title: Pandemic A/H1N1/2009 influenza in a paediatric haematology and oncology unit: successful management of a sudden outbreak.
abstract: Viral respiratory infections are potentially life-threatening among children treated for cancer. We report a nosocomial outbreak of six cases of pandemic influenza A/H1N1/2009 on a paediatric haematology and oncology ward. Three patients developed pneumonia and two of them sustained haemodynamic collapse. The source was probably a relative of the first infected patient. The outbreak was probably spread by cross-infection between patients during communal activities. A few days' delay in identifying the outbreak promoted spread of the influenza. Infection control measures included the use of oral oseltamivir treatment for all hospitalised patients, isolation of the infected patients, strict personal protective controls and a restriction on visitors. No new cases occurred after implementation of these containment measures. At the time when the outbreak was identified, all the patients were already isolated for other reasons. We conclude that A/H1N1/2009 influenza may spread rapidly and cause severe infection in paediatric cancer patients but can be efficiently contained. Identification of isolated or clustered cases should lead to the rapid implementation of appropriate infection control measures.
authors.affiliation: Paediatric Haematology and Oncology Division, EA 3829 Rouen University Hospital, Rouen, France. nimrod.buchbinder@chu-rouen.fr
authors.forename: N
authors.initials: N
authors.lastname: Buchbinder
authors.forename: C
authors.initials: C
authors.lastname: Dumesnil
authors.forename: D
authors.initials: D
authors.lastname: Pinquier
authors.forename: V
authors.initials: V
authors.lastname: Merle
authors.forename: B
authors.initials: B
authors.lastname: Filhon
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.forename: J P
authors.initials: JP
authors.lastname: Vannier
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D004196:Disease Outbreaks; D005602:France / Q000453:epidemiology; D006405:Hematology; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000379:methods*; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects* / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D008495:Medical Oncology; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D010356:Patient Isolation; D010372:Pediatrics
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir