1241. Surveillance for Viral Respiratory Infections in Pediatric Chronic Care Facilities
Session: Poster Abstract Session: Healthcare Epidemiology: Non-acute Care Settings
Friday, October 5, 2018
Room: S Poster Hall
Background: Residents of pediatric chronic care facilities (PCCFs) are vulnerable to acute respiratory infections (ARIs) due to their underlying medical conditions and infection control challenges in congregate living.

Methods: We conducted active, prospective surveillance for ARIs (defined as ≥2 new signs/symptoms of respiratory illness) among all residents in 3 PCCFs near New York City from 12/07/2016 to 5/07/2017. The parents/guardians of some residents also provided consent for research specimen collection at the start of the study. In that subset, nasopharyngeal swabs were obtained ≤4 days of ARI symptom onset and weekly for 4 weeks of follow-up to assess viral shedding. Influenza, respiratory syncytial virus (RSV), rhinovirus (RV), coronavirus (229E, NL63, OC43, HKU1), parainfluenzavirus (PIV 1-4), metapneumovirus (MPV), adenovirus (AdV), bocavirus (BoV), enterovirus, parechovirus, and M. pneumoniae were tested by the Fast Track Diagnostics Respiratory Pathogens 21 real-time RT-PCR panel.

Results:

Subset with research specimen collection: Among 79 residents (aged 0-20 years, median=8), 60 ARIs were reported in 37 (47%) residents. Swabs were obtained at illness onset for 53/60 ARI episodes; among these, there were 25 single-virus detections and 5 co-detections. An additional 33 single- and 5 co-detections occurred in 175 follow-up swabs (Table). Molecular typing of 32 RV+ specimens identified 13 RV types.

All residents: During the 2016-2017 influenza season, 308/322 (96%) age-eligible residents received influenza vaccine and 168/364 (46%) received prophylactic antivirals for influenza exposures. Although influenza was not detected in research swabs, it was detected in 3/200 tests conducted for clinical purposes.

Conclusion: ARIs were common among residents of 3 PCCFs, and a variety of respiratory viruses were detected. The rarity of influenza may reflect strong infection control practices in these facilities, including vaccination and prophylactic use of antivirals.

Table – Viral detections by timing of collection (n=53 ARI episodes)

Viral Detections

Onset

Follow-up

Single detections

RV

14

8

229E

1

1

OC43

3

2

MPV

1

3

BoV

3

17

RSV

2

2

Co-detections*

5

5

Total

30

38

*Co-detections also included PIV3 and AdV

Note: There were no detections for pathogens not shown.

Mila M. Prill, MSPH1, Lindsay Kim, MD, MPH1, Sibyl Wilmont, RN MSN MPH2, Brett L. Whitaker, MS1, Xiaoyan Lu, MS1, Natalie Neu, MD MPH2, Susan I. Gerber, MD1, Shikha Garg, MD, MPH3, Nimalie D. Stone, MD, MS4, Elaine Larson, RN PhD5 and Lisa Saiman, MD, MPH6, (1)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (2)Pediatrics, Columbia University Medical Center, New York, NY, (3)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (4)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (5)School of Nursing, Columbia University, New York, NY, (6)Columbia University; NewYork-Presbyterian Hospital, New York, NY

Disclosures:

M. M. Prill, None

L. Kim, None

S. Wilmont, None

B. L. Whitaker, None

X. Lu, None

N. Neu, None

S. I. Gerber, None

S. Garg, None

N. D. Stone, None

E. Larson, None

L. Saiman, None

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