Molecular epidemiology and environmental contamination during an outbreak of parainfluenza virus 3 in a haematology ward

Kim, T.; Jin, Choong Eun; Sung, Heungsup; Koo, Bon San; Park, J.; Kim, S.-M.; Kim, J.Y.; Chong, Yong Pil; Lee, S.-O.; Choi, Sang‐Ho; Kim, Y.S.; Woo, Jun Hee; Lee, J.-H.; Lee, K.-H.; Shin, Yong-June

doi:10.1016/j.jhin.2017.09.003

Cited by 20 publications

(14 citation statements)

References 24 publications

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“…We could therefore surmise that either another source of infection or other points of contact between patients were present. Cases of health care workers contributing to nosocomial outbreaks are well documented 44– 47 . Although stringent infection control policies are usually in place, transmission from a member of staff cannot be excluded.…”

Section: Discussionmentioning

confidence: 99%

Unrecognised Outbreak: Human parainfluenza virus infections in a pediatric oncology unit. A new diagnostic PCR and virus monitoring system may allow early detection of future outbreaks

Smielewska¹,

Pearson²,

Popay³

et al. 2018

Wellcome Open Res

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Background: Human parainfluenza viruses (HPIVs) are significant causes of both upper and lower respiratory tract infections with type 3 (HPIV3) causing the most severe disease in the immunocompromised cohorts. The objective of this study was to analyse the epidemiological nature of a cluster of cases of HPIV3 in a pediatric oncology unit of a major teaching hospital. Methods: In order to determine whether the activity observed represented a deviation from the norm, seasonal trends of HPIV3 in the surrounding geographical area as well as on the ward in question were analysed. The genetic link between cases was established by the phylogenetic analysis of the non-coding hypervariable region between the M (Matrix) and F (fusion) genes of HPIV3. The 15 cases involved and 15 unrelated cases were sequenced. Transmission routes were subsequently inferred and visualized using Konstanz Information Miner (KNIME) 3.3.2. Results: Of the 15 cases identified, 14 were attributed to a point source outbreak. Two out of 14 outbreak cases were found to differ by a single mutation A182C. The outbreak strain was also seen in 1 out of 15 unrelated cases, indicating that it was introduced from the community. Transmission modeling was not able to link all the cases and establish a conclusive chain of transmission. No staff were tested during the outbreak period. No deaths occurred as a result of the outbreak. Conclusion: A point source outbreak of HPIV3 was recognized post factum on an oncology pediatric unit in a major teaching hospital. This raised concern about the possibility of a future more serious outbreak. Weaknesses in existing systems were identified and a new dedicated respiratory virus monitoring system introduced. Pediatric oncology units require sophisticated systems for early identification of potentially life-threatening viral outbreaks.

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Section: Discussionmentioning

confidence: 99%

Unrecognised Outbreak: Human parainfluenza virus infections in a pediatric oncology unit. A new diagnostic PCR and virus monitoring system may allow early detection of future outbreaks

Smielewska¹,

Pearson²,

Popay³

et al. 2018

Wellcome Open Res

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“…HPIV3 is an important causative agent of ARI that can be complicated with pneumonia, especially in immunocompromised and elderly individuals. Outbreaks caused by HPIV3 have been most frequently described in neonatal units [11][12][13] and inpatient units with hematology/oncology patients [14][15][16] but also among elderly individuals residing in long-term care facilities [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Outbreaks of HPIV in health-care settings have been primarily described in neonatal units [11][12][13] and hematology/oncology wards [14][15][16]. Moreover, HPIV3 has been found to account for 90% of the nosocomial infections in bone marrow transplant units during peak viral seasons [3,[17][18][19].…”

Section: Introductionmentioning

confidence: 99%

An Outbreak of Human Parainfluenza Virus 3 (Phylogenetic Subcluster C5) Infection among Adults at a Residential Care Facility for the Disabled in Croatia, 2018

Čivljak¹,

Košutić-Gulija

Slović

et al. 2019

Intervirology

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Introduction: Although highly pertinent for children, outbreaks of human parainfluenza virus (HPIV) may cause up to 15% of all respiratory illnesses in adults and predispose them to serious adverse outcomes, with HPIV serotype 3 (HPIV3) being the most common. This study represents the first report of an HPIV3 outbreak among adults at a long-term health-care facility in Croatia. Methods: A retrospective study was conducted to investigate an outbreak of acute respiratory infection (ARI) at a single residential care facility for the disabled in Croatia. Demographic, epidemiological, and clinical data were collected for all residents, while hospitalized patients were appraised in detail by laboratory/radio-logical methods. Multiplex PCR for respiratory viruses and sequencing was performed. Partial HPIV3 HN 581 nt sequences were aligned with HPIV3 sequences from the Gen-Bank database to conduct a phylogenetic analysis, where different bioinformatic approaches were employed. Results: In late June 2018, 5 of the 10 units at the facility were affected by the outbreak. Among the 106 residents, 23 (21.7%) developed ARI, and 6 (26.1%) of them were hospitalized. HPIV3 was identified in 18 (73%) of the residents and 5 (83%) of the hospitalized individuals. Isolated HPIV3 strains were classified within the phylogenetic subcluster C5 but grouped on 2 separate branches of the phylogenetic tree. During the entire outbreak period, none of the institution's employees reported symptoms of ARI. Conclusions: Our study has shown that this health care-associated outbreak of HPIV3 infection could have been linked to multiple importation events. Preventive measures in curbing such incidents should be enforced vigorously.

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“…The virus was detected in 43% of environmental samples up to 12 days after it was not detectable in the patient. [4] Respiratory syncytial virus caused outbreaks in consecutive years in another haematology unit. [5] In the first, the index patient was admitted from the community with symptoms, but asymptomatic shedders may have contributed.…”

Section: Respiratory Infections In Specific Patient Groupsmentioning

confidence: 99%

Transmission and prevention of acute viral respiratory tract infections in hospitals

Wilson

Zumla

2019

Current Opinion in Pulmonary Medicine

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Purpose of review: Transmission of acute respiratory tract viral infections in healthcare environments is a major problem worldwide. We review recent literature of visruses impored to hospitals from the local community and from abroad, their modes of transmission and measures required to reduce and contain them. Recent findings: Common causes of outbreaks include Influenza viruses, Respiratory syncytial virus, Adenovirus, and Coronaviruses. Major lethal outbreaks of viral respiratory infections in hospitals have been caused by coronaviruses imported from abroad by travellers. Summary: While viruses circulating in the local community are common causes of hospital outbreaks, major outbreaks have been caused by the coronaviruses imported from abroad by travellers. A high degree of clinical awareness and rapid enforcement of infection control measures are required to prevent transmission and spread.

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Molecular epidemiology and environmental contamination during an outbreak of parainfluenza virus 3 in a haematology ward

Cited by 20 publications

References 24 publications

Unrecognised Outbreak: Human parainfluenza virus infections in a pediatric oncology unit. A new diagnostic PCR and virus monitoring system may allow early detection of future outbreaks

Unrecognised Outbreak: Human parainfluenza virus infections in a pediatric oncology unit. A new diagnostic PCR and virus monitoring system may allow early detection of future outbreaks

An Outbreak of Human Parainfluenza Virus 3 (Phylogenetic Subcluster C5) Infection among Adults at a Residential Care Facility for the Disabled in Croatia, 2018

Transmission and prevention of acute viral respiratory tract infections in hospitals

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