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Infection Control Preparedness for Human Infection With Influenza A H7N9 in Hong Kong

Published online by Cambridge University Press:  05 January 2015

Vincent C. C. Cheng ,
Josepha W. M. Tai ,
W. M. Lee ,
W. M. Chan ,
Sally C. Y. Wong ,
Jonathan H. K. Chen ,
Rosana W. S. Poon ,
Kelvin K. W. To ,
Jasper F. W. Chan  and
P. L. Ho
...Show all authors
Vincent C. C. Cheng
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China Infection Control Team, Queen Mary Hospital, Hong Kong, China
Josepha W. M. Tai
Affiliation:
Infection Control Team, Queen Mary Hospital, Hong Kong, China
W. M. Lee
Affiliation:
Infection Control Team, Queen Mary Hospital, Hong Kong, China
W. M. Chan
Affiliation:
Department of Adult Intensive Care Unit, Queen Mary Hospital, Hong Kong, China
Sally C. Y. Wong
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
Jonathan H. K. Chen
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
Rosana W. S. Poon
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
Kelvin K. W. To
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
Jasper F. W. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
P. L. Ho
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
K. H. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
K. Y. Yuen*
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong, China
*
Address correspondence to K. Y. Yuen, MD, FRCPath, Department of Microbiology, Queen Mary Hospital, Hong Kong, China (kyyuen@hkucc.hku.hk).
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Abstract

OBJECTIVE

To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong.

DESIGN

A descriptive study of responses to the emergence of influenza A H7N9.

SETTING

A university-affiliated teaching hospital.

PARTICIPANTS

Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9.

METHODS

A bundle approach including active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive contact tracing for HCWs with unprotected exposure was implemented. Seventy HCWs with unprotected exposure to an index case were interviewed especially regarding their patient care activities.

RESULTS

From April 1, 2013, through May 31, 2014, a total of 126 (0.08%) of 163,456 admitted patients were tested for the H7 gene by reverse transcription-polymerase chain reaction per protocol. Two confirmed cases were identified. Seventy (53.8%) of 130 HCWs had unprotected exposure to an index case, whereas 41 (58.6%) and 58 (82.9%) of 70 HCWs wore surgical masks and practiced hand hygiene after patient care, respectively. Sixteen (22.9%) of 70 HCWs were involved in high-risk patient contacts. More HCWs with high-risk patient contacts received oseltamivir prophylaxis (P=0.088) and significantly more had paired sera collected for H7 antibody testing (P<0.001). Ten (14.3%) of 70 HCWs developed influenza-like illness during medical surveillance, but none had positive results by reverse transcription-polymerase chain reaction. Paired sera was available from 33 of 70 HCWs with unprotected exposure, and none showed seroconversion against H7N9.

CONCLUSIONS

Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.

Infect Control Hosp Epidemiol 2015;36(1): 87–92

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 1 , January 2015 , pp. 87 - 92
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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