Preschool-Aged Household Contacts as a Risk Factor for Viral Respiratory Infections in Healthcare Personnel

Authors

Zachary M Most
Ann-Christine Nyquist
Lewis J Radonovich
Maria C Rodriguez-Barradas
Connie Savor Price
Michael S Simberkoff
Mary T Bessesen
Derek A T Cummings
Susan M Rattigan
Charlotte Warren-Gash
Charlotte A Gaydos
Cynthia L Gibert
Geoffrey J Gorse
Trish M Perl

Publication Date

2-1-2023

Journal

Open Forum Infectious Diseases

DOI

10.1093/ofid/ofad057

PMID

36824623

PMCID

PMC9942663

PubMedCentral® Posted Date

2-8-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

healthcare-associated infections, healthcare personnel, viral respiratory infections

Abstract

BACKGROUND: Viral respiratory infections (VRIs) are common and are occupational risks for healthcare personnel (HCP). VRIs can also be acquired at home and other settings among HCPs. We sought to determine if preschool-aged household contacts are a risk factor for VRIs among HCPs working in outpatient settings.

METHODS: We conducted a secondary analysis of data from a cluster randomized trial at 7 medical centers in the United States over 4 influenza seasons from 2011-2012 to 2014-2015. Adult HCPs who routinely came within 6 feet of patients with respiratory infections were included. Participants were tested for respiratory viruses whenever symptomatic and at 2 random times each season when asymptomatic. The exposure of interest was the number of household contacts 0-5 years old (preschool-aged) at the beginning of each HCP-season. The primary outcome was the rate of polymerase chain reaction-detected VRIs, regardless of symptoms. The VRI incidence rate ratio (IRR) was calculated using a mixed-effects Poisson regression model that accounted for clustering at the clinic level.

RESULTS: Among the 4476 HCP-seasons, most HCPs were female (85.4%) and between 30 and 49 years of age (54.6%). The overall VRI rate was 2.04 per 100 person-weeks. In the adjusted analysis, HCPs having 1 (IRR, 1.22 [95% confidence interval {CI}, 1.05-1.43]) and ≥2 (IRR, 1.35 [95% CI, 1.09-1.67]) preschool-aged household contacts had higher VRI rates than those with zero preschool-aged household contacts.

CONCLUSIONS: Preschool-aged household contacts are a risk factor for developing VRIs among HCPs working in outpatient settings.

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