132. Acute Respiratory Viral Infection among Outpatient Healthcare Personnel
Session: Oral Abstract Session: Protecting Healthcare Personnel from Viral Respiratory Infections
Thursday, October 3, 2013: 10:48 AM
Room: The Moscone Center: 200-212

Background: Respiratory disease is a common source of morbidity among healthcare personnel (HCP).  However, the causes of acute respiratory illness (ARI) have not been well studied. We assessed the viral causes of respiratory illness among HCP enrolled in a cluster randomized clinical trial at 99 outpatient departments and emergency departments in 7 locations: Baltimore, MD; Denver, CO (3); Houston, TX; New York, NY; and Washington, DC.

Methods:   During 12 weeks of the 2011-2 (YR1) and 2012-3 (YR2) respiratory seasons, HCP were surveyed for signs and symptoms of ARI. Participants with symptoms were cultured and swabs frozen at -800C. Also, two random swabs were obtained during the intervention period. Samples were tested using a multiplex PCR for 13 viruses (PCR/ESI-MS, Abbott labs). Paired blood samples were obtained prior to the start of the intervention period and 2-weeks post-intervention, then tested for influenza antibodies (>2-fold antibody increase). YR2 serum samples have not been tested. 

Results:   Among 1686 participants (609 YR1; 1077 YR2), 4255 swabs were obtained. To date, 1579 swab samples have been tested (1370 YR1; 209 YR2): 544 symptomatic (335 YR1; 209 YR2) and 1035 asymptomatic. Influenza antibodies were tested in 1292 serum samples.  Based on testing, 102 YR1 and 76 YR2 samples revealed the following viral isolates: influenza A (36), influenza B (8), parainfluenza (2), adenovirus (4), coronavirus (78), metapneumovirus (16), rhinovirus (17), and respiratory syncytial virus (RSV, 17) (Figure 1). Four cases of influenza A were identified by serological and viral testing (Figure 2).

Conclusion:   ARIs are common among HCP with 25% developing symptoms during the respiratory viral season.  Among ARI in HCP, 27% had identifiable viral causes – most commonly coronavirus at 44%. This increased in YR2 with identification of rhinovirus.  Most interesting is the significant number of asymptomatic HCP (19%) with identifiable virus.  Some of these viruses cause significant morbidity to patients and transmission from HCP is critical to patient safety and that of the HCP themselves. *** 

Figure 1

Figure 2: Results show both serologic and nose/throat sample results. *Rhinovirus not tested. **Data available for 2 sites, asymptomatic data pending.

***NOTE: The data analysis is ongoing - more information will be available at the presentation.

Meghan Kubala, MS, Hospital Epidemiology and Infection Control, Johns Hopkins University, School of Medicine, Baltimore, MD, Jenna Los, BA, Medicine, Johns Hopkins University, Baltimore, MD, Charlotte Gaydos, DrPH, Medicine, Infectious Diseases, Johns Hopkins University, Baltimore, MD, Mary Bessesen, MD, Infectious Diseases, University of Colorado Denver, Aurora, CO, Derek Cummings, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Cynthia Gibert, MD, MSc, Washington, DC, VAMC, Washington, DC, Geoffrey J. Gorse, MD, Saint Louis University School of Medicine, St. Louis, MO, Jeffery Holden, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, Ann-Christine Nyquist, MD, MSPH, University of Colorado, Denver, CO, Connie Price, MD, Denver Health Medical Center, Denver, CO, Lewis Radonovich, MD, University of Florida College of Medicine, Gainesville, FL, Maria C. Rodriguez-Barradas, MD, Infectious Diseases and Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, Ranga Sampath, PhD, Ibis Biosciences, Inc., A Division of Abbott, Carlsbad, CA, Michael Simberkoff, MD, VA NY Harbor Healthcare System, New York, NY, Trish M. Perl, MD, MSc, FIDSA, FSHEA, Medicine, Johns Hopkins Medical Institutions, Baltimore, MD and The ResPECT Study Team

Disclosures:

M. Kubala, None

J. Los, None

C. Gaydos, IDSA : Research Contractor and Scientific Advisor, Grant recipient, Research support and Salary

M. Bessesen, None

D. Cummings, MedImmune: Consultant, Consulting fee

C. Gibert, None

G. J. Gorse, None

J. Holden, None

A. C. Nyquist, None

C. Price, None

L. Radonovich, None

M. C. Rodriguez-Barradas, None

R. Sampath, Ibis Biosciences, an Abbott Company: Employee, Salary

M. Simberkoff, None

T. M. Perl, None

Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.