Skip to main content Accessibility help
×
Home

Healthcare-Associated Influenza in Canadian Hospitals from 2006 to 2012

Published online by Cambridge University Press:  10 May 2016

Geoffrey Taylor
Affiliation:
University of Alberta Hospital, Edmonton, Alberta, Canada
Robyn Mitchell
Affiliation:
Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada
Allison McGeer
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Charles Frenette
Affiliation:
McGill University Health Centre, Montreal, Quebec, Canada
Kathryn N. Suh
Affiliation:
Ottawa Hospital, Ottawa, Ontario, Canada
Alice Wong
Affiliation:
Royal University Hospital, Saskatoon, Saskatchewan, Canada
Kevin Katz
Affiliation:
North York General Hospital, Ontario, Canada
Krista Wilkinson
Affiliation:
Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada
Barbara Amihod
Affiliation:
Jewish General Hospital, Montreal, Quebec, Canada
Denise Gravel
Affiliation:
Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Ottawa, Ontario, Canada
Corresponding
E-mail address:

Abstract

Objective.

To determine trends, patient characteristics, and outcome of patients with healthcare-associated influenza in Canadian hospitals.

Design.

Prospective surveillance of laboratory-confirmed influenza among hospitalized adults was conducted from 2006 to 2012. Adults with positive test results at or after admission to the hospital were assessed. Influenza was considered to be healthcare associated if symptom onset was equal to or more than 96 hours after admission to a facility or if a patient was readmitted less than 96 hours after discharge or admitted less than 96 hours after transfer from another facility. Baseline characteristics of influenza patients were collected. Patients were reassessed at 30 days to determine the outcome.

Setting.

Acute care hospitals participating in the Canadian Nosocomial Infection Surveillance Program.

Results.

A total of 570 (17.3%) of 3,299 influenza cases were healthcare associated; 345 (60.5%) were acquired in a long-term care facility (LTCF), and 225 (39.5%) were acquired in an acute care facility (ACF). There was year-to-year variability in the rate and proportion of cases that were healthcare associated and variability in the proportion that were acquired in a LTCF versus an ACF. Patients with LTCF-associated cases were older, had a higher proportion of chronic heart disease, and were less likely to be immunocompromised compared with patients with ACF-associated cases; there was no significant difference in 30-day all-cause and influenza-specific mortality.

Conclusions.

Healthcare-associated influenza is a major component of the burden of disease from influenza in hospitals, but the proportion of cases that are healthcare associated varies markedly from year to year, as does the proportion of healthcare-associated infections that are acquired in an ACF versus an LTCF.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

Access options

Get access to the full version of this content by using one of the access options below.

Footnotes

a

Members of the Canadian Nosocomial Infection Surveillance Program are listed at the end of the text.

References

1. Saigado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.CrossRefGoogle Scholar
2. Bradley, SF. Prevention of influenza in long-term-care facilities. Long-Term Care Committee of the Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol 1999; 20(9):629637.CrossRefGoogle ScholarPubMed
3. Coles, FB, Balzano, GJ, Morse, DL. An outbreak of influenza A (H3N2) in a well immunized nursing home population. J Am Geriatr Soc 1992;40(6):589592.CrossRefGoogle Scholar
4. Voirin, N, Barret, B, Metzger, MH, Vanhems, P. Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement. J Hosp Infect 2009;71(1):114.CrossRefGoogle ScholarPubMed
5. Morens, DM, Rash, VM. Lessons from a nursing home outbreak of influenza A. Infect Control Hosp Epidemiol 1995;16(5):275280.CrossRefGoogle ScholarPubMed
6. Cohen, NJ, Morita, JY, Plate, DK, et al. Control of an outbreak due to an adamantine-resistant strain of influenza A (H3N2) in a chronic care facility. Infection 2008;36(5):458462.CrossRefGoogle Scholar
7. Alexander, DC, Winter, AL, Eshaghi, A, et al. Transmission of influenza A pandemic (H1N1) 2009 virus in a long-term care facility in Ontario, Canada. Infect Control Hosp Epidemiol 2010; 31(12):13001302.CrossRefGoogle Scholar
8. Enstone, JE, Myles, PR, Openshaw, PJM, et al. Nosocomial pandemic (H1N1) 2009, United Kingdom, 2009-2010. Emerg Infect Dis 2011;17:592598.CrossRefGoogle ScholarPubMed
9. Khandaker, G, Rashid, H, Zurynski, Y, et al Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case-control study. J Hosp Infect 2012;82(2):94100.CrossRefGoogle ScholarPubMed
10. Veenith, T, Sanfilippo, F, Ercole, A, et al Nosocomial H1N1 infection during 2010-2011 pandemic: a retrospective cohort study from a tertiary referral hospital. J Hosp Infect 2012;81(3): 202205.CrossRefGoogle ScholarPubMed
11. Macesic, N, Kotsimbos, TC, Kelly, P, Cheng, AC. Hospital-acquired influenza in an Australian sentinel surveillance system. MJA 2013;198:370372.Google Scholar
12. Vanhems, P, Voirin, N, Roche, S, et al. Risk of influenza-like illness in an acute health care setting during community influenza epidemics in 2004-2005, 2005-2006, and 2006-2007. Arch Intern Med 2011;171(2):151157.CrossRefGoogle Scholar
13. Wilkinson, K, Mitchell, R, Taylor, G, et al. Laboratory-confirmed pandemic H1N1 influenza in hospitalized adults: findings from the Canadian Nosocomial Infections Surveillance Program, 2009-2010. Infect Control Hosp Epidemiol 2012;33(10):10431046.CrossRefGoogle ScholarPubMed
14. Harper, SA, Bradley, JS, Englund, JA, et al. Seasonal influenza in adults and children-diagnosis, treatment, chemoprophylaxis and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009;48:10031032.CrossRefGoogle ScholarPubMed
15. Skowronski, DM, Hottes, TS, McElhaney, JE, et al. Immuno-epidemiologic correlates of pandemie H1N1 surveillance observations: higher antibody and lower cell-mediated immune responses with advanced age. J Infect Dis 2011;203:158167.CrossRefGoogle Scholar
16. Hall, WN, Goodman, RA, Noble, GR, Kendal, AP, Steece, RS. An outbreak of influenza B in an elderly population. J Infect Dis 1981;144(4):297302.CrossRefGoogle Scholar
17. Aoki, F, Hayden, F. The beneficial effects of neuraminidase in hibitor drug therapy on severe patient outcomes during the 2009-2010 influenza A virus subtype H1N1 pandemic. J Infect Dis 2013;207:547549.CrossRefGoogle Scholar
18. Bryce, E, Embree, J, Evans, G, et al. AMMI Canada position paper: mandatory influenza immunization of health care workers. Can J Infect Dis Med Microbiol 2012;23:e93e95.Google ScholarPubMed
19. Gardam, M, Lemieux, C. Mandatory influenza vaccination? first we need a better vaccine. CMAJ 2013;185:639640.CrossRefGoogle Scholar

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 197 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 17th January 2021. This data will be updated every 24 hours.

Hostname: page-component-77fc7d77f9-vchrx Total loading time: 0.329 Render date: 2021-01-17T17:11:14.752Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags last update: Sun Jan 17 2021 16:54:39 GMT+0000 (Coordinated Universal Time) Feature Flags: { "metrics": true, "metricsAbstractViews": false, "peerReview": true, "crossMark": true, "comments": true, "relatedCommentaries": true, "subject": true, "clr": true, "languageSwitch": true, "figures": false, "newCiteModal": false, "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Healthcare-Associated Influenza in Canadian Hospitals from 2006 to 2012
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Healthcare-Associated Influenza in Canadian Hospitals from 2006 to 2012
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Healthcare-Associated Influenza in Canadian Hospitals from 2006 to 2012
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *