BackgroundSelf-diagnosis of influenza is an important component of pandemic control and management as it may support self-management practices and reduce visits to healthcare facilities, thus helping contain viral spread. However, little is known about the accuracy of self-diagnosis of influenza, particularly during pandemics.MethodsWe used cross-sectional survey data to correlate self-diagnosis of influenza with serological evidence of 2009 pandemic influenza A(H1N1) infection (haemagglutination inhibition titres of ≥1:40) and to determine what symptoms were more likely to be present in accurate self-diagnosis. The sera and risk factor data were collected for the national A(H1N1) seroprevalence survey from November 2009 to March 2010, 3 months after the first pandemic wave in New Zealand (NZ).ResultsThe samples consisted of 318 children, 413 adults and 423 healthcare workers. The likelihood of being seropositive was no different in those who believed they had influenza from those who believed they did not have influenza in all groups. Among adults, 23.3% (95% CI 11.9% to 34.7%) of those who reported having had influenza were seropositive for H1N1, but among those reporting no influenza, 21.3% (95% CI 13% to 29.7%) were also seropositive. Those meeting NZ surveillance or Ministry of Health influenza case definitions were more likely to believe they had the flu (surveillance data adult sample OR 27.1, 95% CI 13.6 to 53.6), but these symptom profiles were not associated with a higher likelihood of H1N1 seropositivity (surveillance data adult sample OR 0.93, 95% CI 0.5 to 1.7).ConclusionsSelf-diagnosis does not accurately predict influenza seropositivity. The symptoms promoted by many public health campaigns are linked with self-diagnosis of influenza but not with seropositivity. These findings raise challenges for public health initiatives that depend on accurate self-diagnosis by members of the public and appropriate self-management action.
Background With the COVID-19 pandemic, many changes were made in healthcare institutions including but not limited to canceling elective surgeries, limiting face-to-face clinic visits, and implementing visitor restrictions. Phased reopening began at West Virginia University (WVU) Medicine on May 25, 2020. While preparing for transition, concern was raised regarding potential for more employee exposures to persons with SARS-CoV-2 infection. In West Virginia (WV), we did not get the predicted surge of SARS-CoV-2. Current cumulative percent positivity for SARS-CoV-2 PCR in WV is 2332 positives of 133,142 tests (1.75%). We provided appropriate personal protective equipment (PPE), including controlled air purifying respirators for all healthcare workers (HCW) caring for persons with suspected or confirmed COVID-19 from the beginning. Policies requiring masks for all HCW and patients took effect on March 27, 2020 and April 29, 2020, respectively. We hypothesized that due to appropriate PPE use there would be no difference in SARS-CoV-2 antibody positivity in HCW working in high versus low risk areas. Methods Serum samples from 1042 randomly selected HCW across 4 WVU Medicine hospitals, ranging from 170 to 690 beds with 121 cumulative SARS-CoV-2 PCR positive patients at the time of the study, were tested for SARS-CoV-2 IgG between May 26, 2020 and June 5, 2020. Physicians, nurses, and respiratory therapists were characterized as high or low risk based on work location. Environmental services (EVS) workers were included but not risk-stratified. A questionnaire was used to obtain information on demographics, chronic medical conditions, symptoms, and exposures. Results SARS-CoV-2 IgG was positive in 9 of 1042 (0.86%) randomly selected HCW. Seroprevalence was lower in high risk 5/835 (0.60%) versus low risk 4/176 (2.27%) group. This was not statistically significant. No EVS workers tested positive 0/31 (0%). Of 9 HCW who tested positive, 2 had previously tested positive for SARS-CoV-2 PCR. Conclusion SARS-CoV-2 IgG seroprevalence in a large sample of HCW across 4 WVU Medicine hospitals was low (0.86%). Low seroprevalence among HCW in high risk areas may be related to appropriate PPE use. Seroprevalence in HCW not caring for patients with COVID-19 could be from community or other inadvertent exposure. Disclosures All Authors: No reported disclosures
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