Abstract
BACKGROUND: Human parainfluenza 3 (HPIV-3) outbreak at the haemato-oncology ward of the Maastricht University Medical Center in the summer of 2016.
AIM: To describe an effective strategy to control the largest reported HPIV-3 outbreak at an adult haematology-oncology ward in the Netherlands by implementing infection control measures and molecular epidemiology investigation.
METHODS: Clinical, patient and diagnostic data were both pro- and retrospectively collected. HPIV-3 real-time-PCR (HPIV-3 RT-PCR) was validated using oropharyngeal rinse samples. Screening of all new and admitted patients was implemented to identify asymptomatic infection or prolonged shedding of HPIV-3 allowing cohort isolation.
FINDINGS: The HPIV-3 outbreak occurred between 9 July and 28 September 2016 and affected 53 patients. HPIV-3 RT-PCR on oropharyngeal rinse samples demonstrated an up to tenfold higher sensitivity compared to pharyngeal swabs. Monitoring showed that at first positive PCR, 20 patients (38%) were asymptomatic (of which 11 remained asymptomatic) and the average duration of shedding was 14 days (range 1-58). Asymptomatic patients had lower viral load, shorter period of viral shedding (≤14 days) and were mostly immune competent oncology patients. The outbreak was under control 5 weeks after implementation of screening of asymptomatic patients.
CONCLUSION: Implementation of a sensitive screening method identified both symptomatic and asymptomatic patients which had lower viral load and allowed early cohort isolation. This is especially important in a ward that combines patients with varying immune status, since both immunocompromised and immune competent patients are likely to spread the HPIV-3 virus, either through prolonged shedding or through asymptomatic course of disease.
Original language | English |
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Pages (from-to) | 56-63 |
Number of pages | 8 |
Journal | Journal of Hospital Infection |
Volume | 126 |
Early online date | 25 Apr 2022 |
DOIs | |
Publication status | Published - Aug 2022 |
Keywords
- CELL TRANSPLANT RECIPIENTS
- CROATIA
- EPIDEMIOLOGY
- Haematology
- Human parainfluenza 3
- INFECTION
- NOSOCOMIAL OUTBREAK
- Nosocomial infections
- Outbreak
- REAL-TIME PCR
- RESPIRATORY-SYNCYTIAL-VIRUS
- TYPE-3
- The Netherlands