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Abstract
Background: Respiratory syncytial virus (RSV) and influenza are important pediatric community-acquired (CA) and hospital-acquired (HA) pathogens. The occurrence of pandemic (H1N1) 2009 influenza resulted in additional efforts to intensify infection control (IC) strategies. We detail the impact of IC strategies between 2003 and 2010 on influenza and RSV. Methods: We assessed the rates of CA infections per 100 admissions and HA infections per 1000 patient-days for both RSV and influenza at Children's Memorial Hospital during the winter seasons (September through May) 2003–2010. The season of 2009, however, was extended through June due to ongoing admissions as a result of pandemic (H1N1) 2009 influenza. IC strategies implemented in response to pandemic (H1N1) 2009 influenza are described. The transmission ratio (HA cases/CA cases) was determined and correlated with IC efforts. Results: Substantial season- to-season variability exists for CA RSV and CA influenza rates. The rates of HA RSV and HA influenza and the transmission ratios for these viruses remained unchanged in 2009–10 in comparison to the prior year (at 0.02 and 0.01, respectively) despite implementation of multiple IC strategies. In contrast, since 2005 an inverse association was noted between hand hygiene compliance and the transmission ratio of both RSV and influenza, with Spearman correlation coefficients of −0.84 (p = 0.051) and −0.89 (p = 0.008), respectively. Conclusions: We observed that improvements in hand hygiene compliance correlated with less transmission of RSV and influenza in the hospital. The important role of hand hygiene in preventing transmission of RSV and influenza to hospitalized children should be emphasized.
Declaration of interest: Dr Anderson has previously served on the speaker's bureau for Merck, has consulted for Merck and GlaxoSmithKline, has received research support from Merck and Meridian Bioscience, Inc., and has received financial compensation for writing Medscape CME. Dr Shulman has previously served on the speaker's bureau for both Merck and GlaxoSmithKline and has served on an advisory board for Merck vaccines and Novartis vaccines. He is currently the chairman of a Data Safety and Monitoring Committee for Pfizer. Dr Noskin is on the advisory board for Theradoc, Inc. The remaining authors have indicated that they have no financial relationships relevant to this article to disclose.