Institute of Virology, University-Hospital of Essen, Germany.
Arch Virol. 2010 Nov;155(11):1797-802. doi: 10.1007/s00705-010-0771-4. Epub 2010 Aug 10.
In February 2008, five patients were infected with the H1N1 subtype of influenza A virus in one hospital ward for immunocompromised patients at a hospital in North Rhine-Westphalia, Germany. All of these patients had an established haematologic disease and tested positive either for viral RNA or antigen shortly after the beginning of respiratory illness. In three of the patients, influenza virus was repeatedly detected, and four of the patients died in coincidence with the virus infection. Sequencing of the amplified (HA1) haemagglutinin yielded identical nucleotide sequences in isolates from three of the patients, whereas one nucleotide difference was found in the isolate of the fourth patient, resulting in an amino acid substitution (G153R). To investigate the source of infection, the medical staff (n = 104) of the hospital unit was tested and found negative for influenza virus RNA and antigen in pharyngeal lavages. Testing for influenza virus antibodies by immunofluorescence assay revealed that 12 staff members were positive for influenza virus A IgA antibodies. These findings suggest that wild-type influenza virus infections occurred within the medical staff at the same time the patients were infected and that the staff might have contributed to the circulation of virus in the hospital ward.
2008 年 2 月，德国北莱茵-威斯特法伦州一家医院免疫功能低下患者病房的一个病房里，有 5 名患者感染了甲型 H1N1 亚型流感病毒。所有这些患者均患有已确诊的血液系统疾病，在呼吸道疾病开始后不久，其病毒 RNA 或抗原检测均呈阳性。在其中 3 名患者中，反复检测到流感病毒，其中 4 名患者在病毒感染时死亡。对扩增（HA1）血凝素的测序结果显示，来自 3 名患者的分离物具有相同的核苷酸序列，而第 4 名患者的分离物中发现了一个核苷酸差异，导致氨基酸取代（G153R）。为了调查感染源，对医院科室的医护人员（n = 104）进行了检测，他们的咽漱液中均未检测到流感病毒 RNA 和抗原。通过免疫荧光检测法检测流感病毒抗体的结果显示，有 12 名医护人员的甲型流感病毒 IgA 抗体呈阳性。这些发现表明，在患者感染的同时，医护人员也发生了野生型流感病毒感染，而且这些医护人员可能促成了医院病房内病毒的传播。
