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Tandjaoui-Lambiotte Y, Lomont A, Moenne-Locoz P, Seytre D, Zahar JR. Spread of viruses, which measures are the most apt to control COVID-19? Infect Dis Now 2023; 53:104637. [PMID: 36526247 PMCID: PMC9746078 DOI: 10.1016/j.idnow.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
The persistent debate about the modes of transmission of SARS-CoV2 and preventive measures has illustrated the limits of our knowledge regarding the measures to be implemented in the face of viral risk. Past and present (pandemic-related) scientific data underline the complexity of the phenomenon and its variability over time. Several factors contribute to the risk of transmission, starting with incidence in the general population (i.e., colonization pressure) and herd immunity. Other major factors include intensity of symptoms, interactions with the reservoir (proximity and duration of contact), the specific characteristics of the virus(es) involved, and a number of unpredictable elements (humidity, temperature, ventilation…). In this review, we will emphasize the difficulty of "standardizing" the situations that might explain the discrepancies found in the literature. We will show that the airborne route remains the main mode of transmission. Regarding preventive measures of prevention, while vaccination remains the cornerstone of the fight against viral outbreaks, we will remind the reader that wearing a mask is the main barrier measure and that the choice of type of mask depends on the risk situations. Finally, we believe that the recent pandemic should induce us in the future to modify our recommendations by adapting our measures in hospitals, not to the pathogen concerned, which is currently the case, but rather to the type of at-risk situation.
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Affiliation(s)
- Y Tandjaoui-Lambiotte
- Service de Pneumologie-Infectiologie, CH Saint Denis, 2 rue Dr. Delafontaine, 93200, France
| | - A Lomont
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - P Moenne-Locoz
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - D Seytre
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France
| | - J R Zahar
- Unité de Prévention du Risque Infectieux, Service de microbiologie clinique, GHU Paris Seine Saint-Denis, Université Sorbonne Paris Nord, France.
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2
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Or PPL, Ching PTY, Chung JWY. Can Flu-Like Absenteeism in Kindergartens Be Reduced Through Hand Hygiene Training for Both Parents and Their Kindergarteners? J Prim Care Community Health 2021; 11:2150132719901209. [PMID: 31948327 PMCID: PMC6970472 DOI: 10.1177/2150132719901209] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Hand hygiene has been found as an effective method to prevent the spread of infectious diseases. Parents, however, were found to have inadequate knowledge, reporting skills, and parenting practices related to seasonal influenza. The aim of our study was to investigate if there was any correlation between the flu infection among parents and their kindergarteners and ascertain the effectiveness of using hand hygiene interventions in kindergartens to lower kindergarteners’ absenteeism attributable to seasonal flu. Methods: This study was a quasi-experimental study with a pretest-posttest design. Fifteen kindergartens were randomly selected from the kindergarten lists in different districts displayed on the Hong Kong government website. From these 15 kindergartens, parents and their kindergarteners were then randomly selected to participate in our hand hygiene program. To support the validity of the program, the WHO hand hygiene checklist was used to ensure sufficient coverage of the objectives. All kindergarteners attended 45-minute session for 4 weeks, while their parents attended a separate session lasting 1 hour. Parents monitored their kindergartners on a daily basis for any flu symptoms and kindergartens monitored their school attendance. Results: The study results showed that kindergarteners with strong parenting and proper hand hygiene compliance had fewer recorded signs and symptoms of flu-like illnesses. Our findings also showed that the kindergarteners’ absence rates in all participating kindergartens owing to flu decreased from 21.5% to 12% of the study period in 3 months. Conclusion: It was found that the flu infection rates of the parents and their kindergarteners were significantly correlated with P = .005. The awareness and personal hygiene skills of the parents and kindergarteners were both raised after the program. The findings in this study supported that positive parenting on hand hygiene can help reduce kindergarteners’ flu-like absenteeism.
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Affiliation(s)
- Peggy Pui-Lai Or
- The Education University of Hong Kong, New Territories, Hong Kong SAR
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Thomas RE. Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions. Geriatrics (Basel) 2021; 6:48. [PMID: 34066781 PMCID: PMC8162358 DOI: 10.3390/geriatrics6020048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents' own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, AB T2M 1M1, Canada
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4
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Thomas RE. Pneumococcal Pneumonia and Invasive Pneumococcal Disease in Those 65 and Older: Rates of Detection, Risk Factors, Vaccine Effectiveness, Hospitalisation and Mortality. Geriatrics (Basel) 2021; 6:13. [PMID: 33557406 PMCID: PMC7931064 DOI: 10.3390/geriatrics6010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/17/2022] Open
Abstract
Pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in seniors worldwide. Incidence rates and serious outcomes worsen with increasing frailty, numbers of risk factors and decreasing immune competence with increasing age. Literature reviews in Medline and Embase were performed for pneumococcal disease incidence, risk factors, vaccination rates and effectiveness in the elderly. The introduction of protein-conjugated pneumoccal vaccines (PCV) for children markedly reduced IPD and PP in seniors, but serotypes not included in vaccines and with previously low levels increased. Pneumococcal polysaccharide (PPV23) vaccination does not change nasal and pharyngeal carriage rates. Pneumococcal and influenza vaccination rates in seniors are below guideline levels, especially in older seniors and nursing home staff. Pneumococcal and influenza carriage and vaccination rates of family members, nursing home health care workers and other contacts are unknown. National vaccination programmes are effective in increasing vaccination rates. Detection of IPD and PP initially depend on clinical symptoms and new chest X ray infiltrates and then varies according to the population and laboratory tests used. To understand how seniors and especially older seniors acquire PP and IPD data are needed on pneumococcal disease and carriage rates in family members, carers and contacts. Nursing homes need reconfiguring into small units with air ventilation externally from all rooms to minimise respiratory disease transmission and dedicated staff for each unit to minimise transmision of infectious diseaases.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
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5
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Ezzine H, Cherkaoui I, Rguig A, Oumzil H, Mrabet M, Bimouhen A, Falaki FE, Regragui Z, Tarhda Z, Youbi M, Naciri M. Influenza epidemiology and risk factors for severe acute respiratory infection in Morocco during the 2016/2017 and 2017/2018 seasons. Pan Afr Med J 2020; 36:159. [PMID: 32874423 PMCID: PMC7436631 DOI: 10.11604/pamj.2020.36.159.21239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/02/2020] [Indexed: 01/23/2023] Open
Abstract
Introduction in order to implement an influenza vaccination program for high-risk-groups in Morocco, as recommended by the World Health Organization, an epidemiological study indicating the influenza virus effect in the development of complicated influenza for subjects with co-morbidity was required. The present study aims to evaluate the risk factors for severe acute respiratory infections caused by influenza in risk groups. Methods this research is based on the epidemiological and virological surveillance data of severe acute respiratory infections and influenza-like illness during the 2016/2017 and 2017/2018 seasons. It was realized using a retrospective series study with a descriptive and analytical purpose. Results the over-recruitment of pediatric cases with a severe acute respiratory infection has been significantly rectified because cases of severe acute respiratory infections under 15 years old in the 2017/2018 season represent only 57.9%, whereas they represented 75.9% of the total cases of severe acute respiratory infections during the 2016/2017 season. The influenza positivity rate has increased globally and specifically by age group, clinical service and co-morbidity. The risk factors considered were significantly associated with hospitalization for influenza-associated severe acute respiratory infections. The multivariate logistic regression analysis considers male sex (OR=2.1), age ≥65 years (OR=5.4), presence of influenza cases in the surroundings (OR=0.1), diabetes (OR=7.5) and chronic respiratory disease (OR=10.9) as risk factors influenza-associated severe acute respiratory infections. Conclusion the risk assessment of influenza-associated severe acute respiratory infections in high-risk groups revealed national epidemiological findings, particularly for diabetics and the elderly. An influenza vaccination program for these high-risk-groups becomes much recommended in Morocco.
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Affiliation(s)
- Hind Ezzine
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco.,Research Center (BIOBIO), Laboratory of Biodiversity, Ecology and Genome, Faculty of Sciences, University Mohammed V of Rabat, Morocco
| | - Imad Cherkaoui
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Ahmed Rguig
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Hicham Oumzil
- National Influenza Center, National Institute of Hygiene, Ministry of Health, Morocco
| | - Mouad Mrabet
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Abderrahman Bimouhen
- National Influenza Center, National Institute of Hygiene, Ministry of Health, Morocco
| | - Fatima El Falaki
- National Influenza Center, National Institute of Hygiene, Ministry of Health, Morocco
| | - Zakia Regragui
- National Influenza Center, National Institute of Hygiene, Ministry of Health, Morocco
| | - Zineb Tarhda
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Mohammed Youbi
- Directorate of Epidemiology and Disease Control, Ministry of Health, Morocco
| | - Mariam Naciri
- Research Center (BIOBIO), Laboratory of Biodiversity, Ecology and Genome, Faculty of Sciences, University Mohammed V of Rabat, Morocco
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Lee MH, Lee GA, Lee SH, Park YH. A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control. PLoS One 2020; 15:e0229911. [PMID: 32155208 PMCID: PMC7064182 DOI: 10.1371/journal.pone.0229911] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 02/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The unique characteristics of long-term care facilities (LTCFs) including host factors and living conditions contribute to the spread of contagious pathogens. Control measures are essential to interrupt the transmission and to manage outbreaks effectively. AIM The aim of this systematic review was to verify the causes and problems contributing to transmission and to identify control measures during outbreaks in LTCFs. METHODS Four electronic databases were searched for articles published from 2007 to 2018. Articles written in English reporting outbreaks in LTCFs were included. The quality of the studies was assessed using the risk-of-bias assessment tool for nonrandomized studies. FINDINGS A total of 37 studies were included in the qualitative synthesis. The most commonly reported single pathogen was influenza virus, followed by group A streptococcus (GAS). Of the studies that identified the cause, about half of them noted outbreaks transmitted via person-to-person. Suboptimal infection control practice including inadequate decontamination and poor hand hygiene was the most frequently raised issue propagating transmission. Especially, lapses in specific care procedures were linked with outbreaks of GAS and hepatitis B and C viruses. About 60% of the included studies reported affected cases among staff, but only a few studies implemented work restriction during outbreaks. CONCLUSIONS This review indicates that the violation of basic infection control practice could be a major role in introducing and facilitating the spread of contagious diseases in LTCFs. It shows the need to promote compliance with basic practices of infection control to prevent outbreaks in LTCFs.
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Affiliation(s)
- Min Hye Lee
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, South Korea
| | - Gyeoung Ah Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Seong Hyeon Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Yeon-Hwan Park
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, South Korea
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Hirsch A, Katz MA, Laufer Peretz A, Greenberg D, Wendlandt R, Shemer Avni Y, Newes-Adeyi G, Gofer I, Leventer-Roberts M, Davidovitch N, Rosenthal A, Gur-Arie R, Hertz T, Glatman-Freedman A, Monto AS, Azziz-Baumgartner E, Ferdinands JM, Martin ET, Malosh RE, Neyra Quijandría JM, Levine M, Campbell W, Balicer R, Thompson MG. Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI): study protocol. BMC Infect Dis 2018; 18:550. [PMID: 30400834 PMCID: PMC6220521 DOI: 10.1186/s12879-018-3444-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/16/2018] [Indexed: 01/04/2023] Open
Abstract
Background The Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI) prospectively follows a cohort of healthcare personnel (HCP) in two hospitals in Israel. SHIRI will describe the frequency of influenza virus infections among HCP, identify predictors of vaccine acceptance, examine how repeated influenza vaccination may modify immunogenicity, and evaluate influenza vaccine effectiveness in preventing influenza illness and missed work. Methods Cohort enrollment began in October, 2016; a second year of the study and a second wave of cohort enrollment began in June 2017. The study will run for at least 3 years and will follow approximately 2000 HCP (who are both employees and members of Clalit Health Services [CHS]) with routine direct patient contact. Eligible HCP are recruited using a stratified sampling strategy. After informed consent, participants complete a brief enrollment survey with questions about occupational responsibilities and knowledge, attitudes, and practices about influenza vaccines. Blood samples are collected at enrollment and at the end of influenza season; HCP who choose to be vaccinated contribute additional blood one month after vaccination. During the influenza season, participants receive twice-weekly short message service (SMS) messages asking them if they have acute respiratory illness or febrile illness (ARFI) symptoms. Ill participants receive follow-up SMS messages to confirm illness symptoms and duration and are asked to self-collect a nasal swab. Information on socio-economic characteristics, current and past medical conditions, medical care utilization and vaccination history is extracted from the CHS database. Information about missed work due to illness is obtained by self-report and from employee records. Respiratory specimens from self-collected nasal swabs are tested for influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, and coronaviruses using validated multiplex quantitative real-time reverse transcription polymerase chain reaction assays. The hemagglutination inhibition assay will be used to detect the presence of neutralizing influenza antibodies in serum. Discussion SHIRI will expand our knowledge of the burden of respiratory viral infections among HCP and the effectiveness of current and repeated annual influenza vaccination in preventing influenza illness, medical utilization, and missed workdays among HCP who are in direct contact with patients. Trial registration NCT03331991. Registered on November 6, 2017. Electronic supplementary material The online version of this article (10.1186/s12879-018-3444-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Avital Hirsch
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.
| | - Mark A Katz
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel.,School of Public Health, Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alon Laufer Peretz
- Rabin Medical Center, Occupational Medicine Department, Petah Tikva, Israel
| | - David Greenberg
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | | | - Yonat Shemer Avni
- Clinical Virology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Ilan Gofer
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Maya Leventer-Roberts
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Anat Rosenthal
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Rachel Gur-Arie
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Tomer Hertz
- Department of Microbiology Immunology and Genetics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.,Vaccine and Infectious Disease Division, Fred Hutch Cancer Research Center, Seattle, WA, USA
| | - Aharona Glatman-Freedman
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | | | - Emily Toth Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ryan E Malosh
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Min Levine
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Ran Balicer
- Chief Physician's Office, Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Lansbury LE, Brown CS, Nguyen‐Van‐Tam JS. Influenza in long-term care facilities. Influenza Other Respir Viruses 2017; 11:356-366. [PMID: 28691237 PMCID: PMC5596516 DOI: 10.1111/irv.12464] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 01/13/2023] Open
Abstract
Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence.
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Affiliation(s)
- Louise E. Lansbury
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
| | - Caroline S. Brown
- Influenza & Other Respiratory Pathogens ProgrammeDivision of Communicable Diseases and Health SecurityWHO Regional Office for EuropeUN CityCopenhagenDenmark
| | - Jonathan S. Nguyen‐Van‐Tam
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
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9
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Casalino E, Antoniol S, Fidouh N, Choquet C, Lucet JC, Duval X, Visseaux B, Pereira L. Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods. PLoS One 2017; 12:e0182191. [PMID: 28813449 PMCID: PMC5558947 DOI: 10.1371/journal.pone.0182191] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/13/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation. METHODS This is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013-2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI). Patients were tested for influenza using specific PCR on naso-pharyngeal swabs. RESULTS Of 1,239 patients, virological samples were taken from 784 (63.3%), 213 (27.2%) of whom were positive for the influenza virus: CAP 52/177 (29.4%), SAS 115/447 (25.7%) and PSSI 46/160 (28.8%) (p = 0.6). In the SAS group positivity rates were: RF 76/263 (28.9%), HF 5/29 (17.2%), CF 15/68 (22.1%), and M 19/87 (21.8%) (p = 0.3). Among the major diagnostic categories, the influenza virus positivity rates were: asthma 60/231 (26%), acute exacerbation of chronic obstructive pulmonary disease 18/86 (20.9%), HIV 5/21 (23.8%) and cardiac failure 33/131 (25.2%). The positivity of the samples has not been associated (p>0.1) nor the presence of signs of severity or admission rate in medical ward nor intensive care unit. CONCLUSIONS Our results indicate that during seasonal influenza epidemics, Influenza virus-positivity rate is similar in patients attending ED for influenza-compatible clinical features, patients with acute symptoms including pneumonia, respiratory, hemodynamic and cardiac distress, and patients presenting for acute decompensation of chronic respiratory and cardiac diseases.
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Affiliation(s)
- Enrique Casalino
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, EA 7334 Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
- * E-mail:
| | - Stephanie Antoniol
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, EA 7334 Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Nadhira Fidouh
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Virology Department, Paris, France
| | - Christophe Choquet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, EA 7334 Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
| | - Jean-Christophe Lucet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat-Claude Bernard Hospital, Infection Control Unit, Paris, France
| | - Xavier Duval
- Inserm CIC-1425, AP-HP, Hôpital Universitaire Bichat, Paris, France
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Benoit Visseaux
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Virology Department, Paris, France
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Laurent Pereira
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Emergency Department, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, EA 7334 Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Paris, France
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France
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