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Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to health care workers presenting to work while ill

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  • Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to health care workers presenting to work while ill

    Am J Infect Control. 2019 Jan 5. pii: S0196-6553(18)31069-1. doi: 10.1016/j.ajic.2018.10.024. [Epub ahead of print]
    Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to health care workers presenting to work while ill.

    Wilson KE1, Wood SM2, Schaecher KE3, Cromwell KB2, Godich J2, Knapp MH4, Sklar MJ5, Ewing D5, Raviprakash K5, Defang G5, Whitman TJ2.
    Author information

    Abstract

    OBJECTIVE:

    To describe an outbreak of influenza A in an oncology unit, highlighting infection control methods implemented, and examining reasons health care workers (HCWs) present to work with influenza-like illness (ILI).
    METHODS:

    Confirmed cases were defined by the presence of ILI and a positive nasopharyngeal polymerase chain reaction swab for influenza A H3. Probable cases were defined as exposed HCWs with ILI who were unavailable for polymerase chain reaction testing. Infection prevention measures included closing the ward for new admissions, oseltamivir prophylaxis for all exposed groups, and dismissal from work of HCWs with ILI until resolution of symptoms. An anonymous survey of the cases in our HCWs was conducted to better elucidate reasons behind presenteeism.
    RESULTS:

    Over the course of 8 days (November 16, 2017, to November 22, 2017), influenza was diagnosed in 7 of 10 inpatients on the oncology ward, 16 HCWs (14 confirmed, 2 probable), and 2 visitors. The suspected index case was an HCW. Of the surveyed HCWs, 64% presented to work despite feeling ill (ie, presenteeism). The most common reason was "sense of duty as a health care worker."
    CONCLUSIONS:

    This nosocomial outbreak of influenza highlights the challenges of protecting inpatients from viral respiratory tract infections. HCWs and patient visitors with ILI should avoid work or visiting until resolution of peak respiratory symptoms and adhere to strict respiratory etiquette.
    Copyright 2018. Published by Elsevier Inc.


    KEYWORDS:

    Hospital epidemiology; Presenteeism

    PMID: 30616930 DOI: 10.1016/j.ajic.2018.10.024
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