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Volume 12, Number 11—November 2006
Dispatch

Avian Influenza H5N1 Screening of Intensive Care Unit Patients with Community-acquired Pneumonia

Anucha Apisarnthanarak*Comments to Author , Pilaipan Puthavathana†, Rungrueng Kitphati‡, Pranee Thavatsupha‡, Malinee Chittaganpitch‡, Prasert Auewarakul†, and Linda M. Mundy§
Author affiliations: *Thammasart University Hospital, Pratumthani, Thailand; †Siriraj Hospital, Bangkok, Thailand; ‡Thai National Institute of Health, Nonthaburi, Thailand; §Saint Louis University School of Public Health, Saint Louis, Missouri, USA

Main Article

Table 2

Cost estimates for routine avian influenza (H5N1) surveillance, laboratory diagnostics, and infection control measures in the ICU, February 1, 2005 – January 31, 2006*

Category No. measures Estimated cost (US$) Total (US$)
Cost associated with H5N1 routine screening
Diagnostic testing
RT-PCR 115 $25 × 115 2,875
Viral culture 115 $30 × 115 3,450
Paired acute- and convalescent-phase serology for anti-H5 antibody† 42 $25 × 42 1,050
Isolation for probable H5N1 (n = 18)‡
Gowns/d 1,800 $1/gown × 1,800 × 9 d 16,200
Gloves/d 1,800 $0.05/pair × 1,800 × 9 d 810
Surgical masks/d 1,800 $0.25/mask × 1,800 × 9 d 4,050
Staff time (min/d) to put on/take off gloves, gowns, and mask 1,800 $1.26/hour × 1,800 2,268
Cost of universal influenza vaccination
ICU HCWs 30 $10 × 30 300
HCWs, entire hospital 980 $10 × 980 9,800

*ICU, intensive care unit; RT-PCR, reverse transcriptase polymerase chain reaction; HCWs, healthcare workers. †All 115 patients had acute phase serum samples tested for anti-H5 antibody; 42 (37%) were <60 years old and survived >14 days after hospitalization. ‡Estimated 1 min to put on and take off the protection gear with 100 encounters per day (15).

*ICU, intensive care unit; RT-PCR, reverse transcriptase polymerase chain reaction; HCWs, healthcare workers. †All 115 patients had acute phase serum samples tested for anti-H5 antibody; 42 (37%) were <60 years old and survived >14 days after hospitalization. ‡Estimated 1 min to put on and take off the protection gear with 100 encounters per day (15).

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References
  1. World Health Organization. Cumulative number of confirmed human cases of avian influenza A (H5N1) reported to WHO, 13 February 2006 [cited 2006 Apr 1]. Available from http://www.who.int/csr/diseases/avian_influenza/country/cases_table _2006_02_13_/en/index.html
  2. Abbott  A, Pearson  H. Fear of human pandemic grows as bird flu sweeps through Asia. Nature. 2004;427:4723. DOIPubMedGoogle Scholar
  3. Chotpitayasunondh  T, Ungchusak  K, Hanshaoworakul  W, Chunsuthiwat  S, Sawanpanyalert  P, Kitphati  R, Human disease from influenza A (H5N1), Thailand, 2004. Emerg Infect Dis. 2005;11:2019.PubMedGoogle Scholar
  4. Tran  TH, Nguyen  TL, Nguyen  TD, Luong  TH, Pham  PM, Nguyen  VC, Avian influenza A (H5N1) in 10 patients in Vietnam. N Engl J Med. 2004;350:117988. DOIPubMedGoogle Scholar
  5. Apisarnthanarak  A, Erb  S, Stephenson  I, Katz  JM, Chittaganpitch  M, Sangkitporn  S, Seroprevalence of anti-H5 antibody among Thai health care workers after exposure to Avian influenza (H5N1) in a tertiary care center. Clin Infect Dis. 2005;40:e168. DOIPubMedGoogle Scholar
  6. Ungchusak  K, Auewarakul  P, Dowell  SF, Kitphati  R, Auwanit  W, Puthavathana  P, Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med. 2005;352:33340. DOIPubMedGoogle Scholar
  7. Apisarnthanarak  A, Kitphati  R, Thongphubeth  K, Patoomanant  P, Anthanont  P, Auwanit  W, Atypical avian influenza (H5N1). Emerg Infect Dis. 2004;10:13214.PubMedGoogle Scholar
  8. de Jong  MD, Bach  VC, Phan  TO, Vo  MH, Tran  TT, Smith  GJ, Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma. N Engl J Med. 2005;352:68691. DOIPubMedGoogle Scholar
  9. Niederman  MS, Bass  JB Jr, Campbell  GD, Fein  AM, Grossman  RF, Mandell  LA, Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am Rev Respir Dis. 1993;148:141826.PubMedGoogle Scholar
  10. Coordinating system for laboratory testing and surveillance [cited 2006 Apr 1]. Available from http://avianflu.cclts.org/
  11. Yuen  KY, Chan  PK, Peiris  M, Tsang  DN, Que  TL, Shortridge  KF, Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus. Lancet. 1998;351:46771. DOIPubMedGoogle Scholar
  12. Spackman  E, Senne  DA, Myers  TJ, Perdue  ML, Garber  LP, Lohman  K, Development of a real-time reverse transcriptase PCR assay for type A influenza virus and the avian H5 and H7 hemagglutinin subtypes. J Clin Microbiol. 2002;40:325660. DOIPubMedGoogle Scholar
  13. Webster  R, Cox  N, Stohr  K. WHO manual on animal influenza diagnosis and surveillance. World Health Organization, Department of Communicable Disease Surveillance and Response. WHO/CDS/CDR/2002.5 Rev. 1.
  14. Rowe  T, Abernathy  RA, Hu-Primmer  J, Thompson  WW, Lu  X, Lim  W, Detection of antibody to avian influenza A (H5N1) virus in human serum by using a combination of serologic assays. J Clin Microbiol. 1999;37:93743.PubMedGoogle Scholar
  15. Apisarnthanarak  A, Kitphati  R, Tawatsupha  P, Thongphubeth  K, Apisarnthanarak  P, Mundy  LM. Varicella-zoster outbreak among Thai healthcare workers. Infect Control Hosp Epidemiol. 2006. In press.PubMedGoogle Scholar

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