Respiratory Virus Shedding in a Cohort of On-Duty Healthcare Workers Undergoing Prospective Surveillance
Published Date:Feb 08 2013
Source:Infect Control Hosp Epidemiol. 34(4):373-378.
Multiplex Polymerase Chain Reaction
Respiratory Tract Infections
Pubmed Central ID:PMC3730277
Funding:1 UL1 RR024975/RR/NCRR NIH HHS/United States
1T32HD060554-01/HD/NICHD NIH HHS/United States
1U01 IP000022/IP/NCIRD CDC HHS/United States
K12 CA090625/CA/NCI NIH HHS/United States
L40 AI084726/AI/NIAID NIH HHS/United States
UL1 RR024975/RR/NCRR NIH HHS/United States
UL1TR000011/TR/NCATS NIH HHS/United States
Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue.
Surveillance for influenza virus among a cohort of healthcare workers (HCWs) was conducted in a tertiary care children’s hospital from November 2009 until April 2010, using biweekly nasal swab collection. If a subject reported respiratory symptoms, an additional specimen was collected. Specimens from ill HCWs and a randomly selected sample from asymptomatic subjects were tested for additional respiratory viruses by multiplex PCR.
From 170 enrolled subjects, 1404 nasal swabs were collected. Influenza circulated at very low levels during the surveillance period and 74.2% of subjects received influenza vaccination. Influenza was not detected in any specimen. Multiplex respiratory virus PCR analysis of all 119 samples from symptomatic subjects and 200 specimens from asymptomatic subjects yielded a total of 42 positive specimens; 7 (16.7%) in asymptomatic subjects. Viral shedding was associated with report of any symptom (OR 13.06, p<0.0001, 95% CI 5.45-31.28) and younger age (OR 0.96, p=0.023, 95% CI 0.92-0.99) when controlled for gender and occupation of physician or nurse. After the surveillance period, 46% of subjects reported working while ill with an influenza-like illness during the previous influenza season.
In this cohort, HCWs working while ill was common, as was viral shedding among those with symptoms. Asymptomatic viral shedding was infrequent, but did occur. HCWs should refrain from patient care duties while ill, and staffing contingencies should accommodate them.
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