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

Zachary M. Most, Pediatric Infectious Diseases Program, Children's Health System of Texas, Dallas, Texas, USA.
Ann-Christine Nyquist, Department of Infectious Disease, Children's Hospital Colorado, Aurora, Colorado, USA.
Lewis J. Radonovich, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
Maria C. Rodriguez-Barradas, Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
Connie Savor Price, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA.
Michael S. Simberkoff, Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, New York, USA.
Mary T. Bessesen, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA.
Derek A. Cummings, Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA.
Susan M. Rattigan, Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA.
Charlotte Warren-Gash, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Charlotte A. Gaydos, Department of Medicine and Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Cynthia L. Gibert, Medical Service/Infectious Disease, Veterans Affairs Medical Center, Washington, District of Columbia, USA.
Geoffrey J. Gorse, Division of Infectious Diseases, Allergy and Immunology, Saint Louis University School of Medicine, St Louis, Missouri, USA.
Trish M. Perl, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Document Type

Journal Article

Publication Date

2-1-2023

Journal

Open forum infectious diseases

Volume

10

Issue

2

DOI

10.1093/ofid/ofad057

Keywords

healthcare personnel; healthcare-associated infections; viral respiratory infections

Abstract

BACKGROUND: Viral 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. METHODS: We 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. RESULTS: Among 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. CONCLUSIONS: Preschool-aged household contacts are a risk factor for developing VRIs among HCPs working in outpatient settings.

Department

Medicine

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