.

    Control of nosocomial respiratory syncytial viral infections

    Pediatrics

    (1978)
  • C.B. Hall

    Nosocomial respiratory syncytial virus infections: the “Cold War” has not ended

    Clin Infect Dis

    (2000)
  • C.B. Hall

    Respiratory syncytial virus: its transmission in the hospital environment

    Yale J Biol Med

    (1982)
  • C.B. Hall et al.

    Infectivity of respiratory syncytial virus by various routes of inoculation

    Infect Immun

    (1981)
  • C.B. Hall et al.

    Possible transmission by fomites of respiratory syncytial virus

    J Infect Dis

    (1980)
  • C.B. Hall et al.

    Nosocomial respiratory syncytial viral infections. Should gowns and masks be used?

    Am J Dis Child

    (1981)
  • J.M. Leclair et al.

    Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions

    N Engl J Med

    (1987)
  • J.M. Langley et al.

    Nosocomial respiratory syncytial virus infection in Canadian pediatric hospitals: a Pediatric Investigators Collaborative Network on Infections in Canada Study

    Pediatrics

    (1997)
  • C.L. Gala et al.

    The use of eye-nose goggles to control nosocomial respiratory syncytial virus infection

    JAMA

    (1986)
  • R. Agah et al.

    Respiratory syncytial virus (RSV) infection rate in personnel caring for children with RSV infections. Routine isolation procedure vs routine procedure supplemented by use of masks and goggles

    Am J Dis Child

    (1987)
  • K.K. Macartney et al.

    Nosocomial respiratory syncytial virus infections: the cost-effectiveness and cost-benefit of infection control

    Pediatrics

    (2000)
  • D.R. Snydman et al.

    Prevention of nosocomial transmission of respiratory syncytial virus in a newborn nursery

    Infect Control Hosp Epidemiol

    (1988)
  • J.D. Siegel et al.

    2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings

  • A.R. Falsey et al.

    Evaluation of four methods for the diagnosis of respiratory syncytial virus infection in older adults

    J Am Geriatr Soc

    (1996)
  • The IMpact-RSV Study Group

    Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants

    Pediatrics

    (1998)
  • K.M. Sullivan et al.

    Estimates of the US health impact of influenza

    Am J Public Health

    (1993)
  • T.R. Talbot et al.

    Influenza vaccination of healthcare workers and vaccine allocation for healthcare workers during vaccine shortages

    Infect Control Hosp Epidemiol

    (2005)
  • A.G. Elder et al.

    Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993-4 epidemic: results of serum testing and questionnaire

    BMJ

    (1996)
  • R.G. Douglas

    Influenza in man

  • R.T. Lester et al.

    Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff

    Infect Control Hosp Epidemiol

    (2003)
  • B.R. Murphy et al.

    Temperature-sensitive mutants of influenza virus. III. Further characterization of the ts-1[E] influenza A recombinant (H3N2) virus in man

    J Infect Dis

    (1973)
  • F.G. Hayden et al.

    Local and systemic cytokine responses during experimental human influenza A virus infection. Relation to symptom formation and host defense

    J Clin Invest

    (1998)
  • C.B. Hall et al.

    Nosocomial influenza infection as a cause of intercurrent fevers in infants

    Pediatrics

    (1975)
  • J.A. Englund et al.

    Common emergence of amantadine- and rimantadine-resistant influenza A viruses in symptomatic immunocompromised adults

    Clin Infect Dis

    (1998)
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      Thus although respiratory molecular assays are a valuable unique tool, there is no single assay that is 100% sensitive. In spite of these problems, molecular testing has become an important method for detecting the respiratory viruses in HSCT patients (Goins et al., 2011; Ison, 2007) and they will continue to be used in these patient populations. The results from RVP multiplex assays support decisions for the administration of appropriate therapy as well as isolation of infected patients in high-risk areas.

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    Funding support: H.K.T. received funding support from the National Institute of Allergy and Infectious Diseases grant K23 AI074863–03 and a T. Franklin Williams Scholarship Award, which is funded by Atlantic Philanthropies, Inc, the John A. Hartford Foundation, the Association of Specialty Professors, and the Infectious Diseases Society of America.

    Disclosures: W.P.G. has no disclosures. H.K.T. has received funding from Protein Sciences Corporation, Wyeth, Sanofi Pasteur, VaxInnate, the National Institutes of Health, and the Centers for Disease Control and Prevention (CDC). T.R.T. has received influenza vaccine donated by Sanofi Pasteur for a study funded by the CDC and serves as a consultant for Joint Commission Resources.

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