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Influenza B outbreak at an adult cystic fibrosis centre - Clinical impact and factors influencing spread
Journal of Cystic Fibrosis ( IF 5.2 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.jcf.2020.04.011
Jordan B Dennis 1 , Andrew M Jones 2 , Emma A Davies 3 , William Welfare 4 , Peter J Barry 2 , Lisa Collier 2 , Andrew Turner 3 , Rowland J Bright-Thomas 2
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INTRODUCTION An outbreak of Influenza B occurred at a large United Kingdom (UK) regional adult cystic fibrosis (CF) centre in May 2016. This was late in the UK 2015-2016 influenza season and occurred on a specialist ward with strict infection control procedures. This study investigates the spread of influenza, clinical consequences and potential contributing factors. METHODS Patient records, clinical status and pulmonary function data were reviewed for all inpatients during this period. Respiratory viral PCR results, influenza vaccination status of patients and staff, and environmental factors were also recorded. Affected patients were prospectively monitored for the following three months. RESULTS 10 of 21 inpatients developed influenza B between 5th and 12th May 2016, an attack rate of 48%. All those characterised were confirmed as the same strain of influenza B/Victoria-lineage. Influenza infection resulted in a mean FEV1 reduction of 10.5% (SD 11.3, p = 0.012), which persisted at 3 months post infection (p = 0.003). Nine of the affected cases rooms were in close proximity on the ward while patients in the two isolation rooms with enhanced ventilation did not become infected. Ventilation measurements in affected rooms ranged from 1.75 to 2.10 air changes/hour, below national recommendations. Seventy percent of affected inpatients had received the 2015/16 trivalent seasonal influenza vaccine, which did not contain a B/Victoria-lineage influenza B virus. CONCLUSION This influenza B outbreak in CF adults had a high attack rate and a significant clinical impact. Room ventilation and a limited protection from the seasonal influenza vaccine were possible contributory factors.

中文翻译:

成人囊性纤维化中心爆发乙型流感 - 临床影响和影响传播的因素

引言 2016 年 5 月,英国 (UK) 一家大型成人囊性纤维化 (CF) 中心爆发了乙型流感。这是在英国 2015-2016 流感季节的后期,发生在具有严格感染控制程序的专科病房。这项研究调查了流感的传播、临床后果和潜在的影响因素。方法回顾所有住院患者在此期间的病历、临床状态和肺功能数据。还记录了呼吸道病毒 PCR 结果、患者和工作人员的流感疫苗接种情况以及环境因素。在接下来的三个月中对受影响的患者进行前瞻性监测。结果 21 名住院患者中有 10 名在 2016 年 5 月 5 日至 12 日期间发展为乙型流感,发病率为 48%。所有被表征的人都被确认为相同的乙型流感/维多利亚谱系毒株。流感感染导致平均 FEV1 降低 10.5%(SD 11.3,p = 0.012),并持续到感染后 3 个月(p = 0.003)。病房内有九间受影响的病房紧邻病房,而两间通风良好的隔离病房中的病人并未受到感染。受影响房间的通风测量值为每小时 1.75 至 2.10 次换气,低于国家建议。70% 的受影响住院患者接种了 2015/16 年三价季节性流感疫苗,该疫苗不含 B/维多利亚系 B 型流感病毒。结论 本次 CF 成人乙型流感暴发具有高发病率和显着的临床影响。
更新日期:2020-09-01
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