Low attack rate of novel influenza A (H1N1) virus infection among healthcare workers: a prospective study in a setting with an elaborated containment plan

Smit, Patrick M.; Mulder, J.; Ahdi, Mohamed; Gerritsen, Ron; Darma, Stanley; Smits, Paul H.M.; Roggeveen, Chris; Gorp, Eric C. M. Van; Rimmelzwaan, Guus F.; Brandjes, Dees P. M.

doi:10.1007/s00420-011-0652-5

Cited by 4 publications

(9 citation statements)

References 18 publications

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“…Studies in the group of outbreak/epidemic investigations included eight household transmission studies (20–27) and three studies in other settings (28–30). In these studies, identification of initial laboratory-confirmed cases was followed by intense follow-up of exposed persons that included repeated collection of respiratory specimens or sera regardless of symptomatic illness.…”

Section: Resultsmentioning

confidence: 99%

“…While most studies defined the asymptomatic fraction as infection completely without symptoms, some studies presented estimates of the asymptomatic fraction in terms of the proportion of infected persons that did not have febrile illness (41, 50), or the proportion of infected persons that did not have an illness which fulfilled a case definition for influenza-like illness that included fever (Table 1) (20, 30, 33, 35, 45). …”

Section: Resultsmentioning

confidence: 99%

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Review Article

Leung

et al. 2015

Epidemiology

135

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Background The fraction of persons with influenza virus infection who do not report any signs or symptoms throughout the course of infection is referred to as the asymptomatic fraction. Methods We conducted a systematic review and meta-analysis of published estimates of the asymptomatic fraction of influenza virus infections. We found that estimates of the asymptomatic fraction were reported from two different types of studies: first, outbreak investigations with short-term follow-up of potentially exposed persons and virologic confirmation of infections; second, studies conducted across epidemics typically evaluating rates of acute respiratory illness among persons with serologic evidence of infection, in some cases adjusting for background rates of illness from other causes. Results Most point estimates from studies of outbreak investigations fell in the range 4%–28% with low heterogeneity (I2=0%) with a pooled mean of 16% (95% CI: 13%, 19%). Estimates from the studies conducted across epidemics without adjustment were very heterogeneous (point estimates 0%–100%; I2=97%), while estimates from studies that adjusted for background illnesses were more consistent with point estimates in the range 65%–85% and moderate heterogeneity (I2=58%). Variation in estimates could be partially explained by differences in study design and analysis, and inclusion of mild symptomatic illnesses as asymptomatic in some studies. Conclusions Estimates of the asymptomatic fraction are affected by the study design, and the definitions of infection and symptomatic illness. Considerable differences between the asymptomatic fraction of infections confirmed by virologic versus serologic testing may indicate fundamental differences in the interpretation of these two indicators.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Review Article

Leung

et al. 2015

Epidemiology

135

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“…[12] Attack rates were high when infection control measures were not followed,[1] but low when proper measures were undertaken. [2] Till date, no study compares the incidence rates in HCP with and without chemoprophylactic intake of neuraminidase inhibitors. We, in our study, attempt to highlight the advantages and disadvantages of chemoprophylactic intake of oseltamivir by HCP following infection control measures in places of high aerosol generation – Swine Flu ICU.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, study of 66 HCP working in a hospital in Amsterdam with high standards of hygiene demonstrated a low incidence rate (incidence rate in the high-risk group was 5.7/1000 person weeks) of influenza A (H1N1) infection during the 2009 pandemic. [2] None of the HCP belonging to intermediate- and low-risk groups tested positive for H1N1 by reverse transcriptase polymerase chain reaction (RT-PCR). [2] However, studies describing the incidence rates of nosocomially acquired H1N1 infection among HCP in India are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir

Samra

Pawar

2012

Indian J Pharmacol

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Objectives:To evaluate the efficacy of chemoprophylactic dose of oseltamivir in preventing H1N1 by comparing the rates of acute respiratory illness and H1N1 positivity of respiratory specimens between HCP with and without consumption of oseltamivir working in swine flu ICU.Materials and Methods:The study was conducted on HCP posted in “Swine Flu Intensive Care Unit” from October 2009 to March 2010. Data on infection control measures, chemoprophylactic use of oseltamivir, flu-like illness, ADRs to oseltamivir, and contact history in family and neighborhood were collected by face-to-face interview conducted by investigator using a set of prespecified items in a questionnaire.Results:All HCP used infection control measures like using long-sleeved cuffed gown, gloves, cap, shoe cover, and N95 mask, and frequent hand washing. There was no history of any unprotected contact with an H1N1-positive case. Out of 100 HCP, 69% took chemoprophylaxis. There was no significant difference in incidence of flu-like illness between HCP who took chemoprophylaxis (48%) and those who did not (29%, P = 0.18). H1N1 testing was done on 17 HCP, but all tested negative. Incidence of adverse effects to chemoprophylactic dose of oseltamivir was high (57%). The most commonly reported adverse effects were nausea (54%), gastritis (51%), and headache (38%).Conclusion:Chemoprophylaxis with oseltamivir is not recommended for HCP working in areas of high aerosol generation like ICU if infection control measures are adopted as there is no significant difference in the incidence of flu-like illness in HCP with and without intake of oseltamivir. This protects HCP from various adverse effects of the drugs, like nausea, gastritis, and headache.

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The Occupational Risk of Influenza A (H1N1) Infection among Healthcare Personnel during the 2009 Pandemic: A Systematic Review and Meta-Analysis of Observational Studies

Lietz¹,

Westermann

Nienhaus

et al. 2016

PLoS ONE

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IntroductionThe aim of this review was to record systematically and assess the published literature relating to the occupational risk of influenza A (H1N1) infection among healthcare personnel during the 2009 pandemic.MethodsThe literature search was performed in June 2015. An update was carried out in May 2016. It was applied to the electronic databases EMBASE, MEDLINE, PsycINFO, PubMed, CINAHL and Google Scholar. The quality assessment was conducted with a tool using eight criteria. A meta-analysis was carried out to compute pooled effect estimates for influenza A (H1N1) infection.ResultsA total of 26 studies were included in the review, 15 studies met the criteria for the meta-analysis. After a sensitivity analysis the pooled analysis showed a significantly increased odds for influenza A (H1N1) infection for healthcare personnel compared to controls/comparisons (OR = 2.08, 95% CI = 1.73 to 2.51). The pooled prevalence rate for healthcare personnel alone was 6.3%.ConclusionsThis review corroborates the assumption that healthcare personnel were particularly at risk of influenza A (H1N1) infection during the 2009 pandemic. Healthcare facilities should intensify their focus on strategies to prevent infections among healthcare personnel, especially during the first period of pandemics.

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Low attack rate of novel influenza A (H1N1) virus infection among healthcare workers: a prospective study in a setting with an elaborated containment plan

Abstract: This study demonstrates a low incidence rate of influenza A (H1N1) infection among healthcare workers during the 2009 H1N1 pandemic in a setting with high hygiene standards.

Cited by 4 publications

References 18 publications

Review Article

Review Article

Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir

The Occupational Risk of Influenza A (H1N1) Infection among Healthcare Personnel during the 2009 Pandemic: A Systematic Review and Meta-Analysis of Observational Studies

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