325. Acute Respiratory Viral Infection among Outpatient Healthcare Personnel
Session: Poster Abstract Session: HAI: Occupational Health
Thursday, October 8, 2015
Room: Poster Hall
  • Krosche_Poster.pdf (2.2 MB)
  • Background: Acute respiratory illness (ARI) is a common source of morbidity among healthcare personnel (HCP). However, the causes of ARI in this high-risk population are not well studied. Over the last 3 respiratory illness seasons, we assessed the viral causes of respiratory illness among HCP working in the outpatient setting enrolled in a cluster, randomized clinical trial at 116 outpatient departments and emergency departments in 7 geographic locations across the US.

    Methods: During 12 weeks of the 2011-2 (YR1), 2012-3 (YR2), 2013-4 (YR3) and 2014-5 (YR4) respiratory seasons, HCP were surveyed for symptoms of ARI. Participants with symptoms were cultured and 2 random swabs were obtained. Samples were tested for 13 viruses by RT-PCR/ESI-MS, (Abbott Molecular). Paired blood samples were obtained for influenza antibodies (>2-fold antibody increase).

    Results: Among 4,947 participants (619 YR1; 1,077 YR2; 1,388 YR3; 1,863 YR4), 11,467 swabs were obtained (1,377 YR1; 2,655 YR2; 3,343 YR3; 4,092 YR4). The pre-study influenza vaccination rates of participants who completed the study are: 84% YR1; 83% YR2; 75% YR3; 72% YR4. Influenza-like-illness (ILI) rates during the study are: 36% YR1; 48% YR2; 44% YR3; 40% YR4. For years 1-3: 1,839 symptomatic (324 YR1; 711 YR2; 804 YR3) and 3,812 asymptomatic (1,044 YR1; 1,977 YR2; 791 YR3) were tested. 38% of participants who had asymptomatic swabs and 44% of participants who had at least one symptomatic swab tested positive. Combined swab and serology results revealed the following viral causes of ARI: 33% coronavirus, 23% rhinovirus, 21% influenza A , 8% influenza B, 7% respiratory syncytial virus (RSV), 4% metapneumovirus, 1% parainfluenza, and 1% adenovirus (Figure 1). Of the total 45% influenza positives, 61% were identified through serology alone (Figure 2).

    Conclusion: ARIs are common among highly vaccinated high risk HCP with 43% developing symptoms during the respiratory viral season and 33% had identifiable viral causes most commonly (33%) coronavirus. Five percent asymptomatic HCP with an identifiable virus were found. Identification of viruses in HCPs that cause morbidity to patients is critical to patient safety and prevention efforts.

    Note: Data analysis is ongoing, more information will be available

    Amanda Krosche, BS, Hospital Epidemiology & Infection Control, Johns Hopkins University, Baltimore, MD, Mary Bessesen, MD, University of Colorado Denver, Aurora, CO, Derek Cummings, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Charlotte Gaydos, DrPH, FIDSA, Medicine, Infectious Diseases, Johns Hopkins University, Baltimore, MD, Cynthia Gibert, MD, MSc, FIDSA, Washington, DC, VAMC, Washington, DC, Geoffrey Gorse, MD, FIDSA, VA St. Louis Healthcare System, St. Louis, MO, Jeffrey Holden, MA, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, Ann-Christine Nyquist, MD, MSPH, FPIDS, University of Colorado, Denver, CO, Connie S. Price, MD, Department of Medicine, Division of Infectious Diseases, Denver Health Medical Center, Denver, CO, Lewis J. Radonovich, MD, VA NY Harbor Healthcare System, New York, NY, Nicholas G Reich, PhD, Biostatistics, Johns Hopkins University, Baltimore, MD, Maria C. Rodriguez-Barradas, MD, FIDSA, Infectious Diseases, Michael E. DeBakey VA Medical Center, Houston, TX, Michael S. Simberkoff, MD, FIDSA, VA New York Harbor Healthcare System, New York, NY, Trish M. Perl, MD, MSc, FIDSA, FSHEA, Medicine, Johns Hopkins Medical Institutions, Baltimore, MD and ResPECT Team


    A. Krosche, None

    M. Bessesen, None

    D. Cummings, None

    C. Gaydos, Abbott/Ibis: Grant Investigator , Research support

    C. Gibert, None

    G. Gorse, None

    J. Holden, None

    A. C. Nyquist, None

    C. S. Price, None

    L. J. Radonovich, None

    N. G. Reich, None

    M. C. Rodriguez-Barradas, None

    M. S. Simberkoff, None

    T. M. Perl, None

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