Original Articles

Combining High-Resolution Contact Data with Virological Data to Investigate Influenza Transmission in a Tertiary Care Hospital

Nicolas Voirin^a1a2 c1, Cécile Payet^a1a2, Alain Barrat^a3a4, Ciro Cattuto^a4, Nagham Khanafer^a1a2, Corinne Régis^a2, Byeul-a Kim^a5, Brigitte Comte^a5, Jean-Sébastien Casalegno^a2a6a7, Bruno Lina^a2a6a7 and Philippe Vanhems^a1a2

^a1 Service d’Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

^a2 Université de Lyon, Université Lyon 1, Lyon, France

^a3 Université Aix Marseille, Université de Toulon, CNRS, CPT UMR 7332, 13288 Marseille, France

^a4 Data Science Laboratory, ISI Foundation, Turin, Italy

^a5 Service de gériatrie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

^a6 Laboratoire de Virologie, Centre National de Référence des Virus Influenzae, Hospices Civils de Lyon, Lyon, France

^a7 Virpath, EA4610, Faculté de Médecine Lyon Est (site Laennec), Université Claude Bernard Lyon 1, 69372 Lyon Cedex 08, France

Abstract

OBJECTIVE Contact patterns and microbiological data contribute to a detailed understanding of infectious disease transmission. We explored the automated collection of high-resolution contact data by wearable sensors combined with virological data to investigate influenza transmission among patients and healthcare workers in a geriatric unit.

DESIGN Proof-of-concept observational study. Detailed information on contact patterns were collected by wearable sensors over 12 days. Systematic nasopharyngeal swabs were taken, analyzed for influenza A and B viruses by real-time polymerase chain reaction, and cultured for phylogenetic analysis.

SETTING An acute-care geriatric unit in a tertiary care hospital.

PARTICIPANTS Patients, nurses, and medical doctors.

RESULTS A total of 18,765 contacts were recorded among 37 patients, 32 nurses, and 15 medical doctors. Most contacts occurred between nurses or between a nurse and a patient. Fifteen individuals had influenza A (H3N2). Among these, 11 study participants were positive at the beginning of the study or at admission, and 3 patients and 1 nurse acquired laboratory-confirmed influenza during the study. Infectious medical doctors and nurses were identified as potential sources of hospital-acquired influenza (HA-Flu) for patients, and infectious patients were identified as likely sources for nurses. Only 1 potential transmission between nurses was observed.

CONCLUSIONS Combining high-resolution contact data and virological data allowed us to identify a potential transmission route in each possible case of HA-Flu. This promising method should be applied for longer periods in larger populations, with more complete use of phylogenetic analyses, for a better understanding of influenza transmission dynamics in a hospital setting.

Infect Control Hosp Epidemiol 2015;00(0): 1–7

(Received August 12 2014)

(Accepted October 26 2014)

(Online publication January 13 2015)

Correspondence

^c1 Address correspondence to Dr. Nicolas Voirin, Service d’Hygiène, Epidémiologie et Prévention, Unité Epidémiologie et Biomarqueurs de l'Infection, Hôpital Edouard Herriot, Hospices Civils de Lyon; Equipe Epidémiologie et Santé Publique, Laboratoire de Biométrie et Biologie Evolutive, Université de Lyon; Université Lyon 1; CNRS, UMR 5558, 5, place d'Arsonval, 69437 Lyon cedex 03 (nicolas.voirin@chu-lyon.fr).