Isaac Barney T J, Kirupakaran Henry, Barney Anitha M, Christopher Devasahayam J
Department of Pulmonary Medicine, Christian Medical College, Vellore, 632004, India.
Department of Student and Staff Health Service, Christian Medical College, Vellore, India.
Indian J Tuberc. 2020 Dec;67(4S):S122-S127. doi: 10.1016/j.ijtb.2020.07.024. Epub 2020 Jul 29.
In the wake of the COVID-19 pandemic caused by a novel corona virus, health care personnel are at increased risk of acquiring the infection. In preparation for the management of health care personnel that are likely to be infected, we looked in to the data collected during the Influenza pandemic in 2009, caused by a novel strain of H1N1 influenza called swine flu. The care of healthcare personnel in our institution, who had an acute febrile respiratory illness (AFRI) during that period was routed through a single channel using a uniform protocol. We retrospectively analysed the available data, during the initial four months of the pandemic, to draw lessons from it.
To study the prevalence, clinical profile and risk factors of swine flu among health care personnel during the pandemic of 2009 in a tertiary care hospital in South India.
This retrospective study enrolled all the health care personnel including students of a tertiary care institution in South India, who presented with an AFRI between June to August, the initial four months of the swine flu pandemic of 2009. The clinical profile and risk factors were extracted. The results of the RT PCR for swine flu was obtained. Prevalence in each demographic group was calculated and compared. Characteristics of those with swine flu were compared with those who turned negative for the swine flu.
The prevalence of all AFRI and only swine flu among health care personnel during the study period was 18 per thousand and 8.7 per thousand respectively. Highest prevalence of swine flu was found among students and office staff. After adjusting for confounding factors, hyperthermia at presentation was significantly higher {OR = 1.97; 95% CI (1.01-3.76)} among those who tested positive for swine flu as compared with those with other AFRI's. Only 2.5% of the entire AFRI group required admission and there was no mortality.
Health care personnel are at increased risk of acquiring infection. Our study demonstrated that students and office staff were the most susceptible. Unprotected exposure to unknown infectious patients and relatives is likely to have been an important factor. Though the mode of transmission is similar, compared to H1N1, COVID-19 is associated with different comorbidities and has significantly higher mortality. Therefore, in preparation for the COVID-19 pandemic, the personal protective equipment of the healthcare personnel need to be escalated.
在新型冠状病毒引发的COVID-19大流行之后，医护人员感染该病毒的风险增加。为了做好可能感染的医护人员的管理准备，我们查阅了2009年甲型H1N1流感（又称猪流感）大流行期间收集的数据。我们机构中在此期间患有急性发热性呼吸道疾病（AFRI）的医护人员的护理工作是通过单一渠道按照统一方案进行的。我们回顾性分析了大流行最初四个月期间的现有数据，从中吸取经验教训。
研究2009年印度南部一家三级医院大流行期间医护人员中猪流感的患病率、临床特征和危险因素。
这项回顾性研究纳入了印度南部一家三级医疗机构的所有医护人员，包括学生，他们在2009年猪流感大流行的最初四个月（6月至8月）期间出现了AFRI。提取了临床特征和危险因素。获得了猪流感的逆转录聚合酶链反应（RT PCR）结果。计算并比较了每个人口统计学组的患病率。将感染猪流感者的特征与猪流感检测呈阴性者的特征进行了比较。
研究期间医护人员中所有AFRI和仅猪流感的患病率分别为千分之18和千分之8.7。在学生和办公人员中发现猪流感的患病率最高。在调整混杂因素后，与其他AFRI患者相比，出现高热的猪流感检测呈阳性者显著更高{比值比（OR）=1.97；95%置信区间（CI）（1.01 - 3.76）}。整个AFRI组中只有2.5%的人需要住院治疗，且无死亡病例。
医护人员感染风险增加。我们的研究表明，学生和办公人员最易感染。无防护地接触不明感染患者和亲属可能是一个重要因素。虽然传播方式相似，但与H1N1相比，COVID-19与不同的合并症相关，死亡率显著更高。因此，为应对COVID-19大流行，医护人员的个人防护装备需要升级。
