title: Combining high-resolution contact data with virological data to investigate influenza transmission in a tertiary care hospital.
abstract: OBJECTIVE
  Contact patterns and microbiological data contribute to a detailed understanding of infectious disease transmission. We explored the automated collection of high-resolution contact data by wearable sensors combined with virological data to investigate influenza transmission among patients and healthcare workers in a geriatric unit.
  
  
  METHODS
  Proof-of-concept observational study. Detailed information on contact patterns were collected by wearable sensors over 12 days. Systematic nasopharyngeal swabs were taken, analyzed for influenza A and B viruses by real-time polymerase chain reaction, and cultured for phylogenetic analysis.
  
  
  METHODS
  An acute-care geriatric unit in a tertiary care hospital.
  
  
  METHODS
  Patients, nurses, and medical doctors.
  
  
  RESULTS
  A total of 18,765 contacts were recorded among 37 patients, 32 nurses, and 15 medical doctors. Most contacts occurred between nurses or between a nurse and a patient. Fifteen individuals had influenza A (H3N2). Among these, 11 study participants were positive at the beginning of the study or at admission, and 3 patients and 1 nurse acquired laboratory-confirmed influenza during the study. Infectious medical doctors and nurses were identified as potential sources of hospital-acquired influenza (HA-Flu) for patients, and infectious patients were identified as likely sources for nurses. Only 1 potential transmission between nurses was observed.
  
  
  CONCLUSIONS
  Combining high-resolution contact data and virological data allowed us to identify a potential transmission route in each possible case of HA-Flu. This promising method should be applied for longer periods in larger populations, with more complete use of phylogenetic analyses, for a better understanding of influenza transmission dynamics in a hospital setting.
authors.affiliation: 1Service d'Hygiène,Epidémiologie et Prévention,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Voirin
authors.affiliation: 1Service d'Hygiène,Epidémiologie et Prévention,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Payet
authors.affiliation: 3Université Aix Marseille,Université de Toulon,CNRS,CPT UMR 7332,13288 Marseille,France.
authors.forename: Alain
authors.initials: A
authors.lastname: Barrat
authors.affiliation: 4Data Science Laboratory,ISI Foundation,Turin,Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Cattuto
authors.affiliation: 1Service d'Hygiène,Epidémiologie et Prévention,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Nagham
authors.initials: N
authors.lastname: Khanafer
authors.affiliation: 2Université de Lyon,Université Lyon 1,Lyon,France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Régis
authors.affiliation: 5Service de gériatrie,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Byeul-A
authors.initials: BA
authors.lastname: Kim
authors.affiliation: 5Service de gériatrie,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Comte
authors.affiliation: 2Université de Lyon,Université Lyon 1,Lyon,France.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Casalegno
authors.affiliation: 2Université de Lyon,Université Lyon 1,Lyon,France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lina
authors.affiliation: 1Service d'Hygiène,Epidémiologie et Prévention,Hôpital Edouard Herriot,Hospices Civils de Lyon,Lyon,France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vanhems
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016358:Contact Tracing / Q000379:methods*; D003428:Cross Infection / Q000175:diagnosis / Q000635:transmission* / Q000821:virology; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D053122:Influenza A Virus, H3N2 Subtype / Q000235:genetics / Q000302:isolation & purification; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification*; D009981:Influenza B virus / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000635:transmission* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D060888:Real-Time Polymerase Chain Reaction; D062606:Tertiary Care Centers