Revolutionary Method Improves Influenza Case Count in Healthcare
TL/DR –
A study suggests that the traditional definition of health care-associated influenza results in a significant undercounting of cases. The study analyzed data from 5,904 patients hospitalized with influenza from 2012 to 2019; only 2.5% of these cases met the traditional definition of health care-associated influenza. However, when the researchers expanded the definition to include patients who tested positive in the first three days post-transfer from acute care facilities or those discharged from hospitalization for non-influenza illness within the previous seven days, an additional 1,031 health care-associated cases were identified, raising the total to 20% of influenza hospitalizations.
Traditional Definition of Healthcare-Associated Influenza Undercounts Cases
The standard understanding of healthcare-associated influenza significantly underestimates the actual number of cases, according to a recent study published in Infection Control & Hospital Epidemiology. The authors, Erin Gettler, MD, and Thomas Talbot, MD, MPH, examined data from 5,904 patients in Middle Tennessee who were hospitalized with influenza from 2012 to 2019. Only 2.5% of these cases met the traditional definition of healthcare-associated influenza, defined by a positive test result after the third day of hospitalization.
Expanded Definition Increases Influenza Estimates
The researchers also included patients who tested positive within the first three days and those transferred from post-acute care facilities or discharged for non-influenza illnesses within the previous week. This inclusion resulted in an additional 1,031 healthcare-associated cases. With this expansion, 20% of influenza hospitalizations were classified as healthcare-related, which is eight times higher than estimates based on the conventional definition.
Implications of the Study
Findings suggest standardizing surveillance methods to consider preadmission healthcare exposures will provide a more accurate estimate of healthcare-associated influenza burden. This measurement can facilitate the development of prevention strategies in healthcare institutions. Team members from Vanderbilt University Medical Center involved in the study include H. Keipp Talbot, MD, MPH, Yuwei Zhu, MD, MS, Danielle Ndi, MPH, Edward Mitchel MS, Tiffanie Markus, PhD, William Schaffner, MD, and Bryan Harris MD, MPH. The study received partial funding from the National Institutes of Health (UL1TR002243).
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