Skip to main content
×
Home

Molecular Characteristics of Outbreaks of Nosocomial Infection with Influenza A/H3N2 Virus Variants

  • Taeko Oguma (a1), Reiko Saito (a1), Hironori Masaki (a2), Kazuhiko Hoshino (a3), Hassan Zaraket (a1), Yasushi Suzuki (a1), Isolde Caperig-Dapat (a1), Clyde Dapat (a1), Tatiana Baranovich (a1), Reiki Kuroki (a3), Yasushi Makimoto (a3), Yutaka Shirahige (a4), Norichika Asoh (a5), Satoshi Degawa (a6), Hidefumi Ishikawa (a4), Hironobu Kageura (a7), Maki Hosoi (a1) and Hiroshi Suzuki (a1)...
Abstract
Objective.

To describe outbreaks of nosocomial influenza infection with molecular methods and to elucidate the viral linkages among outbreak case patients including both inpatients and healthcare workers (HCWs).

Setting.

A 180-bed acute and long-term care hospital in Japan.

Methods.

Retrospective observational study of nosocomial outbreaks of infection with influenza A/H3N2. Together with information about onset dates and vaccination history, we obtained nasopharyngeal swab samples from individuals with cases of influenza or influenzalike illness (ILI). The hemagglutinin genes of the recovered viruses were sequenced and compared, along with those of community-circulating strains, for similarity by phylogenetic tree analysis.

Results.

The outbreaks occurred from February 26 through April 3, 2007, during the 2006–2007 epidemic season, and they involved 11 patients and 13 HCWs. The 2 outbreaks involved 2 different genotypes of influenza A/H3N2 viruses. These virus variants were closely related to the influenza strains that were circulating in the community during the same epidemic season.

Conclusion.

This study showed the dissemination of highly homologous influenza virus variants among inpatients and HCWs within a short period, as a result of nosocomial transmission. These strains were also similar to influenza strains that were circulating in the community.

Copyright
Corresponding author
Division of Public Health, Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-757, Asahimachi-Dori, Chuoku, Niigata City, Niigata Prefecture 951-8510, Japan (t-oguma@med.niigata-u.ac.jp)
References
Hide All
1.Maltezou HC. Nosocomial influenza: new concepts and practice. Curr Opin Infect Dis 2008;21:337343.
2.Salgado CD, Farr BM, Hall KK, Hayden FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.
3.Gooskens J, Jonges M, Claas E, Meijer A, van den Broek P, Kroes A. Morbidity and mortality associated with nosocomial transmission of oseltamivir-resistant influenza A(H1N1) virus. JAMA 2009;301:10421046.
4.Young LC, Dwyer DE, Harris M, Guse Z, Noel V, Levy MH. Summer outbreak of respiratory disease in an Australian prison due to an influenza A/Fujian/411/2002(H3N2)-like virus. Epidemiol Infect 2005;133:107112.
5.Awofeso N, Fennell M, Waliuzzaman Z, et al.Influenza outbreak in a correctional facility. Aust N Z J Public Health 2001;25:443446.
6.Centers for Disease Control and Prevention. Influenza B virus outbreak on a cruise ship: Northern Europe, 2000. MMWRMorb Mortal Wkly Rep 2001;50:137140.
7.Liu P, Wang L, Lin Y, Tsai C, Shi Z. Outbreak of influenza A and B among military recruits: evidence from viral culture and polymerase chain reaction. J Microbiol Immunol Infect 2009;42:114121.
8.Balicer R, Huerta M, Levy Y, Davidovitch N, Grotto I. Influenza outbreak control in confined settings. Emerg Infect Dis 2005;11:579583.
9.D'Agaro P, Rossi T, Burgnich P, et al.The molecular epidemiology of influenza viruses: a lesson from a highly epidemic season. J Clin Pathol 2008;61:355360.
10.Gubareva LV, Novikov DV, Hayden FG. Assessment of hemagglutinin sequence heterogeneity during influenza virus transmission in families. J Infect Dis 2002;186:15751581.
11.Teo S, Ellis J, Aitken C, Booy R. Transmission of influenza A in families. Pediatr Infect Dis J 2007;26:645647.
12.Saito R, Suzuki Y, Li D, et al.Increased incidence of adamantane-resistant influenza A(H1N1) and A(H3N2) viruses during the 2006-2007 influenza season in Japan. J Infect Dis 2008;197:630632; author reply 632-633.
13.Saito R, Li D, Suzuki Y, et al.High prevalence of amantadine-resistance influenza A(H3N2) in six prefectures, Japan, in the 2005-2006 season. J Med Virol 2007;79:15691576.
14.Suzuki Y, Saito R, Zaraket H, et al.Rapid and specific detection of amantadine-resistant Ser31Asl mutated influenza A viruses by cycling probe method: detection of amantadine-resistant influenza A. J Clin Microbiol 2010;48:5763.
15.Hara M, Takao S, Fukuda S, Shimazu Y, Kuwayama M, Miyazaki K. Comparison of four rapid diagnostic kits using immuno-chromatography to detect influenza B viruses [in Japanese]. Kansenshogaku Zasshi 2005;79:803811.
16.Hota S, McGeer A. Antivirale and the control of influenza outbreaks. Clin Infect Dis 2007;45:13621368.
17.Hoffmann E, Stech J, Guan Y, Webster R, Perez D. Universal primer set for the full-length amplification of all influenza A viruses. Arch Virol 2001;146:22752289.
18.Besselaar TG, Botha L, McAnerney JM, Schoub BD. Antigenic and molecular analysis of influenza A(H3N2) virus strains isolated from a localised influenza outbreak in South Africa in 2003. J Med Virol 2004;73:7178.
19.Zaraket H, Saito R, Sato I, et al.Molecular evolution of human influenza A viruses in a local area during eight influenza epidemics from 2000 to 2007. Arch Virol 2009;154:285295.
20.Hall TA. BioEdit: a user-friendly biological sequence alignment editor and analysis program for Windows 95/98/NT. Nucleic Acids Symp Ser 1999;41:9598.
21.Kumar S, Tamura K, Nei M. MEGA3: integrated software for molecular evolutionary genetics analysis and sequence alignment. Brief Bioinform 2004;5:150163.
22.Bao Y, Bolotov P, Dernovoy D, et al.The influenza virus resource at the National Center for Biotechnology Information. J Virol 2008;82:596601.
23.Infectious Disease Surveillance Center, National Institute of Infectious Diseases. 2006/07 Influenza season, Japan. Infectious Agents Surveillance Report (IASR) 2007;28:311313. http://idsc.nih.go.jp/iasr/28/333/dj3331.html.
24.Hirano K, Hara M. Virus isolation on surveillance of infection disease (2006) [in Japanese]. Nagasaki Prefect Inst Environ Res Public Health 2007;53.
25.Lee N, Chan P, Hui D, et al.Viral loads and duration of viral shedding in adult patients hospitalized with influenza. J Infect Dis 2009;200:492500.
26.Babcock HM, Merz LR, Fraser VJ. Is influenza an influenza-like illness? clinical presentation of influenza in hospitalized patients. Infect Control Hosp Epidemiol 2006;27:266270.
27.van den Dool C, Hak E, Wallinga J, van Loon A, Lammers J, Bonten M. Symptoms of influenza virus infection in hospitalized patients. Infect Control Hosp Epidemiol 2008;29:314319.
28.Fiore A, Shay D, Broder K, et al.Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008. MMWR Recomm Rep 2008;57(RR-7):160.
29.Oshitani H, Saito R, Seki N, et al.Influenza vaccination levels and influenza-like illness in long-term-care facilities for elderly people in Niigata, Japan, during an influenza A(H3N2) epidemic. Infect Control Hosp Epidemiol 2000;21:728730.
30.Saito R, Suzuki H, Oshitani H, Sakai T, Seki N, Tanabe N. The effectiveness of influenza vaccine against influenza A(H3N2) virus infections in nursing homes in Niigata, Japan, during the 1998-1999 and 1999-2000 seasons. Infect Control Hosp Epidemiol 2002;23:8286.
31.Shugarman L, Hales C, Setodji C, Bardenheier B, Lynn J. The influence of staff and resident immunization rates on influenzalike illness outbreaks in nursing homes. J Am Med Dir Assoc 2006;7:562567.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 7 *
Loading metrics...

Abstract views

Total abstract views: 110 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st November 2017. This data will be updated every 24 hours.