Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study

2020 ◽  
Author(s):  
Thomas Bénet ◽  
Sélilah Amour ◽  
Martine Valette ◽  
Mitra Saadatian-Elahi ◽  
Ludwig Serge Aho-Glélé ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Cumulative Incidence ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Control Measures ◽  
T1 And T2 ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Abstract Background Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. Method A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016–2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. Results Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%–27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%–9.2%), 13.7% (95% CI: 9.9%–18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%–5.5%) for symptomatic influenza. Conclusions Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. Clinical Trials Registration NCT02868658.

scholarly journals 924. Incidence of Symptomatic and Asymptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S28-S28
Author(s):  
Thomas Bénet ◽  
Martine Valette ◽  
Sélilah Amour ◽  
Serge Aho-Glélé ◽  
Philippe Berthelot ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Cumulative Incidence ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Influenza A ◽  
Control Measures ◽  
University Hospitals ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Abstract Background Influenza is an important cause of viral nosocomial infections; however, the incidence of asymptomatic influenza among healthcare workers (HCWs) is poorly known. The objective was to estimate the cumulative incidence of asymptomatic and symptomatic influenza among HCWs. Methods The AFP (Asymptomatic Influenza Project, NCT02868658) multicenter prospective cohort study was conducted in 5 French university hospitals in Lyon (2 sites), Grenoble, Saint-Etienne, and Dijon. Each voluntary HCW was followed-up during the entire 2016–2017 influenza season with 3 visits for influenza diagnostic by PCR from nasal swabs and serology. The outcome was laboratory confirmed influenza (LCI) defined by an influenza detection by PCR, and/or influenza A seroconversion/significant increase in the anti-A antibodies titer against A/Hong-Kong/4801/2014, with the absence of seroconversion/significant increase in the level of anti-B/Brisbane/60/2008 antibodies; influenza A was indeed the only strain circulating this winter in the Lyon area. Asymptomatic cases presented no general or respiratory sign/symptom, paucisymptomatic LCI cases had those symptoms/signs but not conforming to clinical influenza, symptomatic LCI cases had temperature ≥37.8°C and cough or sore throat. Cumulative incidence was expressed per 100 HCWs. Results Overall 278 HCWs were analyzed, 84.2% were female, the mean age was 38 years, and influenza vaccination coverage in 2016–2017 was 45.3%. Globally, 62 HCWs had evidence of LCI. Among laboratory confirmed influenza cases, 67.7% (95% CI: 55.8%–79.7%, n = 42) were asymptomatic, 21.0% (95% CI: 10.5%–31.4%, n = 13) were paucisymptomatic, and 11.3% (95% CI: 3.2%–19.4%, n = 7) were symptomatic. Among HCWs, global cumulative influenza incidence was 22.3% (95% CI: 17.7%–27.5%). Cumulative incidence of asymptomatic influenza was 15.1% (95% CI: 10.9%–19.3%), it was 4.7% (95% CI: 2.2%–7.2%) for paucisymptomatic influenza, and 2.5% (95% CI: 0.1%–4.4%) for symptomatic influenza. Conclusion Asymptomatic influenza is frequent among HCWs, representing two-third of the influenza burden in this population. This highlights the importance of infection control measures among HCWs no presenting influenza symptoms. Disclosures All authors: No reported disclosures.

Abstract 186: IV tPA Recanalization Rates by Site of Occlusion and Time After tPA Bolus- Main Results Of The Interrsect Multinational Multicenter Prospective Cohort Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Bijoy K Menon ◽  
Mohamed Najm ◽  
Fahad Al-Ajlan ◽  
Josep Puig Alcantara ◽  
Dar Dowlatshahi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Residual Flow ◽  
Wide Range ◽  
Administration Time ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort ◽  
Iv Tpa

Introduction: Decisions to transport patients from primary to comprehensive stroke centre would be influenced by info on likelihood/timing of spontaneous or IV tPA recanalization (recan). We examined recan rates by time for a wide range of occlusion sites in the INTERRSeCT multicenter prospective cohort study. Methods: Acute stroke patients consented/enrolled at 12 centers/5 countries if intracranial occlusion present on baseline CTA; eGFR≥60 ml/min. CTA was repeated 2-6 hrs later for recan unless patient taken for EVT (first run of angio used instead). Primary outcome was successful recan (rAOL scale score 2b/3) interpreted by central core lab. Results: 619 patients enrolled, 81.6% received IV tPA. 59.9% recan by follow-up CTA and 40.1% by first run angio. Median baseline NIHSS 14 (IQR 11); mean age 70.1 yrs (SD 13); median onset to baseline CTA 115 mins (IQR 108). Recan assessment imaging median 162 mins (IQR 198) from IV tPA bolus or baseline CTA (if no IV tPA). Successful recan (rAOL 2b-3) rates comparing baseline to repeat imaging shown in Figure 1a (IV tPA red; no IV tPA blue). IV tPA had much higher recan than non-IV tPA group (30.5% vs 11%, p<0.0001). Successful recan rates by occlusion site and by time from IV tPA bolus shown in Figure 1b. Site of occlusion, tPA administration, time from tPA to recan assessment and baseline residual flow were the only independent predictors of recan (all p<0.0001). Distal M1 MCA had highest recan [RR 4.12; 95% CI 1.91-8.86 vs. ICA]. Conclusions: Early recan rates were low across all occlusion sites. Beyond 6 hrs post tPA, recan rates approached EVT levels except for ICA. Imaging factors such as residual flow may further refine transport/triage decisions.

scholarly journals Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050824
Author(s):  
Laure Mortgat ◽  
Kristien Verdonck ◽  
Veronik Hutse ◽  
Isabelle Thomas ◽  
Cyril Barbezange ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Vaccination Strategy ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Online Questionnaire ◽  
Reverse Transcription Pcr

ObjectivesTo describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April–December 2020.DesignProspective cohort study. Follow-up was originally planned until September and later extended.SettingMulticentre study, 17 hospitals.Participants50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April–May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit.Outcome measuresA semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire.ResultsAmong all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion.ConclusionsThe seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy.Trial registration numberNCT04373889

Tu1507 What Factors Affect the Quality of Bowel Preparation for Colonoscopy? A Multicenter Prospective Cohort Study

2011 ◽  
Vol 73 (4) ◽  
pp. AB431
Author(s):  
Mauro Bruno ◽  
Emanuele Rondonotti ◽  
Cesare Hassan ◽  
Lorenzo Fuccio ◽  
Nico Pagano ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Bowel Preparation ◽  
Prospective Cohort ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort
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