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Disruption of Services in an Internal Medicine Unit Due to a Nosocomial Influenza Outbreak

Published online by Cambridge University Press:  02 January 2015

Catherine Sartor
Affiliation:
Comité de Lutte contre les Infections, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Christine Zandotti
Affiliation:
Laboratoire de Virologie, Hôpital de la Timone, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Fanny Romain
Affiliation:
Département d'Information Médicale, Hôpital de la Conception, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Véronique Jacomo
Affiliation:
Laboratoire de Bactériologie, Hygiène et Epidémiologie Hospitalières, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Sophie Simon
Affiliation:
Laboratoire de Virologie, Hôpital de la Timone, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Catherine Atlan-Gepner
Affiliation:
Service de Médecine Interne, Hôpital Sainte Marguerite, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Roland Sambuc
Affiliation:
Comité de Lutte contre les Infections, Assistance Publique, Hôpitaux de Marseille, Marseille, France Département d'Information Médicale, Hôpital de la Conception, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Bernard Vialettes
Affiliation:
Service de Médecine Interne, Hôpital Sainte Marguerite, Assistance Publique, Hôpitaux de Marseille, Marseille, France
Michel Drancourt*
Affiliation:
Comité de Lutte contre les Infections, Assistance Publique, Hôpitaux de Marseille, Marseille, France Laboratoire de Bactériologie, Hygiène et Epidémiologie Hospitalières, Assistance Publique, Hôpitaux de Marseille, Marseille, France
*
Laboratoire de Bactériologie, Hygiène et Epidémiologic Hospitalière, Hôpital Timone, rue Saint-Pierre, 13005 Marseille, France

Abstract

Objective:

To describe a nosocomial influenza A out-break, how it was managed, what impact it had on subsequent delivery of health care, and the additional charges attributable to it.

Design:

Prospective cohort study and microbiological investigation.

Setting:

One internal medicine unit in an acute care, university-affiliated hospital.

Participants:

Twenty-three patients and 22 staff members from February 28 to March 6,1999.

Results:

Attack rates were 41% (9 of 22) among patients and 23% (5 of 22) among staff members, with 3 of 14 cases being classified as “certain”. The influenza virus isolates were typed as A/SYDNEY/5/97 (H3N2). The index case was a patient who shared a room with the first nosocomial case. Vaccination rates for influenza virus were 43% (10 of 23) among patients and 36% (8 of 22) among staff members. The outbreak resulted in staff members' taking 14 person-days of sick leave. Furthermore, 8 scheduled admissions were postponed and all emergency admissions were suspended for 11 days. Hospital charges attributable to the influenza outbreak totaled $34,179 and the average extra charge per infected patient was $3,798.

Conclusions:

Nosocomial influenza outbreaks increase charges and alter the quality of care delivered in acute care settings. Strategies for their prevention need to be evaluated in acute care settings. (Infect Control Hosp Epidemiol 2002;23:615-619).

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Sugaya, N, Kusumoto, N, Suzuki, Y, Nerome, R, Nerome, K. Large sequential outbreaks caused by influenza A (H3N2) and B viruses in an institution for the mentally handicapped. J Med Virol 1996;50:120125.3.0.CO;2-C>CrossRefGoogle Scholar
2.Advisory Committee on Immunization Practices. Prevention and control of influenza: recommendations. MMWR 2001;50:144.Google Scholar
3.Bradley, SF, the Long-Term-Care Committee of the Society for Healthcare Epidemiology of America. Prevention of influenza in long-term-care facilities. Infect Control Hosp Epidemiol 1999;20:629627.Google Scholar
4.Blumenfeld, H, Kilbourne, E, Louria, D, Roger, D. Studies on influenza in the pandemic of 1957-58: 1. An epidemiologic, clinical, and serologic investigation of an intrahospital epidemic, with a note on vaccine efficacy. J Clin Invest 1959;38:199212.CrossRefGoogle Scholar
5.Evans, ME, Hall, KL, Berry, SE. Influenza control in acute care hospitals. Am J Infect Control 1997;25:357362.Google Scholar
6.Salgado, CD, Farr, BM, Hall, KK, Hayden, FG. Influenza in the acute hospital setting. Lancet Infect Dis 2002;2:145155.CrossRefGoogle ScholarPubMed
7.Van Voris, LP, Belshe, RB, Shaffer, JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med 1982;96:153158.Google Scholar
8.Centers for Disease Control and Prevention. Update: influenza activity— United States, 1997-98 season. MMWR 1997;46:10941098.Google Scholar
9.Orestein, WA, Bernier, RH, Hinman, AR. Assessing vaccine efficacy in the field: further observations. Epidemiol Rev 1988;10:212241.Google Scholar
10.Finkler, SA. The distinction between cost and charges. Ann Intern Med 1982;96:102109.Google Scholar
11.Bauer, CR, Elie, K, Spence, L, Stern, L. Hong Kong influenza in a neonatal unit. JAMA 1973;223:12331235.Google Scholar
12.Hall, CB, Douglas, RG. Nosocomial influenza infection as a cause of intercurrent fevers in infants. Pediatrics 1975;55:673677.CrossRefGoogle ScholarPubMed
13.Meibalane, R, Sedmak, GV, Sasidharan, P, Garg, P, Grausz, JP. Outbreak of influenza in a neonatal intensive care unit. J Pediatr 1977;91:974976.Google Scholar
14.Munoz, FM, Campbell, JR, Atmar, RL, et alInfluenza A virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 1999;18:811815.Google Scholar
15.Cunney, RJ, Bialachowski, A, Thornley, D, Smaill, FM, Pennie, RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449454.Google Scholar
16.Kapila, R, Lintz, DI, Tecson, FT, Ziskin, L, Louria, DB. A nosocomial outbreak of influenza A. Chest 1977;71:576579.CrossRefGoogle ScholarPubMed
17.Weinstock, DM, Eagan, J, Malak, SAet alControl of influenza A on a bone marrow transplant unit. Infect Control Hosp Epidemiol 2000;21:730732.Google Scholar
18.Malavaud, S, Malavaud, B, Sandres, K, et alNosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation 2001;72:535537.CrossRefGoogle Scholar
19.Rivera, M, Gonzalez, N. An influenza outbreak in a hospital. Am J Nurs 1982;18:3638.Google Scholar
20.Pachucki, CT, Pappas, SA, Fuller, GF, Krause, SL, Lentino, JR, Schaaff, DM. Influenza A among hospital personnel and patients: implications for recognition, prevention and control. Arch Intern Med 1989;149:7780.CrossRefGoogle ScholarPubMed
21.Serwint, JR, Miller, RM. Why diagnose influenza infections in hospitalized pediatric patients? Pediatr Infect Dis J 1993;12:200204.CrossRefGoogle ScholarPubMed
22.Weingarten, S, Friedlander, M, Rascon, D, Ault, M, Morgan, M, Meyer, RD. Influenza surveillance in an acute-care hospital. Arch Intern Med 1988;148:113116.CrossRefGoogle Scholar
23.Whimbey, E, Elting, LS, Couch, RB, et alInfluenza A virus infections among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant 1994;13:437440.Google Scholar
24.Serwint, JR, Miller, RM, Korsh, BM. Influenza type A and B infections in hospitalized pediatric patients: who should be immunized? Am J Dis Child 1991;145:623626.CrossRefGoogle Scholar
25.Wenzel, RP, Deal, EC, Hendley, JO. Hospital-acquired viral respiratory illness on a pediatric ward. Pediatrics 1977;60:367371.Google Scholar
26.Carrat, F, Tachet, A, Rouzioux, C, Housset, B, Valleron, A-J. Evaluation of clinical definitions of influenza: detailed investigation of patients during the 1995-1996 epidemic in France. Clin Infect Dis 1999;28:283290.Google Scholar
27.Gross, PA, Rodstein, M, LaMontagne, JR, et alEpidemiology of acute respiratory illness during an influenza outbreak in a nursing home: a prospective study. Arch Intern Med 1988;148:559561.Google Scholar
28.Hayden, FG, Gubareva, LV, Monto, AS, et alInhaled zanamivir for the prevention of influenza in families. N Engl J Med 2000;343:12821289.Google Scholar
29.Murphy, BR, Webster, RG. Orthomyxoviruses. In: Fields, BN, Knipe, DM, Howley, PM, et al, eds. Fields Virology, 3rd ed. Philadelphia: Lippincott-Raven; 1996:13971446.Google Scholar
30.Buxton Bridges, C, Katz, JM, Seto, WH, et alRisk of influenza A (H5N1) infection among health care workers exposed to patients with influenza A (H5N1), Hong Kong. J Infect Dis 2000;181:344348.Google Scholar
31.Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals. JAMA 1999;10:908913.Google Scholar
32.Adal, KA, Flowers, RH, Anglim, AM, et alPrevention of nosocomial influenza. Infect Control Hosp Epidemiol 1996;17:641648.Google Scholar
33.Smith, SA, Poland, GA. Use of influenza and pneumococcal vaccines in people with diabetes. Diabetes Care 2000;23:95108.CrossRefGoogle ScholarPubMed
34.Fedson, DS, Houck, P, Bratzier, D. Hospital-based influenza and pneumococcal vaccination: Sutton's law applied to prevention. Infect Control Hosp Epidemiol 2000;21:692699.Google Scholar