Michael A Jhung1, Tiffany D'Mello2, Alejandro Pérez2, Deborah Aragon3, Nancy M Bennett4, Tara Cooper5, Monica M Farley6, Brian Fowler7, Stephen M Grube8, Emily B Hancock9, Ruth Lynfield10, Craig Morin10, Arthur Reingold11, Patricia Ryan12, William Schaffner13, Ruta Sharangpani14, Leslie Tengelsen15, Ann Thomas16, Diana Thurston17, Kimberly Yousey-Hindes18, Shelley Zansky7, Lyn Finelli2, Sandra S Chaves2. 1. Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: MJhung@cdc.gov. 2. Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA. 3. Colorado Department of Public Health and Environment, Denver, CO. 4. Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 5. Rhode Island Department of Health, Providence, RI. 6. Georgia Division of Public Health, Georgia Emerging Infections Program, Emory University, Atlanta, GA. 7. Ohio Department of Health, Columbus, OH. 8. Oklahoma State Department of Health, Oklahoma City, OK. 9. New Mexico Department of Health, Santa Fe, NM. 10. Minnesota Department of Health, St Paul, MN. 11. California Emerging Infections Program, Oakland, CA. 12. Maryland Department of Health and Mental Hygiene, Baltimore, MD. 13. Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN. 14. Michigan Department of Community Health, Lansing, MI. 15. Idaho Department of Health and Welfare, Boise, ID. 16. Oregon Public Health Division, Portland, OR. 17. Salt Lake Valley Health Department, Salt Lake City, UT. 18. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT.
Abstract
BACKGROUND: Seasonal influenza is responsible for more than 200,000 hospitalizations each year in the United States. Although hospital-onset (HO) influenza contributes to morbidity and mortality among these patients, little is known about its overall epidemiology. OBJECTIVE: We describe patients with HO influenza in the United States during the 2010-2011 influenza season and compare them with community-onset (CO) cases to better understand factors associated with illness. METHODS: We identified laboratory-confirmed, influenza-related hospitalizations using the Influenza Hospitalization Surveillance Network (FluSurv-NET), a network that conducts population-based surveillance in 16 states. CO cases had laboratory confirmation ≤ 3 days after hospital admission; HO cases had laboratory confirmation > 3 days after admission. RESULTS: We identified 172 (2.8%) HO cases among a total of 6,171 influenza-positive hospitalizations. HO and CO cases did not differ by age (P = .22), sex (P = .29), or race (P = .25). Chronic medical conditions were more common in HO cases (89%) compared with CO cases (78%) (P < .01), and a greater proportion of HO cases (42%) than CO cases (17%) were admitted to the intensive care unit (P < .01). The median length of stay after influenza diagnosis of HO cases (7.5 days) was greater than that of CO cases (3 days) (P < .01). CONCLUSION: HO cases had greater length of stay and were more likely to be admitted to the intensive care unit or die compared with CO cases. HO influenza may play a role in the clinical outcome of hospitalized patients, particularly among those with chronic medical conditions. Published by Mosby, Inc.
BACKGROUND: Seasonal influenza is responsible for more than 200,000 hospitalizations each year in the United States. Although hospital-onset (HO) influenza contributes to morbidity and mortality among these patients, little is known about its overall epidemiology. OBJECTIVE: We describe patients with HO influenza in the United States during the 2010-2011 influenza season and compare them with community-onset (CO) cases to better understand factors associated with illness. METHODS: We identified laboratory-confirmed, influenza-related hospitalizations using the Influenza Hospitalization Surveillance Network (FluSurv-NET), a network that conducts population-based surveillance in 16 states. CO cases had laboratory confirmation ≤ 3 days after hospital admission; HO cases had laboratory confirmation > 3 days after admission. RESULTS: We identified 172 (2.8%) HO cases among a total of 6,171 influenza-positive hospitalizations. HO and CO cases did not differ by age (P = .22), sex (P = .29), or race (P = .25). Chronic medical conditions were more common in HO cases (89%) compared with CO cases (78%) (P < .01), and a greater proportion of HO cases (42%) than CO cases (17%) were admitted to the intensive care unit (P < .01). The median length of stay after influenza diagnosis of HO cases (7.5 days) was greater than that of CO cases (3 days) (P < .01). CONCLUSION: HO cases had greater length of stay and were more likely to be admitted to the intensive care unit or die compared with CO cases. HO influenza may play a role in the clinical outcome of hospitalized patients, particularly among those with chronic medical conditions. Published by Mosby, Inc.
Authors: Carmen S Arriola; Evan J Anderson; Joan Baumbach; Nancy Bennett; Susan Bohm; Mary Hill; Mary Lou Lindegren; Krista Lung; James Meek; Elizabeth Mermel; Lisa Miller; Maya L Monroe; Craig Morin; Oluwakemi Oni; Arthur Reingold; William Schaffner; Ann Thomas; Shelley M Zansky; Lyn Finelli; Sandra S Chaves Journal: J Infect Dis Date: 2015-03-27 Impact factor: 5.226
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