Philippe Vanhems, MD, PhD; Nicolas Voirin, PhD; Sylvain Roche, MSc; Vanessa Escuret, MD, PhD; Corinne Regis, RN; Christine Gorain, RN; Silène Pires-Cronenberger, Pharm Dr; Marine Giard, MD, MSc; Bruno Lina, MD, PhD; Fatiha Najioullah, MD; Béatrice Barret, MD; Laurence Pollissard, MD; Sandra David, MD, PhD; Marie-Noelle Crozet, RN; Brigitte Comte, MD; Bernard Hirschel, MD; René Ecochard, MD, PhD. Arch Intern Med. 2011;171(2):151-157. Vol. 171 No. 2, January 24, 2011 Online Only
Background The person-to-person transmission of influenza-like illness (ILI) and influenza has been described mostly in long-term care units. Studies in acute hospital settings are rare and mostly retrospective.
Methods We prospectively estimated the relative risk (RR) of hospital-acquired (HA) ILI during hospitalization according to in-hospital exposures to contagious individuals. Surveillance of ILI and laboratory-confirmed influenza was undertaken at Edouard Herriot Hospital (1100 beds) during 3 influenza seasons. A total of 21 519 patients and 2153 health care workers (HCWs) from 2004 to 2007 were included. The RR of HA-ILI in patients was calculated according to exposure to other contagious patients and HCWs.
Results For patients exposed to at least 1 contagious HCW compared with those with no documented exposure in the hospital, the RR of HA-ILI was 5.48 (95% confidence interval [CI], 2.09-14.37); for patients exposed to at least 1 contagious patient, the RR was 17.96 (95% CI, 10.07-32.03); and for patients exposed to at least 1 contagious patient and 1 contagious HCW, the RR was 34.75 (95% CI, 17.70-68.25).
Conclusions Hospitalized patients exposed to potentially infectious patients and HCWs with ILI inside the hospital are at greater risk for HA-ILI. Such results identify priorities regarding preventive measures for seasonal or pandemic influenza.
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