Whole genome sequencing of an influenza outbreak on a haematology ward
PHE ePoster Library. Blackburn R. Sep 13, 2016; 137960; 206
Dr. Ruth Blackburn
Dr. Ruth Blackburn
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Abstract
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Abstract Introduction: Nosocomial influenza is associated with annual national costs exceeding £2 million; reflecting ward closures, increased hospital stay and mortality. Next generation sequencing (NGS) can determine the whole influenza genome in less than a day and can be used to identify cases within a transmission chain. We describe an influenza outbreak and evaluate how routine hospital surveillance with NGS could mitigate the impact of similar outbreaks.Method: All patients located in haematology/oncology ward in University College London Hospital Trust were swabbed and tested for influenza A virus during a suspected outbreak in January 2016. Samples with confirmed influenza A were retrospectively sequenced using NGS to determine cases linkage. Information on the number and distribution of symptomatic patients and healthcare workers (HCW), ward occupancy, bay closures and bed-days lost was recorded during the outbreak period.Results: The index and second influenza case presented one day apart in disparate bays within the ward and were initially presumed to be unrelated. Over the course of 7 days 9 of 22 (41%) haematology patients developed laboratory confirmed influenza and 5 HCW had symptoms. Without real-time NGS, the full ward was closed within 4 days of the index case: a total of 79 bed days were lost and at least one patient had severe influenza-associated complications. NGS confirmed that all cases were related.Conclusion: Routine use of NGS could facilitate rapid detection of outbreaks and earlier introduction of enhanced infection control measures, potentially reducing human and financial costs. External funding details Funding: Department of Health and Wellcome Trust
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