Respiratory Virus Shedding in a Cohort of On-Duty Healthcare Workers Undergoing Prospective Surveillance

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Esbenshade, Jennifer C. ; Edwards, Kathryn M. ; Esbenshade, Adam J. ; Rodriguez, Vanessa E. ; Talbot, H. Keipp ; Joseph, Marlon F. ; Nwosu, Samuel K. ; Chappell, James D. ; Gern, James E. ; Williams, John V. ; Talbot, Thomas R.
• Description:
  Background
  
  Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue.
  
  Design
  
  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.
  
  Results
  
  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.
  
  Conclusions
  
  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.
  
  
• Subjects:
  Adolescent Adult Aged Article Asymptomatic Diseases Cohort Studies Female Hospitals, Pediatric Humans Infection Control Influenza, Human Logistic Models Male Middle Aged Multiplex Polymerase Chain Reaction Nasal Mucosa Personnel, Hospital Prospective Studies Respiratory Tract Infections Single-Blind Method Vaccination Virus Diseases Virus Shedding Young Adult

  More +
• Source:
  Infect Control Hosp Epidemiol. 34(4):373-378
• Pubmed ID:
  23466910
• Pubmed Central ID:
  PMC3730277
• Document Type:
  Journal Article
• Funding:
  1 UL1 RR024975/RR/NCRR NIH HHS/United States ; 1U01 IP000022/IP/NCIRD CDC HHS/United States ; 1T32HD060554-01/HD/NICHD NIH HHS/United States ; K12 CA090625/CA/NCI NIH HHS/United States ; T32 HD060554/HD/NICHD NIH HHS/United States ; UL1TR000011/TR/NCATS NIH HHS/United States ; U01 IP000022/IP/NCIRD CDC HHS/United States ; UL1 RR024975/RR/NCRR NIH HHS/United States ; L40 AI084726/AI/NIAID NIH HHS/United States
• Place as Subject:
  Tennessee
• Volume:
  34
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cc7070ae52a34490ebf4d769634570ed3564230128fa1623893678fae8f5493b
• Download URL:
  https://stacks.cdc.gov/view/cdc/29697/cdc_29697_DS1.pdf
• File Type:
  [PDF - 162.06 KB ]