574 Epidemiologic profile of health care workers (HCW) with pandemic influenza A H1N1 infection

Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Renata Desordi Lobo, RN , HOSPITAL DAS CLINICAS, SAO Paulo, Brazil
Maura S. Oliveira, MD , HOSPITAL DAS CLINICAS, SAO Paulo, Brazil
Monique Perrot Gentil, MD , HOSPITAL DAS CLINICAS, SAO Paulo, Brazil
Cleide Roque Santos , HOSPITAL DAS CLINICAS, Sao Paulo, Brazil
Mariusa Basso, RN , HOSPITAL DAS CLINICAS, Sao Paulo, Brazil
Patricia Piason , HOSPITAL DAS CLINICAS, Sao Paulo, Brazil
Denise Schout, MD , HOSPITAL DAS CLINICAS, Sao Paulo, Brazil
Anna Sara S. Levin , HOSPITAL DAS CLINICAS, SAO Paulo, Brazil
Background: As of October, 9, 17.219 cases of laboratory-confirmed H1N1 infection (2009-flu), with 1.369 deaths were reported in Brazil and our hospital was reference for severe cases.
Objective: Compare characteristics of HCW with confirmed 2009-flu with those of influenza-like illness by other causes.

Methods: We performed interviewed HCW who had influenza-like symptoms and were tested for 2009-flu infection, from July through September.
Influenza-like illness was defined as ≥ 38°C or cough or sore throat. Confirmed 2009-flu cases were defined as a HCW with influenza-like illness and who had a laboratory-confirmed pandemic H1N1 virus infection by RT-PCR.We described clinical findings, potential exposures at work, in the community and outcomes. We compared cases in which 2009-flu was confirmed with those negative.

Results: 916 HWC received sick-leave due to flu-like illness; 249 were tested, of which 84 (34%) were interviewed. Their characteristics are in Table.
Four of 34 2009- flu cases were hospitalized and 2 died. Among 50 negative cases, 2 were hospitalized and none died.
Conclusions: Fever was more frequent among 2009-flu infected HCW.
Sore throat and coryza were more frequent in 2009 flu-negative HCW.
Activities and profession were not associated with 2009-flu.
Seasonal flu vaccination coverage was low (55%) and was not protective.
Nosocomial and community contact with 2009-flu cases was frequent but not associated with 2009-flu.
2009 flu (n=34)
2009 flu negative (n=50)
RR (95%IC)
p
Median Age  (range)
39 (24-57)
32 (21-67)

.15
Male 
12
12
1.37 (.81-2.30)
.26
Profession                                                                                                                                        
Physician
12
10

.30
Nurse
2
8


Assistant Nurse
12
20


Others
8
12


Workplace
Emergency Room
7
13
.79 (.35-1.78)
.57
ICU
4
12
.42 (.10-1.62)
.16
Ward
12
9
1.96 (.93-4.41)
.07
Other
11
16
1.01 (.54-1.90)
.97
Activities
   Patient assistance
28
41
1 (.82-1.23)
.97
Administrative
3
6
.74 (.20-2.74)
.64
Other
3
3
1.52 (.22-1.25)
.69
Clinical Characteristics of disease
Cough
31
42
1.56 (.58-4.24)
.34
Fever
29
31
2.13 (.97-4.80)
.04
Myalgia
24
33
1.13 (.64-2.02)
.66
Coryza
19
42
.48 (.30-.77)
.004
Dyspnea
16
21
1.13 (.67-1.90)
.65
Arthralgia
13
19
1 (.59-1.71)
.98
Headache
11
23
.70 (.39-1.24)
.21
Sore throat
15
37
.49 (.29-.81)
.005
Diarrhea
10
12
1.17 (.67-2.1)
.58
Conjunctivitis
3
1
1.94 (1.03-3.63)
.15
Others
0
4


Underlying medical conditions-any
14
28
.74 (.46-1.18)
.18
Heart failure
2
3
1.33 (.25-7.08)
.74
Hemoglobinopathy
0
1


Smoke
3
1
9 (.68-52.57)
.06
Pulmonary disease
1
5
.40 (.05-3.1)
.35
Diabetes mellitus 
0
1


Pregnancy
0
2


Arterial hypertension 
3
5
1.20 (.33-4.31)
.78
Obesity
3
4
1.50 (.39-5.8)
.56
Others
2
6
.67 (.15-2.89)
.58
Use of oseltamivir
27/32(84)
40/49
1.13 (.53-2.41)
.75
2008 flu vaccine
19/32
26/50
1.20 (.69-2.09)
.51
Contact with H1N1-suspected case 
18/34
30/50
.84 (.5-1.14)
.52
Contact with 2009flu  case
20/34
30/50
.75 (.45-1.26)
.29
Contact with 2009flu at home
11/33
13/50
1.23 (.71-2.12)
.47
Contact with 2009-flu in the community
15/33
26/50
.85 (.50-1.46)
.56