The Management Of A Hospital-Acquired Influenza Ah(1)N(1) Outbreak In Oncological Patients. A Case Series Report
MEDICAL-SURGICAL JOURNAL-REVISTA MEDICO-CHIRURGICALA(2020)
摘要
Despite prevailing concerns about the risk of influenza infection in immunocompromised patients, the actual rate and effect of infection in this population are not well characterized. We report a fulminant course of a hospital-acquired influenza AH(1)N(1) infection in a public hospital for oncological patients. From a total of 60 persons (40 patients and 20 symptomatic health care workers - HCWs) screened by collecting nasal and pharyngeal swab samples, a number of 33 (24 patients and 9 HCWs) were found positive for respiratory viruses. Of them, 23 cases had influenza A virus (20 patients and 3 HCWs), all contacts with in-hospital influenza cases. The 4 first cases were diagnosed with influenza type A and subtype H1N1. In the epidemiological context we presumed all the other influenza A patients had the subtype H1N1. 9 influenza A patients were managed in the ICU: 5 patients for severe and 4 patients for mild/moderate ARDS. Oseltamivir treatment was instituted in all symptomatic patients and HCWs and in asymptomatic high-risk immune-compromised contacts. All ICU influenza patients and contacts were strictly isolated, had dedicated vaccinated HCWs wearing protective equipment and received oseltamivir treatment for prolonged periods until virus clearance or death. 5 patients died: 3 patients due to severe ARDS and intractable hypoxemia and 2 patients due to unrelated causes. The influenza-related death occurred in the first patients due to late diagnosis and late antiviral treatment institution. The epidemiological measures are described along with the hospital-acquired influenza outbreak course.
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关键词
INFLUENZA, OUTBREAK, ONCOLOGIC
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