Nosocomial Clustering of Pandemic Influenza A (H1N1) Virus Infection as a Source of Fever in Patients with Hematological Malignancy

Abstract

Influenza related morbidity and mortality is higher in immunosuppressive patients. In this paper, four pandemic influenza cases have been described who had been hospitalized in a hematology and oncology unit. Three of the cases acquired pandemic influenza as a nosocomial infection. The sources of transmissions were an infected medical student in two of the cases. One of the cases acquired infection from a patient sharing the same room. All of the patients developed pneumonia and diagnosis of influenza was confirmed by PCR method. All of cases have been initiated to oseltamivir treatment. One of the patients died due to the uncontrolled primary disease. Oseltamivir use was terminated after five days of treatment in other cases. In patients hospitalized for the management of hematological malignancy, influenza should be considered in the differential diagnosis of neutropenic fever especially in the influenza season, and empirical antiviral therapy should be initiated in cases with influenza-like syndrome. To prevent nosocomial spread of influenza strict infection control strategies must be implemented.