Skip to main content
Top
Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Research article

Longitudinal seroepidemiologic study of the 2009 pandemic influenza A (H1N1) infection among health care workers in a children's hospital

Authors: Ting-Yu Yen, Chun-Yi Lu, Luan-Yin Chang, Yi-Ting Tsai, Li-Min Huang

Published in: BMC Infectious Diseases | Issue 1/2012

Login to get access

Abstract

Background

To probe seroepidemiology of the 2009 pandemic influenza A (H1N1) among health care workers (HCWs) in a children's hospital.

Methods

From August 2009 to March 2010, serum samples were drawn from 150 HCWs in a children's hospital in Taipei before the 2009 influenza A (H1N1) pandemic, before H1N1 vaccination, and after the pandemic. HCWs who had come into direct contact with 2009 influenza A (H1N1) patients or their clinical respiratory samples during their daily work were designated as a high-risk group. Antibody levels were determined by hemagglutination inhibition (HAI) assay. A four-fold or greater increase in HAI titers between any successive paired sera was defined as seroconversion, and factors associated with seroconversion were analyzed.

Results

Among the 150 HCWs, 18 (12.0%) showed either virological or serological evidence of 2009 pandemic influenza A (H1N1) infection. Of the 90 unvaccinated HCWs, baseline and post-pandemic seroprotective rates were 5.6% and 20.0%. Seroconversion rates among unvaccinated HCWs were 14.4% (13/90), 22.5% (9/40), and 8.0% (4/50) for total, high-risk group, and low-risk group, respectively. Multivariate analysis revealed being in the high-risk group is an independent risk factor associated with seroconversion.

Conclusion

The infection rate of 2009 pandemic influenza A (H1N1) in HCWs was moderate and not higher than that for the general population. The majority of unvaccinated HCWs remained susceptible. Direct contact of influenza patients and their respiratory samples increased the risk of infection.
Appendix
Available only for authorised users
Literature
1.
go back to reference Update: swine influenza A (H1N1) infections--California and Texas, April 2009. MMWR Morb Mortal Wkly Rep. 2009, 58 (16): 435-437. Update: swine influenza A (H1N1) infections--California and Texas, April 2009. MMWR Morb Mortal Wkly Rep. 2009, 58 (16): 435-437.
2.
go back to reference Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, Zaki SR, Hayden FG, Hui DS, Kettner JD, et al: Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med. 2010, 362 (18): 1708-1719.CrossRefPubMed Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, Zaki SR, Hayden FG, Hui DS, Kettner JD, et al: Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med. 2010, 362 (18): 1708-1719.CrossRefPubMed
3.
go back to reference Salgado CD, Farr BM, Hall KK, Hayden FG: Influenza in the acute hospital setting. Lancet Infect Dis. 2002, 2 (3): 145-155. 10.1016/S1473-3099(02)00221-9.CrossRefPubMed Salgado CD, Farr BM, Hall KK, Hayden FG: Influenza in the acute hospital setting. Lancet Infect Dis. 2002, 2 (3): 145-155. 10.1016/S1473-3099(02)00221-9.CrossRefPubMed
4.
go back to reference Bridges CB, Kuehnert MJ, Hall CB: Transmission of influenza: implications for control in health care settings. Clin Infect Dis. 2003, 37 (8): 1094-1101. 10.1086/378292.CrossRefPubMed Bridges CB, Kuehnert MJ, Hall CB: Transmission of influenza: implications for control in health care settings. Clin Infect Dis. 2003, 37 (8): 1094-1101. 10.1086/378292.CrossRefPubMed
6.
go back to reference Chao DY, Cheng KF, Li TC, Wu TN, Chen CY, Tsai CA, Chen JH, Chiu HT, Lu JJ, Su MC, et al: Serological evidence of subclinical transmission of the 2009 pandemic H1N1 influenza virus outside of Mexico. PLoS One. 2011, 6 (1): e14555-10.1371/journal.pone.0014555. doi:10.1371/journal.pone.0014555CrossRefPubMedPubMedCentral Chao DY, Cheng KF, Li TC, Wu TN, Chen CY, Tsai CA, Chen JH, Chiu HT, Lu JJ, Su MC, et al: Serological evidence of subclinical transmission of the 2009 pandemic H1N1 influenza virus outside of Mexico. PLoS One. 2011, 6 (1): e14555-10.1371/journal.pone.0014555. doi:10.1371/journal.pone.0014555CrossRefPubMedPubMedCentral
7.
go back to reference Hsueh PR, Lee PI, Hsiang Chiu AW, Yen MY: Pandemic (H1N1) 2009 vaccination and class suspensions after outbreaks, Taipei City, Taiwan. Emerg Infect Dis. 2010, 16 (8): 1309-1311.CrossRefPubMedPubMedCentral Hsueh PR, Lee PI, Hsiang Chiu AW, Yen MY: Pandemic (H1N1) 2009 vaccination and class suspensions after outbreaks, Taipei City, Taiwan. Emerg Infect Dis. 2010, 16 (8): 1309-1311.CrossRefPubMedPubMedCentral
8.
go back to reference McCoy KD, Beekmann SE, Ferguson KJ, Vaughn TE, Torner JC, Woolson RF, Doebbeling BN: Monitoring adherence to Standard Precautions. Am J Infect Control. 2001, 29 (1): 24-31. 10.1067/mic.2001.111226.CrossRefPubMed McCoy KD, Beekmann SE, Ferguson KJ, Vaughn TE, Torner JC, Woolson RF, Doebbeling BN: Monitoring adherence to Standard Precautions. Am J Infect Control. 2001, 29 (1): 24-31. 10.1067/mic.2001.111226.CrossRefPubMed
9.
go back to reference Kung HC, Huang KC, Kao TM, Lee YC, Chang FY, Wang NC, Liu YC, Lee WS, Liu HJ, Chen CI, et al: A clinical study to assess the immunogenicity and safety of a monovalent 2009 influenza A (H1N1) vaccine in an area with low-level epidemics of pandemic influenza. Vaccine. 2010, 28 (45): 7337-7343. 10.1016/j.vaccine.2010.08.073.CrossRefPubMed Kung HC, Huang KC, Kao TM, Lee YC, Chang FY, Wang NC, Liu YC, Lee WS, Liu HJ, Chen CI, et al: A clinical study to assess the immunogenicity and safety of a monovalent 2009 influenza A (H1N1) vaccine in an area with low-level epidemics of pandemic influenza. Vaccine. 2010, 28 (45): 7337-7343. 10.1016/j.vaccine.2010.08.073.CrossRefPubMed
10.
go back to reference Lu CY, Shao PL, Chang LY, Huang YC, Chiu CH, Hsieh YC, Lin TY, Huang LM: Immunogenicity and safety of a monovalent vaccine for the 2009 pandemic influenza virus A (H1N1) in children and adolescents. Vaccine. 2010, 28 (36): 5864-5870. 10.1016/j.vaccine.2010.06.059.CrossRefPubMed Lu CY, Shao PL, Chang LY, Huang YC, Chiu CH, Hsieh YC, Lin TY, Huang LM: Immunogenicity and safety of a monovalent vaccine for the 2009 pandemic influenza virus A (H1N1) in children and adolescents. Vaccine. 2010, 28 (36): 5864-5870. 10.1016/j.vaccine.2010.06.059.CrossRefPubMed
11.
go back to reference Mitchell DK, Ruben FL, Gravenstein S: Immunogenicity and safety of inactivated influenza virus vaccine in young children in 2003-2004. Pediatr Infect Dis J. 2005, 24 (10): 925-927. 10.1097/01.inf.0000180978.66362.d9.CrossRefPubMed Mitchell DK, Ruben FL, Gravenstein S: Immunogenicity and safety of inactivated influenza virus vaccine in young children in 2003-2004. Pediatr Infect Dis J. 2005, 24 (10): 925-927. 10.1097/01.inf.0000180978.66362.d9.CrossRefPubMed
12.
go back to reference Ho TS, Wang SM, Liu CC: Historical review of pandemic influenza A in Taiwan, 2009. Pediatr Neonatol. 2010, 51 (2): 83-88. 10.1016/S1875-9572(10)60016-2.CrossRefPubMed Ho TS, Wang SM, Liu CC: Historical review of pandemic influenza A in Taiwan, 2009. Pediatr Neonatol. 2010, 51 (2): 83-88. 10.1016/S1875-9572(10)60016-2.CrossRefPubMed
13.
go back to reference Chen MI, Lee VJ, Barr I, Lin C, Goh R, Lee C, Singh B, Tan J, Lim WY, Cook AR, et al: Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore. Emerg Infect Dis. 2010, 16 (10): 1554-1561.CrossRefPubMedPubMedCentral Chen MI, Lee VJ, Barr I, Lin C, Goh R, Lee C, Singh B, Tan J, Lim WY, Cook AR, et al: Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore. Emerg Infect Dis. 2010, 16 (10): 1554-1561.CrossRefPubMedPubMedCentral
14.
go back to reference Zhou Y, Ng DM, Seto WH, Ip DK, Kwok HK, Ma ES, Ng S, Lau LL, Wu JT, Peiris JS, et al: Seroprevalence of antibody to pandemic influenza A (H1N1) 2009 among healthcare workers after the first wave in Hong Kong. J Hosp Infect. 2011, 78 (4): 308-311. 10.1016/j.jhin.2011.02.017.CrossRefPubMed Zhou Y, Ng DM, Seto WH, Ip DK, Kwok HK, Ma ES, Ng S, Lau LL, Wu JT, Peiris JS, et al: Seroprevalence of antibody to pandemic influenza A (H1N1) 2009 among healthcare workers after the first wave in Hong Kong. J Hosp Infect. 2011, 78 (4): 308-311. 10.1016/j.jhin.2011.02.017.CrossRefPubMed
15.
go back to reference Marshall C, Kelso A, McBryde E, Barr IG, Eisen DP, Sasadeusz J, Buising K, Cheng AC, Johnson P, Richards M: Pandemic (H1N1) 2009 risk for frontline health care workers. Emerg Infect Dis. 2011, 17 (6): 1000-1006. 10.3201/eid1706.101030.CrossRefPubMedPubMedCentral Marshall C, Kelso A, McBryde E, Barr IG, Eisen DP, Sasadeusz J, Buising K, Cheng AC, Johnson P, Richards M: Pandemic (H1N1) 2009 risk for frontline health care workers. Emerg Infect Dis. 2011, 17 (6): 1000-1006. 10.3201/eid1706.101030.CrossRefPubMedPubMedCentral
16.
go back to reference Chen MI, Lee VJ, Lim WY, Barr IG, Lin RT, Koh GC, Yap J, Cui L, Cook AR, Laurie K, et al: 2009 influenza A(H1N1) seroconversion rates and risk factors among distinct adult cohorts in Singapore. JAMA. 2010, 303 (14): 1383-1391. 10.1001/jama.2010.404.CrossRefPubMed Chen MI, Lee VJ, Lim WY, Barr IG, Lin RT, Koh GC, Yap J, Cui L, Cook AR, Laurie K, et al: 2009 influenza A(H1N1) seroconversion rates and risk factors among distinct adult cohorts in Singapore. JAMA. 2010, 303 (14): 1383-1391. 10.1001/jama.2010.404.CrossRefPubMed
17.
go back to reference Lee VJ, Yap J, Cook AR, Chen MI, Tay JK, Barr I, Kelso A, Tan BH, Loh JP, Lin R, et al: Effectiveness of public health measures in mitigating pandemic influenza spread: a prospective sero-epidemiological cohort study. J Infect Dis. 2010, 202 (9): 1319-1326. 10.1086/656480.CrossRefPubMed Lee VJ, Yap J, Cook AR, Chen MI, Tay JK, Barr I, Kelso A, Tan BH, Loh JP, Lin R, et al: Effectiveness of public health measures in mitigating pandemic influenza spread: a prospective sero-epidemiological cohort study. J Infect Dis. 2010, 202 (9): 1319-1326. 10.1086/656480.CrossRefPubMed
18.
go back to reference Ang B, Poh BF, Win MK, Chow A: Surgical masks for protection of health care personnel against pandemic novel swine-origin influenza A (H1N1)-2009: results from an observational study. Clin Infect Dis. 2010, 50 (7): 1011-1014. 10.1086/651159.CrossRefPubMed Ang B, Poh BF, Win MK, Chow A: Surgical masks for protection of health care personnel against pandemic novel swine-origin influenza A (H1N1)-2009: results from an observational study. Clin Infect Dis. 2010, 50 (7): 1011-1014. 10.1086/651159.CrossRefPubMed
19.
go back to reference Loeb M, Dafoe N, Mahony J, John M, Sarabia A, Glavin V, Webby R, Smieja M, Earn DJ, Chong S, et al: Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial. JAMA. 2009, 302 (17): 1865-1871. 10.1001/jama.2009.1466.CrossRefPubMed Loeb M, Dafoe N, Mahony J, John M, Sarabia A, Glavin V, Webby R, Smieja M, Earn DJ, Chong S, et al: Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial. JAMA. 2009, 302 (17): 1865-1871. 10.1001/jama.2009.1466.CrossRefPubMed
20.
go back to reference Huang DT, Shao PL, Huang KC, Lu CY, Wang JR, Shih SR, Chi H, Lai MR, Lee CY, Chang LY, et al: Serologic status for pandemic (H1N1) 2009 virus, Taiwan. Emerg Infect Dis. 2011, 17 (1): 76-78.CrossRefPubMedPubMedCentral Huang DT, Shao PL, Huang KC, Lu CY, Wang JR, Shih SR, Chi H, Lai MR, Lee CY, Chang LY, et al: Serologic status for pandemic (H1N1) 2009 virus, Taiwan. Emerg Infect Dis. 2011, 17 (1): 76-78.CrossRefPubMedPubMedCentral
21.
go back to reference Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. MMWR Morb Mortal Wkly Rep. 2009, 58 (19): 521-524. Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. MMWR Morb Mortal Wkly Rep. 2009, 58 (19): 521-524.
22.
go back to reference Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, Liu F, Dong L, DeVos JR, Gargiullo PM, et al: Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med. 2009, 361 (20): 1945-1952. 10.1056/NEJMoa0906453.CrossRefPubMed Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, Liu F, Dong L, DeVos JR, Gargiullo PM, et al: Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med. 2009, 361 (20): 1945-1952. 10.1056/NEJMoa0906453.CrossRefPubMed
23.
go back to reference Miller E, Hoschler K, Hardelid P, Stanford E, Andrews N, Zambon M: Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. Lancet. 2010, 375 (9720): 1100-1108. 10.1016/S0140-6736(09)62126-7.CrossRefPubMed Miller E, Hoschler K, Hardelid P, Stanford E, Andrews N, Zambon M: Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. Lancet. 2010, 375 (9720): 1100-1108. 10.1016/S0140-6736(09)62126-7.CrossRefPubMed
24.
go back to reference Ikonen N, Strengell M, Kinnunen L, Osterlund P, Pirhonen J, Broman M, Davidkin I, Ziegler T, Julkunen I: High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in Finland. Euro Surveill. 2010, 15 (5): pii = 19478 Ikonen N, Strengell M, Kinnunen L, Osterlund P, Pirhonen J, Broman M, Davidkin I, Ziegler T, Julkunen I: High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in Finland. Euro Surveill. 2010, 15 (5): pii = 19478
25.
go back to reference Huang WT, Chen WW, Yang HW, Chen WC, Chao YN, Huang YW, Chuang JH, Kuo HS: Design of a robust infrastructure to monitor the safety of the pandemic A(H1N1) 2009 vaccination program in Taiwan. Vaccine. 2010, 28 (44): 7161-7166. 10.1016/j.vaccine.2010.08.069.CrossRefPubMed Huang WT, Chen WW, Yang HW, Chen WC, Chao YN, Huang YW, Chuang JH, Kuo HS: Design of a robust infrastructure to monitor the safety of the pandemic A(H1N1) 2009 vaccination program in Taiwan. Vaccine. 2010, 28 (44): 7161-7166. 10.1016/j.vaccine.2010.08.069.CrossRefPubMed
Metadata
Title
Longitudinal seroepidemiologic study of the 2009 pandemic influenza A (H1N1) infection among health care workers in a children's hospital
Authors
Ting-Yu Yen
Chun-Yi Lu
Luan-Yin Chang
Yi-Ting Tsai
Li-Min Huang
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-89

Other articles of this Issue 1/2012

BMC Infectious Diseases 1/2012 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.