Veille documentaire MTPH

Auteur     Jenifer L Jaeger
Auteur     Minal Patel
Auteur     Nila Dharan
Auteur     Kathy Hancock
Auteur     Elissa Meites
Auteur     Christine Mattson
Auteur     Matt Gladden
Auteur     David Sugerman
Auteur     Saumil Doshi
Auteur     Dianna Blau
Auteur     Kathleen Harriman
Auteur     Melissa Whaley
Auteur     Hong Sun
Auteur     Michele Ginsberg
Auteur     Annie S Kao
Auteur     Paula Kriner
Auteur     Stephen Lindstrom
Auteur     Seema Jain
Auteur     Jacqueline Katz
Auteur     Lyn Finelli
Auteur     Sonja J Olsen
Auteur     Alexander J Kallen
Résumé     OBJECTIVE In April 2009, 2009 pandemic influenza A (H1N1) (hereafter, pH1N1) virus was identified in California, which caused widespread illness throughout the United States. We evaluated pH1N1 transmission among exposed healthcare personnel (HCP) and assessed the use and effectiveness of personal protective equipment (PPE) early in the outbreak. DESIGN Cohort study. SETTING Two hospitals and 1 outpatient clinic in Southern California during March 28-April 24, 2009. PARTICIPANTS Sixty-three HCP exposed to 6 of the first 8 cases of laboratory-confirmed pH1N1 in the United States. METHODS Baseline and follow-up questionnaires were used to collect demographic, epidemiologic, and clinical data. Paired serum samples were obtained to test for pH1N1-specific antibodies by microneutralization and hemagglutination-inhibition assays. Serology results were compared with HCP work setting, role, and self-reported PPE use. RESULTS Possible healthcare-associated pH1N1 transmission was identified in 9 (14%) of 63 exposed HCP; 6 (67%) of 9 seropositive HCP had asymptomatic infection. The highest attack rates occurred among outpatient HCP (6/19 [32%]) and among allied health staff (eg, technicians; 8/33 [24%]). Use of mask or N95 respirator was associated with remaining seronegative ([Formula: see text]). Adherence to PPE recommendations for preventing transmission of influenza virus and other respiratory pathogens was inadequate, particularly in outpatient settings. CONCLUSIONS pH1N1 transmission likely occurred in healthcare settings early in the pandemic associated with inadequate PPE use. Organizational support for a comprehensive approach to infectious hazards, including infection prevention training for inpatient- and outpatient-based HCP, is essential to improve HCP and patient safety.
Publication     Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America
Volume     32
Numéro     12
Pages     1149-1157
Date     Dec 2011