ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Real-Time Investigation of a Large Nosocomial Influenza A Outbreak Informed by Genomic Epidemiology.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- The role of mucosal IgA in protection against influenza A H1N1 virus infection in a real-world setting.EBioMedicine · 2026Article
- Severe Respiratory Illness and Death Associated with Outbreak of Human Rhinovirus B14 among Older Adults, France, 2024.Emerging infectious diseases · 2026Article
- Lessons from Two Early COVID-19 Hospital Outbreaks in Germany to Inform Strategies for Controlling Emerging Nosocomial Outbreaks of Highly Transmissible Respiratory Viruses.Journal of clinical medicine · 2026Article
- Ventilator-Associated Pneumonia, Ventilator-Associated Events, and Nosocomial Respiratory Viral Infections on the Leeside of the Pandemic.Respiratory care · 2024Review
- Immunity induced by vaccination with recombinant influenza B virus neuraminidase protein breaks viral transmission chains in guinea pigs in an exposure intensity-dependent manner.Journal of virology · 2023Article
- Feasibility and clinical utility of local rapid Nanopore influenza A virus whole genome sequencing for integrated outbreak management, genotypic resistance detection and timely surveillance.Microbial genomics · 2023Article
- For Patient Safety, It Is Not Time to Take Off Masks in Health Care Settings.Annals of internal medicine · 2023Article
- Investigating Epidemiologic and Molecular Links Between Patients With Community- and Hospital-Acquired Influenza A: 2017-2018 and 2019-2020, Michigan.Open forum infectious diseases · 2023Article
- Immunity induced by vaccination with recombinant influenza B virus neuraminidase protein breaks viral transmission chains in guinea pigs in an exposure intensity-dependent manner.bioRxiv : the preprint server for biology · 2022Article
- Air pollution and health prevention: A document of reflection.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Review
- Transmission visualizations of healthcare infection clusters: A scoping review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- tRNA abundance, modification and fragmentation in nasopharyngeal swabs as biomarkers for COVID-19 severity.Frontiers in cell and developmental biology · 2022Article
- NGSocomial Infections: High-Resolution Views of Hospital-Acquired Infections Through Genomic Epidemiology.Journal of the Pediatric Infectious Diseases Society · 2021Review
- Asynchrony between virus diversity and antibody selection limits influenza virus evolution.eLife · 2020Article
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Authors and funding
27 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundNosocomial respiratory virus outbreaks represent serious public health challenges. Rapid and precise identification of cases and tracing of transmission chains is critical to end outbreaks and to inform prevention measures.
methodsWe combined conventional surveillance with influenza A virus (IAV) genome sequencing to identify and contain a large IAV outbreak in a metropolitan healthcare system. A total of 381 individuals, including 91 inpatients and 290 healthcare workers (HCWs), were included in the investigation.
resultsDuring a 12-day period in early 2019, infection preventionists identified 89 HCWs and 18 inpatients as cases of influenza-like illness (ILI), using an amended definition without the requirement for fever. Sequencing of IAV genomes from available nasopharyngeal specimens identified 66 individuals infected with a nearly identical strain of influenza A H1N1pdm09 (43 HCWs, 17 inpatients, and 6 with unspecified affiliation). All HCWs infected with the outbreak strain had received the seasonal influenza virus vaccination. Characterization of 5 representative outbreak viral isolates did not show antigenic drift. In conjunction with IAV genome sequencing, mining of electronic records pinpointed the origin of the outbreak as a single patient and a few interactions in the emergency department that occurred 1 day prior to the index ILI cluster.
conclusionsWe used precision surveillance to delineate a large nosocomial IAV outbreak, mapping the source of the outbreak to a single patient rather than HCWs as initially assumed based on conventional epidemiology. These findings have important ramifications for more-effective prevention strategies to curb nosocomial respiratory virus outbreaks.
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