Airborne spread of influenza by ‘non-invasive ventilation’

[Wishart, Michael]

Article from Hong Kong suggests healthcare associated airborne
transmission of influenza from a patient undergoing ‘non-invasive
ventilation’. This reaffirms the current requirements for respiratory
precautions for patients undergoing aerosol-generating procedures where
influenza is known or suspected.

Cheers
Michael

From:
http://www.infectioncontroltoday.com/news/2010/11/hong-kong-hospital-rep
orts-possible-airborne-influenza-transmission.aspx
Direct contact and droplets are the primary ways influenza spreads.
Under certain conditions, however, aerosol transmission is possible. In
a study published in the current issue of Clinical Infectious Diseases,
available online, the authors examined such an outbreak in their own
hospital in Hong Kong.
On April 4, 2008, seven inpatients in the hospital’s general medical
ward developed fever and respiratory symptoms. Ultimately, nine
inpatients exhibited influenza-like symptoms and tested positive for
influenza A. The cause of the outbreak was believed to be an influenza
patient who was admitted on March 27. He received a form of non-invasive
ventilation on March 31, and was then moved to the intensive care unit
after 16 hours. During that time, he was located right beside the
outflow jet of an air purifier, which created an unopposed air current
across the ward.
“We showed that infectious aerosols generated by a respiratory device
applied to an influenza patient might have been blown across the
hospital ward by an imbalanced indoor airflow, causing a major
nosocomial outbreak,” says study author Nelson Lee, MD, of the Chinese
University of Hong Kong. “The spatial distribution of affected patients
was highly consistent with an aerosol mode of transmission, as opposed
to that expected from droplet transmission.
“Suitable personal protective equipment, including the use of N95
respirators, will need to be considered when aerosol-generating
procedures are performed on influenza patients,” Lee adds. “Avoiding
such procedures in open wards and improving ventilation design in
healthcare facilities may also help to reduce the risk of nosocomial
transmission of influenza.”

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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[Wishart, Michael]

Sorry, link was possibly broken in my email.

Or even the journal article abstract: http://tinyurl.com/2f5beaa

Michael Wishart | GPH – Infection Control Coordinator
Infection Prevention is everyone’s business!

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

Ramsay Health Care is an environmentally responsible corporation, please
consider the environment before printing this email.
—–Original Message—–
Behalf Of Wishart, Michael
‘non-invasive ventilation’

Article from Hong Kong suggests healthcare associated airborne
transmission of influenza from a patient undergoing ‘non-invasive
ventilation’. This reaffirms the current requirements for respiratory
precautions for patients undergoing aerosol-generating procedures where
influenza is known or suspected.

Cheers
Michael

From:
http://www.infectioncontroltoday.com/news/2010/11/hong-kong-hospital-rep
orts-possible-airborne-influenza-transmission.aspx
Direct contact and droplets are the primary ways influenza spreads.
Under certain conditions, however, aerosol transmission is possible. In
a study published in the current issue of Clinical Infectious Diseases,
available online, the authors examined such an outbreak in their own
hospital in Hong Kong.
On April 4, 2008, seven inpatients in the hospital’s general medical
ward developed fever and respiratory symptoms. Ultimately, nine
inpatients exhibited influenza-like symptoms and tested positive for
influenza A. The cause of the outbreak was believed to be an influenza
patient who was admitted on March 27. He received a form of non-invasive
ventilation on March 31, and was then moved to the intensive care unit
after 16 hours. During that time, he was located right beside the
outflow jet of an air purifier, which created an unopposed air current
across the ward.
“We showed that infectious aerosols generated by a respiratory device
applied to an influenza patient might have been blown across the
hospital ward by an imbalanced indoor airflow, causing a major
nosocomial outbreak,” says study author Nelson Lee, MD, of the Chinese
University of Hong Kong. “The spatial distribution of affected patients
was highly consistent with an aerosol mode of transmission, as opposed
to that expected from droplet transmission.
“Suitable personal protective equipment, including the use of N95
respirators, will need to be considered when aerosol-generating
procedures are performed on influenza patients,” Lee adds. “Avoiding
such procedures in open wards and improving ventilation design in
healthcare facilities may also help to reduce the risk of nosocomial
transmission of influenza.”

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

Ramsay Health Care is an environmentally responsible corporation, please
consider the environment before printing this email.

This e-mail message and any accompanying files may contain
information that is confidential and subject to privilege. If you
are not the intended recipient, and have received the e-mail
in error, you are notified that any use, dissemination,
distribution, forwarding, printing or copying of the message
and any attached files is strictly prohibited. If you have
received this e-mail message in error please immediately
advise the sender by return e-mail, or telephone 1800 243 903.
You must destroy the original transmission and its contents.
Any views expressed within this communication are those of
the individual sender, except where the sender specifically
states them to be the views of Ramsay Health Care.
This communication should not be copied or disseminated
without permission.
————————————————————————

Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of AICA.

Archive of all messages are available at http://aicalist.org.au/archives
– registration and login required.

Replies to this message will be directed back to the list. To create a
new message send an email to aicalist@aicalist.org.au

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aicalist-request@aicalist.org.au.

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(without the quotes) to listserv@aicalist.org.au

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