HCWs infected in ’97 with avian flu

An analysis of health care workers who cared for avian influenza patients in 1997 revealed that eight exposed health care workers became antibody-positive, demonstrating human-to-human transmission. One developed mild respiratory symptoms, and the rest were asymptomatic. Two health care workers with no patient exposure (but possible community or poultry exposure) became antibody-positive. Here are some exposures studied:1

• Group A. A 54-year-old man was admitted to the hospital on his sixth day of illness with bilateral pneumonia. Avian influenza (H5N1) was not diagnosed until after he died, on the 12th day of illness. Although health care workers followed standard infection-control procedures, they did not use droplet precautions, such as wearing masks, gloves, and gowns when within 3 feet of the patient. Five health care workers exposed to this patient became antibody-positive. Bathing and changing bed linens were the activities associated with becoming seropositive.

• Group B. A 13-year-old girl was hospitalized on the sixth day of illness with bilateral pneumonia. Droplet precautions began on the 14th day, when H5N1 infection was diagnosed. She died on the 31st day of illness. Three exposed health care workers were found to be antibody-positive.

• Group C. Three children were admitted to the same general pediatric ward, all with mild, uncomplicated H5N1-associated respiratory illnesses. A 2-year-old boy was hospitalized on the second day of his illness and remained hospitalized for two days. He was discharged before the diagnosis of H5N1. A 5-year-old girl was hospitalized on her fourth day of illness, was admitted for 1.5 days and then transferred to a respiratory isolation room with a diagnosis of H5N1. A 2-year-old male cousin of the second child was admitted directly to a respiratory isolation room on the second day of his illness. None of the exposed health care workers who were tested became antibody-positive.

Reference

1. Bridges CB, Katz JM, Seto WH, et al. Risk of influenza A (H5N1) infection among health care workers exposed to patients with influenza A (H5N1), Hong Kong. J Infect Dis 2000; 181:344-348.