1756. Acute Respiratory Infections (ARI) among Outpatient Healthcare Personnel (HCP)
Session: Oral Abstract Session: Prevalence and Outcome of Respiratory Tract Infections
Saturday, October 29, 2016: 9:45 AM
Room: 275-277

Background: Acute respiratory illness (ARI) is common among healthcare personnel (HCP); however, the causes of ARI in this high-risk population are not well studied. Over the last 4 respiratory virus seasons, we assessed the viral causes of ARI in enrolled HCP at 116 outpatient and emergency departments in 7 geographic locations across the US.

Methods:  During 12 weeks of the 2011-2, 2012-3, 2013-4, and 2014-5 respiratory virus seasons, participants were surveyed for ARI symptoms. A combined nasal and throat swab was obtained when participants reported symptoms. In addition, two swabs were obtained at randomly assigned times regardless of participant symptoms. Samples were tested for 13 viruses by RT-PCR/ESI-MS (Abbott Molecular). Paired blood samples, pre- and post-season, were tested for influenza antibodies with a ≥4-fold antibody increase defined as influenza infection.

Results:  Among 5,185 eligible participants (662 YR1; 1,182 YR2; 1,528 YR3; 1,813 YR4), 11,876 swabs were obtained (1,511 YR1; 2,734 YR2; 3,485 YR3; 4,146 YR4). 59% of participants received the flu vaccine prior to study activation. ARI was identified in 42% of participants. To date 97.5% of swabs have been tested: 3,043 symptomatic and 8,540 asymptomatic. Virus was identified in 4% of asymptomatic swabs and 28% of symptomatic swabs. 20% of HCP had at least one swab test positive. Overall, ARI were associated with coronavirus (35%), rhinovirus/enterovirus (34%), influenza A virus (12%), respiratory syncytial virus (RSV, 10%), metapneumovirus (4%), influenza B virus (3%), adenovirus (2%), and parainfluenza (1%) (Figure 1). 67% of participants with influenza infection were identified by serology alone (346 cases: 256 influenza A, 90 influenza B; Figure 2).

Conclusion:  ARIs were common in a high risk population of front-line HCP with 42% developing symptoms during the respiratory viral season and 28% of those with PCR identifiable viral causes, most commonly coronavirus (35%). Serologic testing added to the number of likely influenza infections that occurred. Identification of viruses in HCP that could be transmitted to patients and others supports efforts to promote use of respiratory precautions to reduce transmission.

Amanda Krosche, BS, Hospital Epidemiology & Infection Control, Johns Hopkins University, Baltimore, MD, Mary Bessesen, MD, VA Eastern Colorado Healthcare System, Denver, 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, Jenna Los, MLA, Medicine, Johns Hopkins University, Baltimore, MD, Ann-Christine Nyquist, MD, MSPH, FPIDS, University of Colorado School of Medicine/Children’s Hospital of Colorado, Aurora, CO; Infectious Diseases, Children’s Hospital Colorado, Aurora, CO, Connie Price, MD, Infectious Diseases, University of Colorado School of Medicine/ Denver Health and Hospital, Denver, CO, Lewis Radonovich, MD, Department of Veterans Affairs Veterans Health Administration Office of Public Health, Gainesville, FL, Nicholas Reich, PhD, Department of Biostatistics and Epidemiology, School of Public Health, University of Massachusetts Amherst, Amherst, MA, Maria C. Rodriguez-Barradas, MD, FIDSA, Section of Infectious Diseases, Department of Medicine, 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 The ResPECT Study Team

Disclosures:

A. Krosche, None

M. Bessesen, None

D. Cummings, None

C. Gaydos, None

C. Gibert, None

G. Gorse, None

J. Los, None

A. C. Nyquist, None

C. Price, None

L. Radonovich, None

N. Reich, None

M. C. Rodriguez-Barradas, None

M. S. Simberkoff, None

T. M. Perl, None

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