TITLE

Influenza Aerosols in UK Hospitals during the H1N1 (2009) Pandemic – The Risk of Aerosol Generation during Medical Procedures

AUTHOR(S)
Thompson, Katy-Anne; Pappachan, John V.; Bennett, Allan M.; Mittal, Himanshu; Macken, Susan; Dove, Brian K.; Nguyen-Van-Tam, Jonathan S.; Copley, Vicky R.; O’Brien, Sarah; Hoffman, Peter; Parks, Simon; Bentley, Andrew; Isalska, Barbara; Thomson, Gail
PUB. DATE
February 2013
SOURCE
PLoS ONE;Feb2013, Vol. 8 Issue 2, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Nosocomial infection of health-care workers (HCWs) during outbreaks of respiratory infections (e.g. Influenza A H1N1 (2009)) is a significant concern for public health policy makers. World Health Organization (WHO)-defined ‘aerosol generating procedures’ (AGPs) are thought to increase the risk of aerosol transmission to HCWs, but there are presently insufficient data to quantify risk accurately or establish a hierarchy of risk-prone procedures. Methodology/Principal Findings: This study measured the amount of H1N1 (2009) RNA in aerosols in the vicinity of H1N1 positive patients undergoing AGPs to help quantify the potential risk of transmission to HCWs. There were 99 sampling occasions (windows) producing a total of 198 May stages for analysis in the size ranges 0.86–7.3 µm. Considering stages 2 (4–7.3 µm) and 3 (0.86–4 µm) as comprising one sample, viral RNA was detected in 14 (14.1%) air samples from 10 (25.6%) patients. Twenty three air samples were collected while potential AGPs were being performed of which 6 (26.1%) contained viral RNA; in contrast, 76 May samples were collected when no WHO 2009 defined AGP was being performed of which 8 (10.5%) contained viral RNA (unadjusted OR = 2.84 (95% CI 1.11–7.24) adjusted OR = 4.31 (0.83–22.5)). Conclusions/Significance: With our small sample size we found that AGPs do not significantly increase the probability of sampling an H1N1 (2009) positive aerosol (OR (95% CI) = 4.31 (0.83–22.5). Although the probability of detecting positive H1N1 (2009) positive aerosols when performing various AGPs on intensive care patients above the baseline rate (i.e. in the absence of AGPs) did not reach significance, there was a trend towards hierarchy of AGPs, placing bronchoscopy and respiratory and airway suctioning above baseline (background) values. Further, larger studies are required but these preliminary findings may be of benefit to infection control teams.
ACCESSION #
87624455

 

Related Articles

  • Modelling an influenza pandemic: A guide for the perplexed. Fisman, David // CMAJ: Canadian Medical Association Journal;8/4/2009, Vol. 181 Issue 3/4, p171 

    The article presents an analysis on the pandemic swine influenza, which started in Mexico. Accordingly, influenza A (H1N1) has now caused outbreaks of disease in at least 74 nations as declared by the World Health Organization (WHO). It is noted that factors of epidemic models have always...

  • Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 virus.  // Weekly Epidemiological Record;11/13/2009, Vol. 84 Issue 46, p481 

    The article focuses on the global epidemic caused by the pandemic influenza A (H1N1) 2009 virus. It mentions the reports issued by ministries of health of various countries on the disease's impact which include increase in hospitalization and mortality rates. It also discusses the investigations...

  • 2009 Pandemic Influenza A Virus Subtype H1N1 Vaccination in Africa—Successes and Challenges. Mihigo, Richard; Torrealba, Claudia Vivas; Coninx, Kanokporn; Nshimirimana, Deo; Kieny, Marie Paule; Carrasco, Peter; Hedman, Lisa; Widdowson, Marc-Alain // Journal of Infectious Diseases;Dec2012 Supplement 1, Vol. 206 Issue suppl_1, pS22 

    To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected...

  • WHO Pandemic Alert Phases.  // Immunization Newsletter;2009, Vol. 31 Issue 3, p2 

    The article presents a discussion related to the pandemic alert phases for influenza A(H1N1) adapted from http://www.who.int/csr/disease/avian influenza/ phase/en/) provided by the World Health Organization (WHO).

  • H1N1 PANDEMIC OFFICIALLY ENDS. Passi, Gouri Rao // Indian Pediatrics;Oct2010, Vol. 47 Issue 10, p899 

    The article reports on the official declaration by World Health Organization (WHO) director Margaret Chan on August 10, 2010 that there is no longer a pandemic of the H1N1 virus based on epidemiological and virological information around the world, particularly in the Southern Hemisphere.

  • H1N1 virus declines in temperate zone.  // Fire Engineering;Apr2010, Vol. 163 Issue 4, p64 

    The article reports that more than 212 countries have reported laboratory-confirmed cases of pandemic influenza H1N1 as of February 7, 2010, including 15,292 deaths, according to a report by the World Health Organization (WHO).

  • Novel Pandemic Influenza A(H1N1) Viruses Are Potently Inhibited by DAS181, a Sialidase Fusion Protein.  // PLoS ONE;2009, Vol. 4 Issue 11, p1 

    The article discusses a study which examined the activity of DAS181 against several pandemic influenza A (H1N1) virus isolates in MDCK cells, differentiated primary human respiratory tract culture, ex-vivo human bronchi tissue and mice. As explained, DAS181 (Fludase) is a sialidase fusion...

  • Prior immunity helps to explain wave-like behaviour of pandemic influenza in 1918-9. Mathews, John D.; McBryde, Emma S.; McVernon, Jodie; Pallaghy, Paul K.; McCaw, James M. // BMC Infectious Diseases;2010, Vol. 10 Issue 1, p128 

    Background: The ecology of influenza may be more complex than is usually assumed. For example, despite multiple waves in the influenza pandemic of 1918-19, many people in urban locations were apparently unaffected. Were they unexposed, or protected by pre-existing cross-immunity in the first...

  • A New Sentinel Surveillance System for Severe Influenza in England Shows a Shift in Age Distribution of Hospitalised Cases in the Post-Pandemic Period. Bolotin, Shelly; Pebody, Richard; White, Peter J.; McMenamin, James; Perera, Luke; Nguyen-Van-Tam, Jonathan S.; Barlow, Thomas; Watson, John M. // PLoS ONE;Jan2012, Vol. 7 Issue 1, p1 

    Background: The World Health Organization and European Centre for Disease Prevention and Control have highlighted the importance of establishing systems to monitor severe influenza. Following the H1N1 (2009) influenza pandemic, a sentinel network of 23 Trusts, the UK Severe Influenza...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics