title: Infection control preparedness for human infection with influenza A H7N9 in Hong Kong.
abstract: OBJECTIVE To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong. DESIGN A descriptive study of responses to the emergence of influenza A H7N9. SETTING A university-affiliated teaching hospital. PARTICIPANTS Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9. METHODS A bundle approach including active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive contact tracing for HCWs with unprotected exposure was implemented. Seventy HCWs with unprotected exposure to an index case were interviewed especially regarding their patient care activities. RESULTS From April 1, 2013, through May 31, 2014, a total of 126 (0.08%) of 163,456 admitted patients were tested for the H7 gene by reverse transcription-polymerase chain reaction per protocol. Two confirmed cases were identified. Seventy (53.8%) of 130 HCWs had unprotected exposure to an index case, whereas 41 (58.6%) and 58 (82.9%) of 70 HCWs wore surgical masks and practiced hand hygiene after patient care, respectively. Sixteen (22.9%) of 70 HCWs were involved in high-risk patient contacts. More HCWs with high-risk patient contacts received oseltamivir prophylaxis (P=0.088) and significantly more had paired sera collected for H7 antibody testing (P<0.001). Ten (14.3%) of 70 HCWs developed influenza-like illness during medical surveillance, but none had positive results by reverse transcription-polymerase chain reaction. Paired sera was available from 33 of 70 HCWs with unprotected exposure, and none showed seroconversion against H7N9. CONCLUSIONS Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Vincent C C
authors: VC
authors: Cheng
authors: 2Infection Control Team,Queen Mary Hospital,Hong Kong,China.
authors: Josepha W M
authors: JW
authors: Tai
authors: 2Infection Control Team,Queen Mary Hospital,Hong Kong,China.
authors: W M
authors: WM
authors: Lee
authors: 3Department of Adult Intensive Care Unit,Queen Mary Hospital,Hong Kong,China.
authors: W M
authors: WM
authors: Chan
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Sally C Y
authors: SC
authors: Wong
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Jonathan H K
authors: JH
authors: Chen
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Rosana W S
authors: RW
authors: Poon
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Kelvin K W
authors: KK
authors: To
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: Jasper F W
authors: JF
authors: Chan
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: P L
authors: PL
authors: Ho
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: K H
authors: KH
authors: Chan
authors: 1Department of Microbiology,Queen Mary Hospital,Hong Kong,China.
authors: K Y
authors: KY
authors: Yuen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000391:Air Microbiology; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003428:Cross Infection / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006282:Health Personnel; D006723:Hong Kong; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000458:organization & administration; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D064766:Influenza A Virus, H7N9 Subtype / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000032:analysis / Q000517:prevention & control*; D053139:Oseltamivir / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D056990:Post-Exposure Prophylaxis; D012134:Respiratory Protective Devices; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D053139:Oseltamivir