956Management of a respiratory outbreak due to concomitantly circulating influenza A and parainfluenza 1 in a residential care facility
Bibliographic record
Abstract
Background. Respiratory viruses are common causes of outbreaks in residential care. Multiplex PCR assays for respiratory viruses enable the detection of multiple viruses, though the clinical significance of dual infections is unclear. We describe an outbreak of 2 respiratory viruses co-circulating in a residential care facility in Vancouver, Canada. Methods. Outbreak investigation was conducted in a facility with 216 residents distributed among 3 separate units in January 2014. Cases were defined as any resident or staff with acute onset respiratory illness [fever (>38.0°C) and cough], and with at least one of the following: sore throat, nasal congestion, malaise, chills, muscle aches, headache or change in mental status. Affected patients were placed on contact and droplet precautions. Nasopharyngeal swabs were collected on symptomatic residents and tested using an in-house multiplex PCR assay (influenza A/B, respiratory syncytial virus, parainfluenza 1/2/3, adenovirus and human metapneumovirus). An epidemic curve of the outbreak was created. Results. The outbreak persisted for 13 days. Twelve patients were infected, including 7 with parainfluenza 1, 2 with influenza A and 3 with parainfluenza 1/influenza A co-infection (figure). All patients manifesting respiratory symptoms were tested (12/28, 43%), rather than empirically treating subsequent patients meeting case definition. Treatment with oseltamivir was provided for 5 patients positive for influenza A, with all others receiving prophylaxis. Two staff developed upper respiratory tract symptoms and were considered cases. Outbreak management also included cessation of group activities, closure to admissions and enhanced unit cleaning. Influenza vaccination rates were 94% for residents and 83% for healthcare workers. Conclusion. Routine testing using a multiplex PCR assay detected a respiratory outbreak involving single and co-infections. Two circulating viruses can affect outbreak management. In this outbreak, all symptomatic residents were tested and confirmed rather than empirically treated. In addition to accurate classification and management of cases, overall consumption of oseltamivir prophylaxis can be reduced by monitoring for the persistence of both viruses. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".