LB-4. Evaluating Healthcare Workers for Acquisition of Zika ‎Virus While Providing Critical Care
Session: Oral Abstract Session: Late Breaker Oral Abstracts
Saturday, October 29, 2016: 11:00 AM
Room: 283-285
Background:  June 25, 2016, a critically ill, hospitalized patient with Zika virus (ZIKV) infection died. 2 weeks later, a close family contact was diagnosed with ZIKV disease despite having no established risk factors for becoming infected. Because the index patient had an unusually high viral load and the contact spent considerable time at the index patient’s bedside, direct (non-sexual) contact resulting in person-to-person transmission was proposed. An investigation was immediately initiated to identify any infected healthcare workers (HCWs), assess risk factors for infection, and determine the utility of standard precautions to protect HCWs.

Method:  From work logs, we identified HCWs having interacted (e.g. direct patient care or environmental services) with the index patient and administered a questionnaire. Types of interactions, exposure to body fluids, personal protective equipment (PPE) used, recent travel, flavivirus vaccinations, symptoms, and pregnancy status were obtained. Those with significant patient interactions (i.e. direct contact with patient or patient’s body fluids), pregnancy, or symptoms consistent with ZIKV infection had their blood drawn and tested for evidence of recent ZIKV infection.

Result:  As of July 30th, 132 HCWs that interacted with the index patient were identified. 85 (64%) met criteria for testing: 77 (91%) significant patient interactions, 7 (8%) currently pregnant or attempting pregnancy, and 1 (1%) with symptoms. Interactions were mostly in the intensive care unit (53; 62%). The majority of HCWs provided direct patient care (71; 84%), such as nurses (23; 32%). Overall, 56 (66%) HCWs reported contact with body fluids such as blood, sweat, and respiratory secretions. Most encounters were reported as protected (i.e., standard precautions); only two HCWs reported unprotected exposures to blood. To date, all HCW samples have tested negative by IgM-MAC ELISA for recent ZIKV infection.

Conclusion:  Despite significant exposures to a patient with an extremely high viral load of ZIKV, established infection control practices and standard precautions have been sufficient to date to prevent ZIKV transmission to HCWs in this setting.

Shannon Novosad, MD, MPH1, Bryan E. Christensen, PhD, MEPC2, J. Erin Staples, MD, PhD3, Allyn Nakashima, MD4, Kimberly Christensen, BS5, Annette Atkinson, MS, M(ASCP)5, WM Bryan Burk, BA5, Brigette Beyer, PA-C, MPH6, Brook Vietor, MS, APRN7, Robert Mccullough, RN7, Kathy Seiber, MS8, Jeanmarie Mayer, MD9, Scott Fridkin, MD, FIDSA10 and Michael Rubin, MD, PhD, FIDSA11, (1)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (2)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (3)Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, (4)Utah Department of Health, Salt Lake City, UT, (5)Utah Public Health Laboratory, Taylorsville, UT, (6)Univertiy of Utah, Salt Lake City, UT, (7)University of Utah, Salt Lake City, UT, (8)Division of Healthcare Quality Promotion, CDC, Atlanta, GA, (9)Medicine, University of Utah School of Medicine, Salt Lake City, UT, (10)Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (11)Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT

Disclosures:

S. Novosad, None

B. E. Christensen, None

J. E. Staples, None

A. Nakashima, None

K. Christensen, None

A. Atkinson, None

W. B. Burk, None

B. Beyer, None

B. Vietor, None

R. Mccullough, None

K. Seiber, None

J. Mayer, None

S. Fridkin, None

M. Rubin, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.