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Successful use of oseltamivir prophylaxis in managing a nosocomial outbreak of influenza A in a hematology and allogeneic stem cell transplant unit
- Source :
- Asia-Pacific Journal of Clinical Oncology. 13:37-43
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- To describe a nosocomial outbreak of H1N1 influenza A in an inpatient hematology and allogeneic stem cell transplant unit and outcomes of universal oseltamivir prophylaxis. Medical records of all patients admitted to the unit were reviewed to define the nosocomial outbreak, commencing 1 week prior to the index case until 4 weeks following institution of oseltamivir prophylaxis. Timelines for clinical symptoms, viral spread, management, patient outcomes and follow up testing were constructed. All cases of influenza were confirmed on nasopharyngeal swabs and/or bronchoalveolar lavages collected for polymerase chain reaction testing. In addition to the index case, further 11 patients were diagnosed with influenza A during the outbreak. Six patients (50%) had influenza-like-illness, five (42%) had respiratory symptoms only and one (8%) was asymptomatic. In total, five patients died, including four (33%) patients who were admitted to intensive care. A clustering of seven cases led to recognition of the outbreak and subsequent commencement of universal prophylaxis with oseltamivir 75 mg/day in all inpatients within the unit. Strict infection control processes were reinforced concurrently. There were no further cases of influenza A linked to the outbreak after the implementation of universal oseltamivir prophylaxis. Three later cases were linked to H1N1 exposure during the original outbreak. H1N1 influenza infection is associated with significant mortality in hematology patients. Universal prophylaxis with oseltamivir during a nosocomial outbreak appeared to be effective in controlling spread of the virus. We recommend early institution of infection control and universal prophylaxis in any nosocomial outbreak of influenza.
- Subjects :
- 0301 basic medicine
Oseltamivir
medicine.medical_specialty
Pediatrics
030106 microbiology
Asymptomatic
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Intensive care
Internal medicine
medicine
Infection control
030212 general & internal medicine
Intensive care medicine
Index case
Hematology
business.industry
Medical record
virus diseases
Outbreak
General Medicine
Oncology
chemistry
medicine.symptom
business
Subjects
Details
- ISSN :
- 17437555
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Asia-Pacific Journal of Clinical Oncology
- Accession number :
- edsair.doi...........b2537a10f35fb2b7ca57570c7fc0219b