Cluster of XXXX among hospital staff working in coronary care units.

@entity1 @entity697 @entity646 @entity625 @entity1910 @entity2036 @entity8344 @entity377 @entity281 @entity8585 @entity4841 @entity221 @entity8543
BACKGROUND: @entity8344 is associated with @entity8585 in @entity1 or @entity4841 and @entity625 in adults. The virus is relatively conserved and @entity377 identity is expected in viruses that are epidemiologically related. Here, we describe the first cluster of @entity8543 among hospital staff documented in Taiwan. METHODS: Active surveillance was conducted in coronary care units (CCUs) at a 2200-bed teaching hospital for 1 month in 2007. A case defined clinically as occurring in a @entity1 or staff in CCUs with new onset of @entity221 or @entity1910 . Serum was tested for @entity8344 IgM and IgG by immunoblotting and DNA by nested polymerase chain reaction. When @entity646 was detected, @entity377 sequences were analyzed and compared with those of two clinical isolates. The attack rate was defined as the cumulative incidence of @entity697 in CCU staff and @entity1 during the study period. RESULTS: Among 57 staff and 15 @entity1 , five nurses met the clinical case definition. Three had @entity697 as demonstrated by viral DNA and IgM. The attack rate was 5.3% for the staff and zero for @entity1 . Seroprevalence rate was lower in staff than in @entity1 (26.3%vs. 53.3%). The isolates collected from three cases were highly similar to a community isolate, and they varied with each other by 2-6 @entity2036 . The isolate collected from a nurse was identical to that from her friend 3 weeks apart and was concordant with mutual transmission. A sequence with 45 @entity377 variations was identified from a staff member with @entity281 who was negative for IgM and had only weak IgG anti-VP1 reaction with immunoblotting. We did not find any @entity1 as the source of @entity281 . CONCLUSION: We identified a cluster of @entity8543 that was caused by three circulating strains which did not support the hypothesis of transmission of a single strain in CCUs.
