Infection Control Preparedness for Human Infection With Influenza A H7N9 in Hong Kong. (5th January 2015)

• Record Type: Journal Article
• Authors: Cheng, Vincent C. C.; Tai, Josepha W. M.; Lee, W. M.; Chan, W. M.; Wong, Sally C. Y.; Chen, Jonathan H. K.; Poon, Rosana W. S.; To, Kelvin K. W.; Chan, Jasper F. W.; Ho, P. L.; Chan, K. H.; Yuen, K. Y.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 1(2015)
• Page Start: 87
• Page End: 92
• Publication Date: 2015-01-05
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2014.2
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>OBJECTIVE</title> <p>To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong.</p> </sec> <sec id="abs2" sec-type="general"> <title>DESIGN</title> <p>A descriptive study of responses to the emergence of influenza A H7N9.</p> </sec> <sec id="abs3" sec-type="general"> <title>SETTING</title> <p>A university-affiliated teaching hospital.</p> </sec> <sec id="abs4" sec-type="general"> <title>PARTICIPANTS</title> <p>Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9.</p> </sec> <sec id="abs5" sec-type="methods"> <title>METHODS</title> <p>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.</p> </sec> <sec id="abs6" sec-type="results"> <title>RESULTS</title> <p>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 (<italic>P</italic>=0.088) and significantly more had paired sera collected for H7 antibody testing (<italic>P</italic><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.</p> </sec> <sec id="abs7" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.</p> <p>Infect Control Hosp Epidemiol 2015;36(1): 87–92</p> </sec> </abstract>