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Disruption of Services in an Internal Medicine Unit Due to a Nosocomial Influenza Outbreak

  • Catherine Sartor (a1), Christine Zandotti (a2), Fanny Romain (a3), Véronique Jacomo (a4), Sophie Simon (a2), Catherine Atlan-Gepner (a5), Roland Sambuc (a1) (a3), Bernard Vialettes (a5) and Michel Drancourt (a1) (a4)...

Abstract

Objective:

To describe a nosocomial influenza A out-break, how it was managed, what impact it had on subsequent delivery of health care, and the additional charges attributable to it.

Design:

Prospective cohort study and microbiological investigation.

Setting:

One internal medicine unit in an acute care, university-affiliated hospital.

Participants:

Twenty-three patients and 22 staff members from February 28 to March 6,1999.

Results:

Attack rates were 41% (9 of 22) among patients and 23% (5 of 22) among staff members, with 3 of 14 cases being classified as “certain”. The influenza virus isolates were typed as A/SYDNEY/5/97 (H3N2). The index case was a patient who shared a room with the first nosocomial case. Vaccination rates for influenza virus were 43% (10 of 23) among patients and 36% (8 of 22) among staff members. The outbreak resulted in staff members' taking 14 person-days of sick leave. Furthermore, 8 scheduled admissions were postponed and all emergency admissions were suspended for 11 days. Hospital charges attributable to the influenza outbreak totaled $34,179 and the average extra charge per infected patient was $3,798.

Conclusions:

Nosocomial influenza outbreaks increase charges and alter the quality of care delivered in acute care settings. Strategies for their prevention need to be evaluated in acute care settings. (Infect Control Hosp Epidemiol 2002;23:615-619).

Copyright

Corresponding author

Laboratoire de Bactériologie, Hygiène et Epidémiologic Hospitalière, Hôpital Timone, rue Saint-Pierre, 13005 Marseille, France

References

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1.Sugaya, N, Kusumoto, N, Suzuki, Y, Nerome, R, Nerome, K. Large sequential outbreaks caused by influenza A (H3N2) and B viruses in an institution for the mentally handicapped. J Med Virol 1996;50:120125.
2.Advisory Committee on Immunization Practices. Prevention and control of influenza: recommendations. MMWR 2001;50:144.
3.Bradley, SF, the Long-Term-Care Committee of the Society for Healthcare Epidemiology of America. Prevention of influenza in long-term-care facilities. Infect Control Hosp Epidemiol 1999;20:629627.
4.Blumenfeld, H, Kilbourne, E, Louria, D, Roger, D. Studies on influenza in the pandemic of 1957-58: 1. An epidemiologic, clinical, and serologic investigation of an intrahospital epidemic, with a note on vaccine efficacy. J Clin Invest 1959;38:199212.
5.Evans, ME, Hall, KL, Berry, SE. Influenza control in acute care hospitals. Am J Infect Control 1997;25:357362.
6.Salgado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.
7.Van Voris, LP, Belshe, RB, Shaffer, JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med 1982;96:153158.
8.Centers for Disease Control and Prevention. Update: influenza activity— United States, 1997-98 season. MMWR 1997;46:10941098.
9.Orestein, WA, Bernier, RH, Hinman, AR. Assessing vaccine efficacy in the field: further observations. Epidemiol Rev 1988;10:212241.
10.Finkler, SA. The distinction between cost and charges. Ann Intern Med 1982;96:102109.
11.Bauer, CR, Elie, K, Spence, L, Stern, L. Hong Kong influenza in a neonatal unit. JAMA 1973;223:12331235.
12.Hall, CB, Douglas, RG. Nosocomial influenza infection as a cause of intercurrent fevers in infants. Pediatrics 1975;55:673677.
13.Meibalane, R, Sedmak, GV, Sasidharan, P, Garg, P, Grausz, JP. Outbreak of influenza in a neonatal intensive care unit. J Pediatr 1977;91:974976.
14.Munoz, FM, Campbell, JR, Atmar, RL, et alInfluenza A virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 1999;18:811815.
15.Cunney, RJ, Bialachowski, A, Thornley, D, Smaill, FM, Pennie, RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449454.
16.Kapila, R, Lintz, DI, Tecson, FT, Ziskin, L, Louria, DB. A nosocomial outbreak of influenza A. Chest 1977;71:576579.
17.Weinstock, DM, Eagan, J, Malak, SAet alControl of influenza A on a bone marrow transplant unit. Infect Control Hosp Epidemiol 2000;21:730732.
18.Malavaud, S, Malavaud, B, Sandres, K, et alNosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation 2001;72:535537.
19.Rivera, M, Gonzalez, N. An influenza outbreak in a hospital. Am J Nurs 1982;18:3638.
20.Pachucki, CT, Pappas, SA, Fuller, GF, Krause, SL, Lentino, JR, Schaaff, DM. Influenza A among hospital personnel and patients: implications for recognition, prevention and control. Arch Intern Med 1989;149:7780.
21.Serwint, JR, Miller, RM. Why diagnose influenza infections in hospitalized pediatric patients? Pediatr Infect Dis J 1993;12:200204.
22.Weingarten, S, Friedlander, M, Rascon, D, Ault, M, Morgan, M, Meyer, RD. Influenza surveillance in an acute-care hospital. Arch Intern Med 1988;148:113116.
23.Whimbey, E, Elting, LS, Couch, RB, et alInfluenza A virus infections among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant 1994;13:437440.
24.Serwint, JR, Miller, RM, Korsh, BM. Influenza type A and B infections in hospitalized pediatric patients: who should be immunized? Am J Dis Child 1991;145:623626.
25.Wenzel, RP, Deal, EC, Hendley, JO. Hospital-acquired viral respiratory illness on a pediatric ward. Pediatrics 1977;60:367371.
26.Carrat, F, Tachet, A, Rouzioux, C, Housset, B, Valleron, A-J. Evaluation of clinical definitions of influenza: detailed investigation of patients during the 1995-1996 epidemic in France. Clin Infect Dis 1999;28:283290.
27.Gross, PA, Rodstein, M, LaMontagne, JR, et alEpidemiology of acute respiratory illness during an influenza outbreak in a nursing home: a prospective study. Arch Intern Med 1988;148:559561.
28.Hayden, FG, Gubareva, LV, Monto, AS, et alInhaled zanamivir for the prevention of influenza in families. N Engl J Med 2000;343:12821289.
29.Murphy, BR, Webster, RG. Orthomyxoviruses. In: Fields, BN, Knipe, DM, Howley, PM, et al, eds. Fields Virology, 3rd ed. Philadelphia: Lippincott-Raven; 1996:13971446.
30.Buxton Bridges, C, Katz, JM, Seto, WH, et alRisk of influenza A (H5N1) infection among health care workers exposed to patients with influenza A (H5N1), Hong Kong. J Infect Dis 2000;181:344348.
31.Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals. JAMA 1999;10:908913.
32.Adal, KA, Flowers, RH, Anglim, AM, et alPrevention of nosocomial influenza. Infect Control Hosp Epidemiol 1996;17:641648.
33.Smith, SA, Poland, GA. Use of influenza and pneumococcal vaccines in people with diabetes. Diabetes Care 2000;23:95108.
34.Fedson, DS, Houck, P, Bratzier, D. Hospital-based influenza and pneumococcal vaccination: Sutton's law applied to prevention. Infect Control Hosp Epidemiol 2000;21:692699.

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