Large Epidemiological Influenza A Outbreak in a Teaching Hospital from Guatemala City

Carlos Mejía,Ingrid Escobar,Judith García,Sandra Terraza,Iris Cazali,Leticia Castillo,Monica Silvestre,Ruth Sánchez,Leticia García

doi:10.5402/2012/638042

Abstract

Objective. To describe the characteristics and interventions to control a large epidemiological Influenza A Outbreak. Methods. During the months of February to April 2006, a large outbreak of Influenza A was detected, which affected Health Care Workers and hospitalized patients in a large teaching Hospital in Guatemala City. Interventions to interrupt transmission were implemented and included barrier methods (N95 masks, respiratory isolation measures, etc.) and enhanced hand hygiene, vaccination of healthy Health Care Workers (HCW), restrictions for patient visits. Results. From February to April 2006, 59 hospitalized patients diagnosed with Influenza A. 19 AIDS patients (mortality: 71%) and 5/40 (12.5%) in other diseases: cancer (3), severe cardiac failure (1) and severe malnutrition (1). The attack rate at day 20 in doctors and medical students was 21% while in other HCW it was 10.5%. Within 3 weeks of the beginning of the plan, deaths were stopped and no more cases in HCW were detected after 3 additional weeks. Conclusion. A rapid, comprehensive plan for the control of nosocomial epidemic Influenza A outbreaks is essential to limit severe morbidity and mortality in hospitals who attend large immunocompromised populations, including AIDS patients. HCW regular vaccinations programs are mandatory.

Highlights

Influenza A and B cause highly contagious, acute respiratory illness, associated with high morbidity and mortality among persons with underlying diseases
During the months of February to April 2006, a large outbreak of Influenza A was detected at Roosevelt Hospital; health care workers and hospitalized patients were affected in this large teaching Hospital in Guatemala City
In the period from February to April 2006, 59 hospitalized patients were diagnosed with Influenza A; 19 of them were AIDS patients while 5/40 (12.5%) had other underlying diseases including cancer (3), severe cardiac failure (1), and severe malnutrition (1)

Summary

Introduction

Influenza A and B cause highly contagious, acute respiratory illness, associated with high morbidity and mortality among persons with underlying diseases. Influenza can cause extensive nosocomial outbreaks with high mortality rates. The causes of death in the more severe forms of influenza are (a) severe pneumonia with respiratory distress, (b) neurological complications, and (c) secondary bacterial pneumonia. Senior facilities, cancer centers, neonatal units, pulmonary rehabilitation centers, emergency departments, and others have been described. Large nosocomial outbreaks in large tertiary referral hospitals that provide care to large numbers of patients with advanced AIDS have not been frequently described. Roosevelt Hospital is a large teaching, university tertiary referral hospital in Guatemala City, with 850 beds capacity

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Discussion

Conclusion