Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore

Abstract

We describe incidence and risk factors for pandemic (H1N1) 2009 virus infection in healthcare personnel during the June-September 2009 epidemic in Singapore. Personnel contributed 3 serologic samples during June-October 2009, with seroconversion defined as a ≥4-fold increase in hemagglutination inhibition titers to pandemic (H1N1) 2009. Of 531 participants, 35 showed evidence of seroconversion. Seroconversion rates were highest in nurses (28/290) and lowest in allied health staff (2/116). Significant risk factors on multivariate analysis were being a nurse (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] 1.0-19.6) and working in pandemic (H1N1) 2009 isolation wards (aOR 4.5, 95% CI 1.3-15.6). Contact with pandemic (H1N1) 2009-infected colleagues (aOR 2.5, 95% CI 0.9-6.6) and larger household size (aOR 1.2, 95% CI 1.0-1.4) were of borderline significance. Our study suggests that seroconversion was associated with occupational and nonoccupational risk factors.

Figure

Univariate analysis for nonoccupational exposures to pandemic (H1N1) 2009 among healthcare workers, Singapore. Error bars indicate 95% confidence intervals (CIs) for odds ratios (ORs). †n/N, no. of seroconverters/no. in strata. HH, household; HCP, healthcare provider; HHM, household member; ARI, acute respiratory illness; FRI, febrile respiratory illness.