Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-16T17:27:00.282Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of H1N1 (2009) Influenza among Healthcare Workers in a Tertiary Care Center in Saudi Arabia: A 6-Month Surveillance Study

Published online by Cambridge University Press:  02 January 2015

Hanan H. Balkhy ,
Aiman El-Saed  and
Mahmoud Sallah
Hanan H. Balkhy*
Affiliation:
King Abdulaziz Medical City, Riyadh, Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention and Control, Riyadh, Saudi Arabia
Aiman El-Saed
Affiliation:
King Abdulaziz Medical City, Riyadh, Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Gulf Cooperation Council States and World Health Organization Collaborating Center for Infection Prevention and Control, Riyadh, Saudi Arabia
Mahmoud Sallah
Affiliation:
King Abdulaziz Medical City, Riyadh, Saudi Arabia
*
Infection Prevention and Control Department-2134, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Saudi Arabia (balkhyh@hotmail.com)
Get access Rights & Permissions [Opens in a new window]

Extract

Background.

Certain emerging infections, such as severe acute respiratory syndrome and avian influenza, represent a great risk to healthcare workers (HCWs). There are few data about the epidemiology of H1N1 influenza among HCWs.

Methods.

We conducted a prospective surveillance study for all HCWs at King Abdulaziz Medical City (Riyadh, Saudi Arabia) who were confirmed positive for H1N1 influenza by polymerase chain reaction (PCR) from June 1 through November 30, 2009.

Results.

During 6 months of surveillance, 526 HCWs were confirmed positive for H1N1 influenza. The distribution of these cases showed 2 clear outbreaks: an initial outbreak (peak at early August) and a shorter second wave (peak at end of October). Among all PCR-confirmed cases, the attack rate was significantly higher in clinical HCWs than in nonclinical HCWs (6.0% vs 4.3%; P < .001 ) and in HCWs in emergency departments than in HCWs in other hospital locations (17.4% vs 5.0%, P < .001). The percentage of HCWs who received regular influenza vaccination was greater for clinical HCWs than for nonclinical HCWs (46.2% vs 24.6%; P < .001). The majority of HCWs with confirmed H1N1 influenza were young (mean age ± standard deviation, 34.5 ± 9.5 years), not Saudi (58.4%), female (55.1%), and nurses (36.1%). Approximately 4% of women who were less than 50 years old were pregnant. Reported exposures included contact with a case (41.0%), contact with a sick household member (23.8%), and recent travel history (13.3%). Respiratory symptoms (98.0%), including cough (90.1%), were the most frequently reported symptoms, followed by muscle aches (66.2%), fever (62.5%), headache (57.9%), diarrhea (16.5%), and vomiting (9.8%). None of these HCWs died, and all recovered fully without hospital admission.

Conclusions.

The results confirm the vulnerability of HCWs, whether clinical or nonclinical, to emerging H1N1 influenza.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 10 , October 2010 , pp. 1004 - 1010
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control and Prevention. Interim guidance for infection control for care of patients with confirmed or suspected novel influenza A (H1N1) virus infection in a healthcare setting. Atlanta, Georgia: US Department of Health and Human Services. 2009. http://www .cdc.gov/hlnlflu/guidelines_infection_control.htm. Accessed February 7, 2010.Google Scholar
2. Association of National Health Occupational Physicians (ANHOPS). Immunisation of Healthcare Workers, http://www.anhops.com/docs/29_9 _immuninisation.pdf. Published April 2006. Accessed February 7, 2010.Google Scholar
3.Chan-Yeung, M. Severe acute respiratory syndrome (SARS) and healthcare workers. Int J Occup Environ Health 2004;10:421–427.Google Scholar
4.Rapila, R, Lintz, DI, Tecson, FT, Ziskin, L, Louria, DB. A nosocomial outbreak of influenza A. Chest 1977;71:576–579.Google Scholar
5.Cunney, RJ, Bialachowski, A, Thornley, D, Smaili, FM, Pennie, RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449–454.Google Scholar
6.Malavaud, S, Malavaud, B, Sandres, K, et al.Nosocomial outbreak of influenza virus A (H3N2) infection in a solid-organ transplant department. Transplantation 2001;72:535–537.CrossRefGoogle Scholar
7.Centers for Disease Control and Prevention. Outbreak of swine-origin influenza A (H1N1) virus infection—Mexico, March-April 2009. MMWR Morb Mortal Wkly Rep 2009;58(17):467–470.Google Scholar
8.Centers for Disease Control and Prevention. Update: swine influenza A (H1N1) infections—California and Texas, April 2009. MMWR Morb Mortal Wkly Rep 2009;58(16):435–437.Google Scholar
9. World Health Organization. Infection prevention and control in health care for confirmed or suspected cases of pandemic (H1N1) 2009 and influenza-like illnesses; interim guidance. December updates, http://www.who.int/csr/resources/publications/cpl50_2009_1612_ipc_interim _guidance_hlnl.pdf. Published 2009. Accessed February 7, 2010.Google Scholar
10.Apisarnthanarak, A, Mundy, LM. Surveillance for influenza A 2009 H1N1 among Thai healthcare workers. Infect Control Hosp Epidemiol 2009;30:1236–1237.CrossRefGoogle ScholarPubMed
11.Centers for Disease Control and Prevention. Novel influenza A (H1N1) virus infections among healthcare personnel—United States, April-May 2009. MMWR Morb Mortal Wkly Rep 2009;58(23):641–645.Google Scholar
12.AlMazroa, M, Memish, Z, AlWadey, A. Pandemic influenza A (H1N1) in Saudi Arabia: description of the first one hundred cases. Ann Saudi Med 2010;30:11–14.Google Scholar
13. Saudi Press Agency. The Health Ministry has announced detection of a case of swine flu. http://www.spa.gov.sa/English/details.php?id = 670933. Published June 3, 2009. Accessed Februray 7, 2010.Google Scholar
14. World Health Organization. Preparing for the second wave: lessons from current outbreaks. Pandemic (H1N1) briefing note 9. http://www.who .int/csr/disease/swineflu/notes/en/index.html. Published August 2009. Accessed February 7, 2010.Google Scholar
15.Reynolds, MG, Anh, BH, Thu, VH, et al.Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003. BMC Public Health 2006;6:207.Google Scholar
16.Wang, FD, Chen, YY, Lee, YM, et al.Positive rate of serum SARS-CoV immunoglobulin G antibody among healthcare workers. Scand J Infect Dis 2007;39:152–156.CrossRefGoogle ScholarPubMed
17.Jordan, R, Hayward, A. Should healthcare workers have the swine flu vaccine? BMJ 2009;339:b3398.Google Scholar
18.Chor, JS, Ngai, KL, Goggins, WB, et al.Willingness of Hong Kong healthcare workers to accept prepandemic influenza vaccination at different WHO alert levels: two questionnaire surveys. BMJ 2009;339:b3391.CrossRefGoogle ScholarPubMed
19.Cheson, BD. Making the H1N1 (swine) flu vaccine mandatory for hospital employees. Clin Adv Hematol Oncol 2009;7:614.Google Scholar
20.Garcia-Garcia, L, Valdespino-Gomez, JL, Lazcano-Ponce, E, et al.Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City. BMJ 2009;339:b3928.Google Scholar