Risk of Influenza-Like Illness in an Acute Health Care Setting During Community Influenza Epidemics in 2004-2005 2005-2006 and 2006-2007

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Vanhems, Philippe | Voirin, N. | Roche, S. | Escuret, V. | Regis, C. | Gorain, C. | Pieres-Cronenberger, S. | Giard, M. | Lina, B. | Najioullah, F. | Barret, Brice | Pollissard, L. | David, S. | Crozet, M.N. | Comte, B. | Hirschel, B. | Ecochard, R.

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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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