Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks

Summary Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 pa...

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Bibliographic Details
Published in:	The Journal of hospital infection Vol. 67; no. 4; pp. 336 - 343
Main Authors:	Cheng, V.C.C, Wu, A.K.L, Cheung, C.H.Y, Lau, S.K.P, Woo, P.C.Y, Chan, K.H, Li, K.S.M, Ip, I.K.S, Dunn, E.L.W, Lee, R.A, Yam, L.Y.C, Yuen, K.Y
Format:	Journal Article
Language:	English
Published:	Kent Elsevier Ltd 01-12-2007 Elsevier
Subjects:	Adult Aged Alcohol hand rub Alcohols - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Biological and medical sciences China - epidemiology Cross Infection - epidemiology Cross Infection - prevention & control Directly observed Directly Observed Therapy - methods Female General aspects Hand Disinfection - methods Human infectious diseases. Experimental studies and models Human metapneumovirus Humans Infection Control - methods Infectious Disease Infectious Disease Transmission, Patient-to-Professional - prevention & control Infectious diseases Male Medical sciences Mental Disorders Metapneumovirus - classification Metapneumovirus - pathogenicity Middle Aged Outbreak Paramyxoviridae Infections - prevention & control Pharmacology. Drug treatments Psychiatric Department, Hospital Sentinel Surveillance China Directly observed Alcohol hand rub Outbreak Human metapneumovirus Epidemic Human Nosocomial infection Health staff Alcohol Epidemiology Hand Biological activity Incidence Infection Prevention Viral disease Antiviral Molecular biology Antibacterial agent Reverse transcription polymerase chain reaction
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Summary:	Summary Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 patients. Human metapneumovirus was detected in seven (23%) patients by reverse transcription–polymerase chain reaction and nucleotide sequencing. A review of outbreak surveillance records showed that six nosocomial outbreaks occurred in the year 2005, of which four (67%) were confirmed or presumably related to a respiratory viral infection. Directly observed deliveries of alcohol hand rub 4-hourly during daytime to all psychiatric patients was instituted in December 2005. Only one nosocomial respiratory viral outbreak occurred in the following year. The total number of patients and staff involved in nosocomial outbreaks due to presumed or proven respiratory virus infections decreased significantly from 60 to six ( P < 0.001), whereas those due to all types of nosocomial outbreaks also decreased from 70 to 24 ( P = 0.004). Alcohol hand rub has been shown to have potent bactericidal and virucidal activity against a wide range of nosocomial pathogens. Regular use of directly observed alcohol hand rub may decrease the incidence and scale of nosocomial outbreaks due to enveloped respiratory viruses especially in mentally incapacitated patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0195-6701 1532-2939
DOI:	10.1016/j.jhin.2007.09.010