1887
  1. Home
  2. Eurosurveillance
  3. Volume 29, Issue 31, 01/Aug/2024
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

Healthcare personnel (HCP) are at high risk for respiratory infections through occupational exposure to respiratory viruses.

Aim

We used data from a prospective influenza vaccine effectiveness study in HCP to quantify the incidence of acute respiratory infections (ARI) and their associated presenteeism and absenteeism.

Methods

At the start and end of each season, HCP at two Israeli hospitals provided serum to screen for antibodies to influenza virus using the haemagglutination inhibition assay. During the season, active monitoring for the development of ARI symptoms was conducted twice a week by RT-PCR testing of nasal swabs for influenza and respiratory syncytial virus (RSV). Workplace presenteeism and absenteeism were documented. We calculated incidences of influenza- and RSV-associated ARI and applied sampling weights to make estimates representative of the source population.

Results

The median age of 2,505 participating HCP was 41 years, and 70% were female. Incidence was 9.1 per 100 person-seasons (95% CI: 5.8–14.2) for RT-PCR-confirmed influenza and 2.5 per 100 person-seasons (95% CI: 0.9–7.1) for RSV illness. Each season, 18–23% of unvaccinated and influenza-negative HCP seroconverted. The incidence of seroconversion or RT-PCR-confirmed influenza was 27.5 per 100 person-seasons (95% CI: 17.8–42.5). Work during illness occurred in 92% (95% CI: 91–93) of ARI episodes, absence from work in 38% (95% CI: 36–40).

Conclusion

Influenza virus and RSV infections and associated presenteeism and absenteeism were common among HCP. Improving vaccination uptake among HCP, infection control, and encouraging sick HCP to stay home are important strategies to reduce ARI incidence and decrease the risk of in-hospital transmission.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.31.2300580
2024-08-01
2024-12-12
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.31.2300580
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/31/eurosurv-29-31-3.html?itemId=/content/10.2807/1560-7917.ES.2024.29.31.2300580&mimeType=html&fmt=ahah

References

  1. Cherian T, Morales KF, Mantel C, Lambach P, Al Awaidy S, Bresee JS, et al. Factors and considerations for establishing and improving seasonal influenza vaccination of health workers: Report from a WHO meeting, January 16-17, Berlin, Germany. Vaccine. 2019;37(43):6255-61.  https://doi.org/10.1016/j.vaccine.2019.07.079  PMID: 31500965 
  2. Kuster SP, Shah PS, Coleman BL, Lam PP, Tong A, Wormsbecker A, et al. Incidence of influenza in healthy adults and healthcare workers: a systematic review and meta-analysis. PLoS One. 2011;6(10):e26239.  https://doi.org/10.1371/journal.pone.0026239  PMID: 22028840 
  3. Gur-Arie R, Katz MA, Hirsch A, Greenberg D, Malosh R, Newes-Adeyi G, et al. "You have to die not to come to work": a mixed methods study of attitudes and behaviors regarding presenteeism, absenteeism and influenza vaccination among healthcare personnel with respiratory illness in Israel, 2016-2019. Vaccine. 2021;39(17):2366-74.  https://doi.org/10.1016/j.vaccine.2021.03.057  PMID: 33789798 
  4. Peasah SK, Azziz-Baumgartner E, Breese J, Meltzer MI, Widdowson MA. Influenza cost and cost-effectiveness studies globally--a review. Vaccine. 2013;31(46):5339-48.  https://doi.org/10.1016/j.vaccine.2013.09.013  PMID: 24055351 
  5. Dilokthornsakul P, Lan LM, Thakkinstian A, Hutubessy R, Lambach P, Chaiyakunapruk N. Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis. EClinicalMedicine. 2022;47:101410.  https://doi.org/10.1016/j.eclinm.2022.101410  PMID: 35497069 
  6. Sumner KM, Duca LM, Arriola CS, Neyra J, Soto G, Romero C, et al. Knowledge, attitudes, and practices associated with frequent influenza vaccination among healthcare personnel in Peru, 2016─2018. Vaccine X. 2023;14:100314.  https://doi.org/10.1016/j.jvacx.2023.100314  PMID: 37234596 
  7. McCarron M, Marcenac P, Yau TS, Lafond KE, Ebama MS, Duca LS. Healthcare personnel acceptance and recommendations for influenza vaccine in twelve low- and middle-income countries: a pooled analysis from 2018-2020. Vaccine. 2024.
  8. Ambrose CS, Antonova EN. The healthcare and societal burden associated with influenza in vaccinated and unvaccinated European and Israeli children. Eur J Clin Microbiol Infect Dis. 2014;33(4):569-75.  https://doi.org/10.1007/s10096-013-1986-6  PMID: 24091746 
  9. Lafond KE, Porter RM, Whaley MJ, Suizan Z, Ran Z, Aleem MA, et al. Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis. PLoS Med. 2021;18(3):e1003550.  https://doi.org/10.1371/journal.pmed.1003550  PMID: 33647033 
  10. Kassem E, Na’amnih W, Bdair-Amsha A, Zahalkah H, Muhsen K. Comparisons between ethnic groups in hospitalizations for respiratory syncytial virus bronchiolitis in Israel. PLoS One. 2019;14(4):e0214197.  https://doi.org/10.1371/journal.pone.0214197  PMID: 30933992 
  11. Glatman-Freedman A, Kaufman Z, Applbaum Y, Dichtiar R, Steiman A, Gordon ES, et al. Respiratory Syncytial Virus hospitalization burden: a nation-wide population-based analysis, 2000-2017. J Infect. 2020;81(2):297-303.  https://doi.org/10.1016/j.jinf.2020.05.078  PMID: 32504738 
  12. Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018;391(10127):1285-300.  https://doi.org/10.1016/S0140-6736(17)33293-2  PMID: 29248255 
  13. National Institute for Occupational Safety and Health (NIOSH). Absenteeism in the Workplace. Washington: NIOSH. [Accessed: 25 May 2023]. Available from: https://www.cdc.gov/niosh/surveillance/absenteeism/?CDC_AAref_Val=https://www.cdc.gov/niosh/topics/absences/default.html
  14. Hirsch A, Katz MA, Laufer Peretz A, Greenberg D, Wendlandt R, Shemer Avni Y, et al. Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI): study protocol. BMC Infect Dis. 2018;18(1):550.  https://doi.org/10.1186/s12879-018-3444-7  PMID: 30400834 
  15. Thompson MG, Ferber JR, Odouli R, David D, Shifflett P, Meece JK, et al. Results of a pilot study using self-collected mid-turbinate nasal swabs for detection of influenza virus infection among pregnant women. Influenza Other Respir Viruses. 2015;9(3):155-60.  https://doi.org/10.1111/irv.12309  PMID: 25711978 
  16. Seaman CP, Tran LTT, Cowling BJ, Sullivan SG. Self-collected compared with professional-collected swabbing in the diagnosis of influenza in symptomatic individuals: A meta-analysis and assessment of validity. J Clin Virol. 2019;118:28-35.  https://doi.org/10.1016/j.jcv.2019.07.010  PMID: 31400670 
  17. Belongia EA, Irving SA, Waring SC, Coleman LA, Meece JK, Vandermause M, et al. Clinical characteristics and 30-day outcomes for influenza A 2009 (H1N1), 2008-2009 (H1N1), and 2007-2008 (H3N2) infections. JAMA. 2010;304(10):1091-8.  https://doi.org/10.1001/jama.2010.1277  PMID: 20823435 
  18. Sokolow LZ, Naleway AL, Li DK, Shifflett P, Reynolds S, Henninger ML, et al. Severity of influenza and noninfluenza acute respiratory illness among pregnant women, 2010-2012. Am J Obstet Gynecol. 2015;212(2):202.e1-11.  https://doi.org/10.1016/j.ajog.2014.08.004  PMID: 25111585 
  19. Henkle E, Irving SA, Naleway AL, Gaglani MJ, Ball S, Spencer S, et al. Comparison of laboratory-confirmed influenza and noninfluenza acute respiratory illness in healthcare personnel during the 2010-2011 influenza season. Infect Control Hosp Epidemiol. 2014;35(5):538-46.  https://doi.org/10.1086/675832  PMID: 24709723 
  20. Azziz-Baumgartner E, Neyra J, Yau TS, Soto G, Owusu D, Zhang C, et al. Healthcare personnel in 2016-2019 prospective cohort infrequently got vaccinated, worked while ill, and frequently used antibiotics rather than antivirals against viral influenza illnesses. Influenza Other Respir Viruses. 2023;17(9):e13189.  https://doi.org/10.1111/irv.13189  PMID: 37693773 
  21. Thompson MG, Soto G, Peretz A, Newes-Adeyi G, Yoo YM, Hirsch A, et al. Influenza vaccine effectiveness within prospective cohorts of healthcare personnel in Israel and Peru 2016-2019. Vaccine. 2021;39(47):6956-67.  https://doi.org/10.1016/j.vaccine.2021.07.077  PMID: 34509322 
  22. Dong Y, Peng CY. Principled missing data methods for researchers. Springerplus. 2013;2(1):222.  https://doi.org/10.1186/2193-1801-2-222  PMID: 23853744 
  23. Agah R, Cherry JD, Garakian AJ, Chapin M. Respiratory syncytial virus (RSV) infection rate in personnel caring for children with RSV infections. Routine isolation procedure vs routine procedure supplemented by use of masks and goggles. Am J Dis Child. 1987;141(6):695-7.  https://doi.org/10.1001/archpedi.1987.04460060111049  PMID: 3578197 
  24. Israel Ministry of Health. Arexvy RSV vaccine for adults by GSK. Jerusalem: Ministry of Health. [Accessed: 15 May 2024]. Hebrew. Available from: https://www.gov.il/BlobFolder/policy/rsv-vaccine/he/files_publications_units_epidemiology_vaccine_guidelines_380_RSV_vaccine.pdf
  25. Hall CB, Douglas RG Jr, Geiman JM, Messner MK. Nosocomial respiratory syncytial virus infections. N Engl J Med. 1975;293(26):1343-6.  https://doi.org/10.1056/NEJM197512252932604  PMID: 1186836 
  26. PATH. RSV clinical trial tracker. Seattle: PATH; 2020 [cited 2021 April 16]. Available from: https://www.path.org/our-impact/resources/rsv-and-mab-trial-tracker
  27. Mazur NI, Terstappen J, Baral R, Bardají A, Beutels P, Buchholz UJ, et al. Respiratory syncytial virus prevention within reach: the vaccine and monoclonal antibody landscape. Lancet Infect Dis. 2023;23(1):e2-21.  https://doi.org/10.1016/S1473-3099(22)00291-2  PMID: 35952703 
  28. Imai C, Hall L, Lambert SB, Merollini KMD. Presenteeism among health care workers with laboratory-confirmed influenza infection: A retrospective cohort study in Queensland, Australia. Am J Infect Control. 2020;48(4):355-60.  https://doi.org/10.1016/j.ajic.2019.07.024  PMID: 31515100 
  29. Kaldjian LC, Shinkunas LA, Reisinger HS, Polacco MA, Perencevich EN. Attitudes about sickness presenteeism in medical training: is there a hidden curriculum? Antimicrob Resist Infect Control. 2019;8(1):149.  https://doi.org/10.1186/s13756-019-0602-7  PMID: 31508227 
  30. Tamò R, Turk T, Böni J, Kouyos RD, Schmutz S, Huber M, et al. Secondary attack rates from asymptomatic and symptomatic influenza virus shedders in hospitals: Results from the TransFLUas influenza transmission study. Infect Control Hosp Epidemiol. 2022;43(3):312-8.  https://doi.org/10.1017/ice.2021.112  PMID: 33952361 
  31. Kuster SP, Böni J, Kouyos RD, Huber M, Schmutz S, Shah C, et al. Absenteeism and presenteeism in healthcare workers due to respiratory illness. Infect Control Hosp Epidemiol. 2021;42(3):268-73.  https://doi.org/10.1017/ice.2020.444  PMID: 33239124 
  32. Centers for Disease Control and Prevention (CDC). Prevention strategies for seasonal influenza in healthcare settings. Atlanta: CDC; 2021. Available from: https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm
  33. Jiang L, McGeer A, McNeil S, Katz K, Loeb M, Muller MP, et al. Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during 4 influenza seasons: 2010-2011 to 2013-2014. Infect Control Hosp Epidemiol. 2019;40(8):889-96.  https://doi.org/10.1017/ice.2019.141  PMID: 31208477 
  34. Gianino MM, Politano G, Scarmozzino A, Stillo M, Amprino V, Di Carlo S, et al. Cost of sickness absenteeism during seasonal influenza outbreaks of medium intensity among health care workers. Int J Environ Res Public Health. 2019;16(5):747.  https://doi.org/10.3390/ijerph16050747  PMID: 30832264 
  35. Li T, Qi X, Li Q, Tang W, Su K, Jia M, et al. A Systematic review and meta-analysis of seasonal influenza vaccination of health workers. Vaccines (Basel). 2021;9(10):1104.  https://doi.org/10.3390/vaccines9101104  PMID: 34696212 
  36. Dawood FS, Naleway AL, Flannery B, Levine MZ, Murthy K, Sambhara S, et al. Comparison of the Immunogenicity of cell culture-based and recombinant quadrivalent influenza vaccines to conventional egg-based quadrivalent influenza vaccines among healthcare personnel aged 18-64 years: a randomized open-label trial. Clin Infect Dis. 2021;73(11):1973-81.  https://doi.org/10.1093/cid/ciab566  PMID: 34245243 
  37. National Institutes of Health (NIH). Immunogenicity trial of recombinant influenza vaccine among HCP in Israel. Maryland: NIH. [Accessed 22 Apr 2024]. Available from: https://clinicaltrials.gov/study/NCT04523324
  38. Venkatesan S, Myles PR, Bolton KJ, Muthuri SG, Al Khuwaitir T, Anovadiya AP, et al. Neuraminidase inhibitors and hospital length of stay: a meta-analysis of individual participant data to determine treatment effectiveness among patients hospitalized with nonfatal 2009 pandemic influenza A(H1N1) Virus Infection. J Infect Dis. 2020;221(3):356-66. PMID: 31314899 
  39. Tsang TK, Perera RAPM, Fang VJ, Wong JY, Shiu EY, So HC, et al. Reconstructing antibody dynamics to estimate the risk of influenza virus infection. Nat Commun. 2022;13(1):1557.  https://doi.org/10.1038/s41467-022-29310-8  PMID: 35322048 
  40. Filc D, Davidovich N, Novack L, Balicer RD. Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system? Int J Equity Health. 2014;13(1):115.  https://doi.org/10.1186/s12939-014-0115-1  PMID: 25431139 
Incidence of laboratory-confirmed influenza and RSV and associated presenteeism and absenteeism among healthcare personnel, Israel, influenza seasons 2016 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Eduardo+Azziz-Baumgartner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Azziz-Baumgartner Eduardo</a>, <a href="/search?value1=Avital+Hirsch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hirsch Avital</a>, <a href="/search?value1=Young+M+Yoo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yoo Young M</a>, <a href="/search?value1=Alon+Peretz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Peretz Alon</a>, <a href="/search?value1=David+Greenberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Greenberg David</a>, <a href="/search?value1=Yonat+Shemer+Avni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Avni Yonat Shemer</a>, <a href="/search?value1=Aharona+Glatman-Freedman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Glatman-Freedman Aharona</a>, <a href="/search?value1=Michal+Mandelboim&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mandelboim Michal</a>, <a href="/search?value1=Adam+MacNeil&option1=author&noRedirect=true" class="nonDisambigAuthorLink">MacNeil Adam</a>, <a href="/search?value1=Emily+T+Martin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martin Emily T</a>, <a href="/search?value1=Gabriella+Newes-Adeyi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Newes-Adeyi Gabriella</a>, <a href="/search?value1=Mark+Thompson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thompson Mark</a>, <a href="/search?value1=Arnold+S+Monto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monto Arnold S</a>, <a href="/search?value1=Ran+D+Balicer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Balicer Ran D</a>, <a href="/search?value1=Min+Z+Levine&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Levine Min Z</a>, <a href="/search?value1=Mark+A+Katz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Katz Mark A</a></span>. Incidence of laboratory-confirmed influenza and RSV and associated presenteeism and absenteeism among healthcare personnel, Israel, influenza seasons 2016 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(31):pii=2300580. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.31.2300580" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.31.2300580</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 21 Oct 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 22 May 2024 </span> </p>
/content/10.2807/1560-7917.ES.2024.29.31.2300580
/content/10.2807/1560-7917.ES.2024.29.31.2300580
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error