Preschool-Aged Household Contacts as a Risk Factor for Viral Respiratory Infections in Healthcare Personnel

Author:

Most Zachary M12ORCID,Nyquist Ann-Christine34,Radonovich Lewis J5,Rodriguez-Barradas Maria C67,Price Connie Savor89,Simberkoff Michael S1011,Bessesen Mary T812,Cummings Derek A T1314,Rattigan Susan M13,Warren-Gash Charlotte15,Gaydos Charlotte A16,Gibert Cynthia L1718,Gorse Geoffrey J19,Perl Trish M1420

Affiliation:

1. Pediatric Infectious Diseases Program, Children’s Health System of Texas , Dallas, Texas , USA

2. Division of Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center , Dallas, Texas , USA

3. Department of Infectious Disease, Children’s Hospital Colorado , Aurora, Colorado , USA

4. Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colorado , USA

5. Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown, West Virginia , USA

6. Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center , Houston, Texas , USA

7. Department of Medicine, Baylor College of Medicine , Houston, Texas , USA

8. Division of Infectious Diseases, University of Colorado School of Medicine , Aurora, Colorado , USA

9. Infectious Disease Department, Denver Health Medical Center , Denver, Colorado , USA

10. Department of Medicine, Veterans Affairs New York Harbor Healthcare System , New York, New York , USA

11. Division of Infectious Diseases, New York University Grossman School of Medicine , New York, New York , USA

12. Medical Service/Infectious Disease, Veterans Affairs Eastern Colorado Healthcare System , Aurora, Colorado , USA

13. Department of Biology and Emerging Pathogens Institute, University of Florida , Gainesville, Florida , USA

14. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA

15. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , United Kingdom

16. Department of Medicine and Division of Infectious Diseases, Johns Hopkins School of Medicine , Baltimore, Maryland , USA

17. Medical Service/Infectious Disease, Veterans Affairs Medical Center , Washington, District of Columbia , USA

18. Department of Medicine, George Washington University School of Medical and Health Sciences , Washington, District of Columbia , USA

19. Division of Infectious Diseases, Allergy and Immunology, Saint Louis University School of Medicine , St Louis, Missouri , USA

20. Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center , Dallas, Texas , USA

Abstract

AbstractBackgroundViral respiratory infections (VRIs) are common and are occupational risks for healthcare personnel (HCP). VRIs can also be acquired at home and other settings among HCPs. We sought to determine if preschool-aged household contacts are a risk factor for VRIs among HCPs working in outpatient settings.MethodsWe conducted a secondary analysis of data from a cluster randomized trial at 7 medical centers in the United States over 4 influenza seasons from 2011–2012 to 2014–2015. Adult HCPs who routinely came within 6 feet of patients with respiratory infections were included. Participants were tested for respiratory viruses whenever symptomatic and at 2 random times each season when asymptomatic. The exposure of interest was the number of household contacts 0–5 years old (preschool-aged) at the beginning of each HCP-season. The primary outcome was the rate of polymerase chain reaction–detected VRIs, regardless of symptoms. The VRI incidence rate ratio (IRR) was calculated using a mixed-effects Poisson regression model that accounted for clustering at the clinic level.ResultsAmong the 4476 HCP-seasons, most HCPs were female (85.4%) and between 30 and 49 years of age (54.6%). The overall VRI rate was 2.04 per 100 person-weeks. In the adjusted analysis, HCPs having 1 (IRR, 1.22 [95% confidence interval {CI}, 1.05–1.43]) and ≥2 (IRR, 1.35 [95% CI, 1.09–1.67]) preschool-aged household contacts had higher VRI rates than those with zero preschool-aged household contacts.ConclusionsPreschool-aged household contacts are a risk factor for developing VRIs among HCPs working in outpatient settings.

Funder

Centers for Disease Control and Prevention

Veterans Health Administration

Biomedical Advanced Research and Development Authority

Wellcome Intermediate Clinical Fellowship

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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