1159. Influenza Symptoms in Vaccinated Healthcare Workers in an H3N2-Dominant Season
Session: Poster Abstract Session: Healthcare Epidemiology: Environmental and Occupational Health
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Influenza Symptoms in Vaccinated HCW IDWeek 2018.pdf (663.9 kB)
  • Background:

    Influenza vaccination of healthcare workers is an important component of keeping patients safe, but must be paired with exclusion of ill healthcare workers (HCW) from work. CDC recommends exclusion from work until afebrile for 24 hours, but not all HCW with influenza develop fever and may still be a risk for spreading. Half of HCW with influenza in an H1N1-dominant season (2013-14) at our institution were afebrile.

    Methods:

    From 1/31-4/24/18 (H3N2-dominant season), HCW with fever or cough were screened for influenza and respiratory syncytial virus by polymerase chain reaction of flocked nasopharyngeal swabs. Additional HCW were tested by their primary care providers. We collected influenza vaccination status and symptoms and calculated the proportion of influenza-positive HCWs with fever or cough. Infection control practitioners (ICPs) contacted each influenza-positive HCW to identify potential patient or HCW exposures 24 hours prior to symptom onset and offered oseltamivir prophylaxis to exposed patients and HCW.

    Results:

    Of 186 HCW tested by UCM, 49 (26%) tested positive for influenza (35 with influenza A; 14 with influenza B) and 11 (6%) tested positive for RSV. 48 HCW (98%) received influenza vaccination. Fever was reported in only 19 (54%) HCW with influenza A and 3 (21%) HCW with influenza B. Cough was present in the majority of HCW (34 (97%) with influenza A and 12 (86%) with influenza B). An additional 55 HCW were diagnosed with influenza by their primary care providers. ICPs performed contact investigations for 43 HCW who reported exposure to patients or other HCW between 24 hours before symptom onset through the time of diagnosis. Occupational medicine provided 138 courses of prophylactic oseltamivir to HCW.

    Conclusion:

    Afebrile influenza illness is common; current workforce guidelines are insufficient to prevent exposure in the healthcare setting. Expanding employee influenza screening to include fever OR cough doubled the number influenza positive HCW identified. Despite excellent influenza vaccination rates, vigilance is critical to prevent influenza transmission in the hospital. HCW screening for influenza based on fever OR cough, exclusion from work, and identification of potential exposures can help keep patients and colleagues safe.

    Allison Bartlett, MD, MS1, Jessica P. Ridgway, MD, MS2, Rachel Marrs, DNP, RN, CIC3, Amanda M. Henson, MS, MLS(ASCP), CIC3, Vera Chu, MS, MLS(ASCP), CIC3, Aurea Enriquez, M(ASCP), CIC3, Cynthia Murillo, M(ASCP), CIC3, Demetria Runjo, MPH3, Alexandra Seguin, BSN, RN3, Kathleen G. Beavis, MD4,5, Caroline Guenette, MS6 and Emily Landon, MD7, (1)Department of Pediatrics, Section Infectious Disease, University of Chicago / Comer Children Hospital, Chicago, IL, (2)Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, (3)Infection Control Program, The University of Chicago Medicine, Chicago, IL, (4)Department of Pathology, University of Chicago, Chicago, IL, (5)University of Chicago, Department of Pathology, Chicago, IL, (6)Occupational Medicine, The University of Chicago Medicine, Chicago, IL, (7)Infectious Diseases and Global Health, The University of Chicago Medicine, Chicago, IL

    Disclosures:

    A. Bartlett, None

    J. P. Ridgway, None

    R. Marrs, None

    A. M. Henson, None

    V. Chu, None

    A. Enriquez, None

    C. Murillo, None

    D. Runjo, None

    A. Seguin, None

    K. G. Beavis, None

    C. Guenette, None

    E. Landon, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.