Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Influenza Other Respir Viruses. 2020 Sep;14(5):524-529. doi: 10.1111/irv.12750. Epub 2020 May 6.
Healthcare workers are at increased risk of contracting influenza. However, existing studies do not differentiate professional categories or domains of the healthcare system that are most at risk.
This case-control study compared proportions of patients with professional activity in the healthcare system between cases consulting their primary care physician for an influenza-like illness (ILI) and controls from the general patient population of the same practices of the Swiss sentinel network. Influenza was confirmed by rRT-PCR in a subset of practices. Analysis used a mixed logistic regression model, including age and sex as potential confounders.
During the 2018/2019 influenza surveillance season, out of 4287 ILI cases and 28 561 controls reported in 168 practices, 235 (5.5%), respectively 872 (3.1%), were active in the healthcare system. After adjustment, being active in health care increased the odds of consulting for an ILI (OR 1.66, 95% CI 1.40-1.97). The association was strongest for physicians and nursing aides. In terms of work setting, odds of consulting for ILI were increased for professionals of almost all healthcare settings except home-based care.
Individuals active in the healthcare system were more likely to consult their primary care physician for an influenza-like illness than for another reason, compared with individuals not active in the healthcare system. These results warrant further efforts to understand influenza transmission in the healthcare system at large.
医护人员感染流感的风险增加。然而,现有的研究并没有区分最容易感染的医护人员职业类别或医疗系统领域。
本病例对照研究比较了在瑞士监测网络的相同实践中,因流感样疾病(ILI)就诊于初级保健医生的病例与一般患者人群中的对照组中,具有医疗系统专业活动的患者比例。在部分实践中通过 rRT-PCR 确认流感。分析采用混合逻辑回归模型,包括年龄和性别作为潜在混杂因素。
在 2018/2019 流感监测季节,在 168 个实践中报告的 4287 例 ILI 病例和 28561 例对照中,分别有 235 例(5.5%)和 872 例(3.1%)活跃于医疗系统。调整后,在卫生保健中活跃增加了ILI 就诊的可能性(OR 1.66,95% CI 1.40-1.97)。该关联在医生和护理助手最强。就工作环境而言,除了家庭护理外,几乎所有医疗保健环境中的专业人员咨询ILI 的几率都有所增加。
与未在医疗系统中活跃的个体相比,在医疗系统中活跃的个体更有可能因流感样疾病而咨询其初级保健医生,而不是其他原因。这些结果需要进一步努力,以了解整个医疗系统中的流感传播情况。