Combining high-resolution contact data with virological data to investigate influenza transmission in a tertiary care hospital.

Voirin, Nicolas; Payet, Cécile; Barrat, Alain; Cattuto, Ciro; Khanafer, Nagham; Régis, Corinne; Kim, Byeul-A; Comte, Brigitte; Casalegno, Jean-Sébastien; Lina, Bruno; Vanhems, Philippe
OBJECTIVE: Contact patterns and microbiological data contribute to a detailed understanding of infectious disease transmission. We explored the automated collection of high-resolution contact data by wearable sensors combined with virological data to investigate influenza transmission among patients and healthcare workers in a geriatric unit.$\backslash$n$\backslash$nDESIGN: Proof-of-concept observational study. Detailed information on contact patterns were collected by wearable sensors over 12 days. Systematic nasopharyngeal swabs were taken, analyzed for influenza A and B viruses by real-time polymerase chain reaction, and cultured for phylogenetic analysis.$\backslash$n$\backslash$nSETTING: An acute-care geriatric unit in a tertiary care hospital.$\backslash$n$\backslash$nPARTICIPANTS: Patients, nurses, and medical doctors.$\backslash$n$\backslash$nRESULTS: A total of 18,765 contacts were recorded among 37 patients, 32 nurses, and 15 medical doctors. Most contacts occurred between nurses or between a nurse and a patient. Fifteen individuals had influenza A (H3N2). Among these, 11 study participants were positive at the beginning of the study or at admission, and 3 patients and 1 nurse acquired laboratory-confirmed influenza during the study. Infectious medical doctors and nurses were identified as potential sources of hospital-acquired influenza (HA-Flu) for patients, and infectious patients were identified as likely sources for nurses. Only 1 potential transmission between nurses was observed.$\backslash$n$\backslash$nCONCLUSIONS: Combining high-resolution contact data and virological data allowed us to identify a potential transmission route in each possible case of HA-Flu. This promising method should be applied for longer periods in larger populations, with more complete use of phylogenetic analyses, for a better understanding of influenza transmission dynamics in a hospital setting.
Research areas:
Type of Publication:
Cross Infection; Human
Infection control and hospital epidemiology
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