BACKGROUND Viral respiratory illnesses are common causes of outbreaks and can be fatal to some patients. AIM To investigate the association between laboratory-confirmed viral respiratory infections and potential sources of exposure during the previous 7 days. METHODS In this nested case-control analysis, healthcare personnel from nine Canadian hospitals who developed acute respiratory illnesses during the winters of 2010/11-2013/14 submitted swabs that were tested for viral pathogens. Associated illness diaries and the weekly diaries of non-ill participants provided information on contact with people displaying symptoms of acute respiratory illness in the previous week. Conditional logistic regression assessed the association between cases, who were matched by study week and site with controls with no respiratory symptoms. FINDINGS There were 814 laboratory-confirmed viral respiratory illnesses. The adjusted odds ratio (aOR) of a viral illness was higher for healthcare personnel reporting exposures to ill household members [7.0, 95% confidence interval (CI) 5.4-9.1], co-workers (3.4, 95% CI 2.4-4.7) or other social contacts (5.1, 95% CI 3.6-7.1). Exposures to patients with respiratory illness were not associated with infection (aOR 0.9, 95% CI 0.7-1.2); however, healthcare personnel with direct patient contact did have higher odds (aOR 1.3, 95% CI 1.1-1.6). The aORs for exposure and for direct patient contact were similar for illnesses caused by influenza. CONCLUSION Community and co-worker contacts are important sources of viral respiratory illness in healthcare personnel, while exposure to patients with recognized respiratory infections is not associated. The comparatively low risk associated with direct patient contact may reflect transmission related to asymptomatic patients or unrecognized infections.

中文翻译：

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加拿大急症护理医院医护人员的病毒性呼吸道感染来源。


背景技术病毒性呼吸道疾病是爆发的常见原因，并且对一些患者来说可能是致命的。目的 调查实验室确诊的病毒性呼吸道感染与过去 7 天内潜在暴露源之间的关联。方法 在这项巢式病例对照分析中，来自 9 家加拿大医院的医护人员在 2010 年 11 月至 2013 年 2014 年冬季期间出现急性呼吸道疾病，他们提交了拭子以进行病毒病原体检测。相关的疾病日记和未患病参与者的每周日记提供了上周与出现急性呼吸道疾病症状的人接触的信息。条件逻辑回归评估了病例之间的关联，这些病例按研究周和研究地点与无呼吸道症状的对照进行匹配。结果 共有 814 例经实验室确诊的病毒性呼吸道疾病。对于报告接触患病家庭成员的医护人员（7.0，95% 置信区间 (CI) 5.4-9.1）和同事（3.4，95% CI 2.4-4.7），病毒性疾病的调整后比值比 (aOR) 较高或其他社会接触（5.1，95% CI 3.6-7.1）。接触患有呼吸道疾病的患者与感染无关（aOR 0.9，95% CI 0.7-1.2）；然而，直接接触患者的医护人员确实有更高的几率（aOR 1.3，95% CI 1.1-1.6）。对于流感引起的疾病，暴露和直接患者接触的 aOR 相似。结论 社区和同事接触是医护人员病毒性呼吸道疾病的重要来源，而接触已确诊呼吸道感染的患者则没有相关性。 与直接患者接触相关的相对较低的风险可能反映了与无症状患者或未被识别的感染相关的传播。