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Nosocomial influenza infection as a cause of intercurrent fevers in infants
Insights
Infants hospitalized during an influenza A outbreak faced significant risks. Nosocomial influenza A infections led to prolonged fevers and increased likelihood of severe respiratory illness and secondary bacterial pneumonia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Community outbreak of influenza A.
- Infants' ward patients with intercurrent fevers were monitored.
- Nosocomial infections pose risks in hospital settings.
Purpose of the Study:
- Investigate viral and bacterial causes of fever in hospitalized infants during an influenza A outbreak.
- Assess the risk of complications from nosocomial influenza infections in infants.
- Determine the duration of influenza virus shedding in affected infants.
Main Methods:
- Prospective study of infants admitted to a ward during an influenza A outbreak.
- Clinical observation and laboratory testing for viral and bacterial etiology.
- Analysis of fever duration, white blood cell counts, respiratory complications, and viral shedding.
Main Results:
- 13 of 17 infants hospitalized for over seven days acquired influenza A nosocomially.
- These infants experienced prolonged fevers, elevated white blood cell counts, and a high risk of lower respiratory tract disease.
- Seven infants had chest X-ray infiltrates, and five developed secondary bacterial pneumonia. Younger infants (<6 months) with cardiorespiratory conditions were at highest risk.
- Prolonged influenza virus shedding (7-21 days) was observed in most affected infants.
Conclusions:
- Nosocomial influenza A poses a significant threat to hospitalized infants, particularly those who are young or have underlying conditions.
- Influenza infection in this population is associated with severe respiratory complications and secondary bacterial infections.
- Extended viral shedding highlights the potential for continued transmission within healthcare settings.
Abstract:
All patients on an infants' ward manifesting intercurrent fevers were studied for viral and bacterial etiology during a community outbreak of influenza A. During a one-month period, of 29 infants admitted to the ward, 17 were hospitalized for seven or more days. Intercurrent fever complicated the course of 13 (76%) of these 17 infants. Nosocomially acquired influenza A infection was found in 13 infants. Two of these also contracted a dual infection with influenza B. The fever lasted an average of 2.7 days with a peak of 38.2 to 39.8 C. Initial white blood cell counts tended to by high and shifted to the left. These infants appeared to be at high risk for developing lower respiratory tract disease. Seven of the 12 had infiltrates on chest X-ray, and five subsequently developed a secondary bacterial pneumonia. These infants tended to be young, five were under 6 months, and all but one had underlying cardiorespiratory disease. They also appeared to have prolonge shedding of influenza virus from their nasal secretions. Six of seven shed the virus for 7 or 21 days.