Nosocomial Pandemic (H1N1) 2009, United Kingdom, 2009–2010

DOI: 10.3201/eid1704.101679
Suggested citation for this article: Enstone JE, Myles PR, Openshaw PJM, Gadd EM, Lim WS, Semple MS, et al. Nosocomial pandemic (H1N1) 2009, United Kingdom, 2009–2010. Emerg Infect Dis. 2011 Apr; [Epub ahead of print]


Nosocomial Pandemic (H1N1) 2009, United Kingdom, 2009–2010
Joanne E. Enstone, Puja R. Myles, Peter J.M. Openshaw, Elaine M. Gadd, Wei Shen Lim, Malcolm G. Semple, Robert C. Read, Bruce L. Taylor, James McMenamin, Colin Armstrong, Barbara Bannister, Karl G. Nicholson, and Jonathan S. Nguyen-Van-Tam

Author affiliations: University of Nottingham, Nottingham, UK (J.E. Enstone, P.R. Myles, J.S. Nguyen-Van-Tam); Imperial College, London, UK (P.J.M. Openshaw); Department of Health, London (E.M. Gadd, C. Armstrong, B. Bannister); Nottingham University Hospitals National Health Service Trust, Nottingham (W.S. Lim); University of Liverpool, Liverpool, UK (M.G. Semple); Royal Hallamshire Hospital, Sheffield, UK (R.C. Read); Portsmouth
Hospitals National Health Service Trust, Portsmouth, UK (B.L. Taylor); Health Protection Scotland, Glasgow, Scotland, UK (J. McMenamin); and University Hospitals of Leicester National Health Service Trust, Leicester, UK (K.G. Nicholson)

To determine the effect of nosocomial infections on health in the United Kingdom, we studied 1,520 patients in 75 National Health Service hospitals. We identified and characterized patients who acquired influenza in hospitals during the pandemic (H1N1) 2009 outbreak. Of 30 patients, 12 (80%) of 15 adults and 14 (93%) of 15 children had serious underlying illnesses. Only 12 (57%) of 21 patients who received antiviral therapy did so within 48 hours after symptom onset, but 53% needed escalated care or mechanical ventilation; 8 (27%) of 30 died. Despite national guidelines and standardized infection control procedures, nosocomial transmission remains a problem when influenza is prevalent. Health care workers should be routinely offered influenza vaccine, and vaccination should be prioritized for all patients at high risk. Staff should remain alert to the possibility of influenza in patients with complex clinical problems and be ready to institute antiviral therapy while awaiting diagnosis during influenza outbreaks.

Nosocomial influenza is a well-recognized problem in acute-care hospital settings (1,2). Outbreaks of influenza A have been reported in general wards (3,4), pediatric units (5), neonatal intensive care units (ICUs) (6–8), hemopoietic and solid organ transplantation units (9–11),...

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