title: Influenza in the acute hospital setting.
abstract: Influenza poses special hazards inside healthcare facilities and can cause explosive outbreaks of illness. Healthcare workers are at risk of acquiring influenza and thus serve as an important reservoir for patients under their care. Annual influenza immunisation of high-risk persons and their contacts, including healthcare workers, is the primary means of preventing nosocomial influenza. Despite influenza vaccine effectiveness, it is substantially underused by healthcare providers. Influenza can be diagnosed by culturing the virus from respiratory secretions and by rapid antigen detection kits; recognition of a nosocomial outbreak is important in order to employ infection-control efforts. Optimal control of influenza in the acute-care setting should focus upon reducing potential influenza reservoirs in the hospital, including: isolating patients with suspected or documented influenza, sending home healthcare providers or staff who exhibit typical symptoms of influenza, and discouraging persons with febrile respiratory illness from visiting the hospital during a known influenza outbreak in the community. (Note: influenza and other respiratory viruses can cause non-febrile illness but are still transmissible.) The antiviral M2 protein inhibitors (amantadine, rimantadine) and neuraminidase inhibitors (zanamivir, oseltamivir) have proven efficacy in treating and preventing influenza illness; however, their role in the prevention and control of influenza in the acute hospital setting remains to be more fully studied.
authors.affiliation: University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Cassandra D
authors.initials: CD
authors.lastname: Salgado
authors.forename: Barry M
authors.initials: BM
authors.lastname: Farr
authors.forename: Keri K
authors.initials: KK
authors.lastname: Hall
authors.forename: Frederick G
authors.initials: FG
authors.lastname: Hayden
mesh_terms: D000081:Acetamides / Q000008:administration & dosage; D000547:Amantadine / Q000008:administration & dosage; D000998:Antiviral Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D006146:Guanidines; D006761:Hospitals; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D009741:Nursing Staff, Hospital / Q000523:psychology; D053139:Oseltamivir; D011714:Pyrans; D012299:Rimantadine / Q000008:administration & dosage; D012794:Sialic Acids / Q000008:administration & dosage; D014611:Vaccination; D014768:Virginia; D053243:Zanamivir
chemical_list: D000081:Acetamides; D000998:Antiviral Agents; D006146:Guanidines; D007252:Influenza Vaccines; D011714:Pyrans; D012794:Sialic Acids; D012299:Rimantadine; D053139:Oseltamivir; D000547:Amantadine; D053243:Zanamivir