Download PDF
Semin Respir Crit Care Med 2009; 30(1): 067-085
DOI: 10.1055/s-0028-1119811
© Thieme Medical Publishers

Healthcare-Associated Atypical Pneumonia

Sarah Forgie1 , Thomas J. Marrie2
  • 1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
  • 2Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Further Information

Publication History

Publication Date:
06 February 2009 (online)

    Permissions and Reprints

ABSTRACT

Atypical pneumonia was first described in 1938, and over time, Mycoplasma, Legionella, and Chlamydophila were the agents commonly linked with community-associated atypical pneumonia. However, as technology has improved, so has our understanding of this clinical entity. It is now known that there are many agents linked with atypical pneumonia in the community, and many of these agents are also major causes of healthcare-associated pneumonia. This article discusses the history, epidemiology, and pathogenesis of infection; control of infection; clinical findings; diagnosis; and, where applicable, treatment of the agents of healthcare-associated atypical pneumonia. Bacterial agents include Legionella species, Mycoplasma pneumoniae, Chlamydophila species, and Coxiella burnetii. Although there are over 100 viruses that can cause respiratory tract infections, only a fraction of those have been defined in the context of healthcare-associated atypical pneumonia: adenovirus and human bocavirus (HBoV); rhinovirus; human coronaviruses (HCoV), including HCoV 229E, HCoV OC43, HCoV NL63, HCoV HKU1; members of the paramyxoviridae (parainfluenza viruses, human metapneumovirus, and respiratory syncytial virus); hantavirus; influenza; and severe acute respiratory syndrome (SARS) Co-V. Our knowledge about healthcare-associated atypical pneumonia will continue to evolve as newer pathogens are identified and as newer diagnostic modalities such as multiplex polymerase chain reaction are introduced.

KEYWORDS

Atypical pneumonia - legionnaires disease - SARS - viral - Coxiella burnetii

REFERENCES

  • 1 Reimann H A. An acute infection of the respiratory tract with atypical pneumonia.  JAMA. 1938;  111 2377-2384
    CrossrefPubMedGoogle Scholar
  • 2 Fraser D W, Tsai T R, Orenstein W and the Field Investigation Team et al.. Legionnaires' disease: description of an epidemic of pneumonia.  N Engl J Med. 1977;  297 1189-1197
    CrossrefPubMedGoogle Scholar
  • 3 Tsai T F, Finn D R, Plikaytis B D, McCauley W, Martin S M, Fraser D W. Legionnaires' disease: clinical features of the epidemic in Philadelphia.  Ann Intern Med. 1979;  90 509-517
    CrossrefPubMedGoogle Scholar
  • 4 McDade J E, Shepard C C, Fraser D W, Tsai T R, Redus M A, Dowdle W R. and the Laboratory Investigation Team . Legionnaires' disease: isolation of a bacterium and demonstration of its role in other respiratory diseases.  N Engl J Med. 1977;  297 1197-1203
    CrossrefPubMedGoogle Scholar
  • 5 Meyer R D. Legionella infections: a review of five years of research.  Rev Infect Dis. 1983;  5 258-278
    PubMedGoogle Scholar
  • 6 Joseph C A. Legionnaires' disease in Europe 2000 – 2002.  Epidemiol Infect. 2004;  132 417-424
    CrossrefPubMedGoogle Scholar
  • 7 Boccia S, Laurenti P, Borella P et al.. Prospective 3-year surveillance for nosocomial and environmental Legionella pneumophila: implications for infection control.  Infect Control Hosp Epidemiol. 2006;  27 459-465
    CrossrefPubMedGoogle Scholar
  • 8 Marrie T J, MacDonald S, Clarke K, Haldane D. Nosocomial Legionnaires' disease: lessons from a four year prospective study.  Am J Infect Control. 1991;  19 79-85
    CrossrefPubMedGoogle Scholar
  • 9 Benin A L, Benson R F, Besser R E. Trends in legionnaires disease, 1990–1998: declining mortality and new patterns of diagnosis.  Clin Infect Dis. 2002;  35 1039-1046
    CrossrefPubMedGoogle Scholar
  • 10 Fields B S, Benson R F, Besser R E. Legionella and legionnaires' disease: 25 years of investigation.  Clin Microbiol Rev. 2002;  15 506-526
    CrossrefPubMedGoogle Scholar
  • 11 Yu V L. Nosocomial legionellosis.  Curr Opin Infect Dis. 2000;  13 385-388
    PubMedGoogle Scholar
  • 12 Parry M F, Stampkman L, Hutchinson J H, Folta D, Steinberg M G, Krasnogor L J. Waterborne Legionella bozemanii and nosocomial pneumonia in immunosuppressed patients.  Ann Intern Med. 1985;  103 205-210
    PubMedGoogle Scholar
  • 13 Tang P W, Toma S, MacMillan L G. Legionella oakridgensis: laboratory diagnosis of a human infection.  J Clin Microbiol. 1985;  21 462-463
    PubMedGoogle Scholar
  • 14 Marrie T J, Haldane D, Bezanson G, Peppard R. Each water outlet is a unique ecological niche for Legionella pneumophila .  Epidemiol Infect. 1992;  108 261-270
    PubMedGoogle Scholar
  • 15 Marrie T J, Haldane D, MacDonald S et al.. Control of endemic nosocomial legionnaires' disease by using sterile potable water for high risk patients.  Epidemiol Infect. 1991;  107 591-605
    PubMedGoogle Scholar
  • 16 Bezanson G, Burbridge S, Haldane D, Yoell C, Marrie T. Diverse populations of Legionella pneumophila present in water of geographically clustered institutions served by the same water reservoir.  J Clin Microbiol. 1992;  30 570-576
    PubMedGoogle Scholar
  • 17 Bezanson G, Fernandez R, Haldane D, Burbridge S, Marrie T. Virulence of patient and water isolates of Legionella pneumophila in guinea pigs and mouse L929 cells varies with bacterial genotype.  Can J Microbiol. 1994;  40 426-431
    PubMedGoogle Scholar
  • 18 Bezanson G, Burbridge S, Haldane D, Marrie T. In situ colonization of polyvinyl chloride, brass and copper by Legionella pneumophila .  Can J Microbiol. 1992;  38 328-330
    PubMedGoogle Scholar
  • 19 Plouffe J F, Para M F, Mathea W E, Hackman B, Webster L. Subtypes of Legionella pneumophila serogroup 1 associated with different attack rates.  Lancet. 1983;  2 649-650
    PubMedGoogle Scholar
  • 20 Plouffe J F, Webster L R, Hackman B. Relationships between colonization of hospital buildings with Legionella pneumophila and hot water temperatures.  Appl Environmental Microbiol. 1983;  46 769-770
    PubMedGoogle Scholar
  • 21 O'Neill E, Humphreys H. Surveillance of hospital water and primary prevention of nosocomial legionellosis: what is the evidence?.  J Hosp Infect. 2005;  59 273-279
    CrossrefPubMedGoogle Scholar
  • 22 Allegheny County Health Department .Approaches to Prevention and Control of Legionella Infection in Allegheny County Health Care Facilities. 2nd ed. Pittsburgh, PA; Allegheny County Health Department 1977: 1-15
    Google Scholar
  • 23 Gorman G W, Yu V L, Brown A et al.. Isolation of Pittsburgh pneumonia agent from nebulizers used in respiratory therapy.  Ann Intern Med. 1980;  93 572-573
    PubMedGoogle Scholar
  • 24 Jones E, Checko P, Dalton A et al.. Nosocomial legionnaires' disease associated with exposure to respiratory therapy equipment, Connecticut. In: Thornsberry C, Feeley JC Proceedings of the Second International Symposium on Legionella . American Society for Microbiology, Washington, DC 1984: 225-226
    Google Scholar
  • 25 Kaan J A, Simoons-Smit A M, MacLaren D M. Another source of aerosol causing nosocomial legionnaires' disease.  J Infect. 1985;  11 145-148
    CrossrefPubMedGoogle Scholar
  • 26 Hanrahan J P, Morse D L, Scharf V B et al.. Community hospital legionellosis outbreak linked to hot water showers: transmission by potable hot water.  Am J Epidemiol. 1987;  125 639-649
    PubMedGoogle Scholar
  • 27 Cordes L G, Wiesenthal A M, Gorman G W et al.. Isolation of Legionella pneumophila from hospital shower heads.  Ann Intern Med. 1981;  94 195-197
    PubMedGoogle Scholar
  • 28 Garbe P L, Davis B J, Weisfeld J S et al.. Nosocomial legionnaires' disease: epidemiologic demonstration of cooling towers as a source.  JAMA. 1985;  254 521-524
    CrossrefPubMedGoogle Scholar
  • 29 Levy P Y, Teysseire N, Etienne J, Raoult D. A nosocomial outbreak of Legionella pneumophila caused by contaminated transesophageal probes.  Infect Control Hosp Epidemiol. 2003;  24 619-622
    CrossrefPubMedGoogle Scholar
  • 30 Modol J, Sabria M, Reynaga E et al.. Hospital-acquired legionnaires disease in a university hospital: impact of the copper–silver ionization system.  Clin Infect Dis. 2007;  44 263-265
    CrossrefPubMedGoogle Scholar
  • 31 Tablan O C, Anderson L J, Besser R, Bridges C, Hajjeh R. CDC; Healthcare Infection Control Practices Advisory Committee . Guidelines for preventing health care associated pneumonia. 2003.  MMWR Recomm Rep. 2004;  53(RR-3) 1-36
    PubMedGoogle Scholar
  • 32 Marrie T J, Haldane D, Bezanson G. Nosocomial Legionnaires' disease: clinical and radiographic patterns.  Can J Infect Dis. 1992;  3 253-260
    PubMedGoogle Scholar
  • 33 Rudin J E, Wing E J. A comparative study of Legionella micdadei and other nosocomially acquired pneumonia.  Chest. 1984;  86 675-680
    CrossrefPubMedGoogle Scholar
  • 34 Kirby B D, Snyder K M, Meyer R D, Finegold S M. Legionnaires disease: report of 65 nosocomially acquired cases and review of the literature.  Medicine. 1980;  59 188-205
    PubMedGoogle Scholar
  • 35 Sanders K L, Walker D H, Lee T J. Relapse of legionnaires disease in a renal transplant recipient.  Arch Intern Med. 1980;  140 833-834
    CrossrefPubMedGoogle Scholar
  • 36 Marrie T J, Johnson W M, Tyler S D, Bezanson G S, Burbridge S. Genomic stability of Legionella pneumophila isolates recovered from two cardiac transplant patients with nosocomial legionnaires' disease.  J Clin Microbiol. 1994;  32 3085-3087
    PubMedGoogle Scholar
  • 37 Waterer G W, Baselski V S, Wunderink R G. Legionella and community-acquired pneumonia: a review of current diagnostic tests from a clinician's viewpoint.  Am J Med. 2001;  110 41-48
    CrossrefPubMedGoogle Scholar
  • 38 Den Boer J W, Yzerman E PF. Diagnosis of Legionella infection in legionnaires' disease.  Eur J Clin Microbiol Infect Dis. 2004;  23 871-878
    PubMedGoogle Scholar
  • 39 Plouffe J F, File Jr T M, Breiman R F et al.. Reevaluation of the definition of legionnaires disease: use of the urinary antigen assay. Community Based Pneumonia Incidence Study Group.  Clin Infect Dis. 1995;  20 1286-1291
    PubMedGoogle Scholar
  • 40 Plouffe J F, Breiman R F, Fields B S et al.. Azithromycin in the treatment of Legionella pneumonia requiring hospitalization.  Clin Infect Dis. 2003;  37 1475-1480
    CrossrefPubMedGoogle Scholar
  • 41 Yu V L, Greenberg R N, Zadeikis N et al.. Levofloxacin efficacy in the treatment of community-acquired legionellosis.  Chest. 2004;  125 2135-2139
    CrossrefPubMedGoogle Scholar
  • 42 Yu V L, Zuravleff J J, Gavlik L, Magnussen M H. Lack of evidence for person-to-person transmission of legionnaires' disease.  J Infect Dis. 1983;  147 362
    PubMedGoogle Scholar
  • 43 Marrie T J, George J, MacDonald S, Haase D. Are health care workers at risk for infection during an outbreak of nosocomial legionnaires' disease?.  Am J Infect Control. 1986;  14 209-213
    CrossrefPubMedGoogle Scholar
  • 44 Chanock R M. Mycoplasma infections of man.  N Engl J Med. 1965;  273 1199-1206, 1257–1264
    CrossrefPubMedGoogle Scholar
  • 45 Foy H M, Kenny G E, Mc Mahan A M, Grayston J T. Mycoplasma pneumoniae pneumonia in an urban area. Five years of surveillance.  JAMA. 1970;  214 1666-1672
    CrossrefPubMedGoogle Scholar
  • 46 Foy H M, Kenny G E, Cooney M K, Allan I D. Long-term epidemiology of infections with Mycoplasma pneumoniae. .  J Infect Dis. 1979;  139 681-687
    CrossrefPubMedGoogle Scholar
  • 47 Balassanian N, Robbins F C. Mycoplasma pneumoniae infection in families.  N Engl J Med. 1967;  277 719-725
    PubMedGoogle Scholar
  • 48 Kleemola M, Jokinen C. Mycoplasma pneumoniae infection among hospital personnel studied by nucleic acid hybridization test.  J Hosp Infect. 1992;  21 213-221
    CrossrefPubMedGoogle Scholar
  • 49 Louie M, Dyck B, Parker S et al.. Nosocomial pneumonia in a Canadian tertiary care center: a prospective surveillance study.  Infect Control Hosp Epidemiol. 1991;  12 356-363
    CrossrefPubMedGoogle Scholar
  • 50 Goldwater P N, Martin A J, Ryan B et al.. A survey of nosocomial respiratory viral infections in a children's hospital: occult respiratory infections in patients admitted during an epidemic season.  Infect Control Hosp Epidemiol. 1991;  12 231-238
    PubMedGoogle Scholar
  • 51 Casalta J P, Piquet P, Alazia M, Guidon-Attalia C, Drancourt M, Raoult D. Mycoplasma pneumoniae pneumonia following assisted ventilation.  Am J Med. 1996;  101 165-169
    CrossrefPubMedGoogle Scholar
  • 52 Fisher B, Yu B, Armstrong D, Magill J. Outbreak of Mycoplasma pneumoniae infection amongst hospital personnel.  Am J Med Sci. 1978;  276 205-209
    PubMedGoogle Scholar
  • 53 Schachter J, Stamm W E. Chlamydia. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH Manual of Clinical Microbiology. 7th ed. Washington, DC; American Society of Microbiology 1999: 795-806
    Google Scholar
  • 54 Troy C J, Peeling R W, Ellis A G et al.. Chlamydia pneumoniae as a new source of infectious outbreaks in nursing homes.  JAMA. 1997;  277 1214-1218
    CrossrefPubMedGoogle Scholar
  • 55 Grayston J T, Kuo C-C, Wang S-P, Altman J. A new Chlamydia psittaci strain, TWAR, isolated in acute respiratory tract infections.  N Engl J Med. 1986;  315 161-168
    PubMedGoogle Scholar
  • 56 Nakashima K, Tanaka T, Kramer M H et al.. Outbreak of Chlamydia pneumonia infection in a Japanese nursing home, 1999–2000.  Infect Control Hosp Epidemiol. 2006;  27 1171-1177
    CrossrefPubMedGoogle Scholar
  • 57 Strausbaugh L J, Sukumar S, Joseph C L. Infectious disease outbreaks in nursing homes: an unappreciated hazard for frail elderly persons.  Clin Infect Dis. 2003;  36 870-876
    CrossrefPubMedGoogle Scholar
  • 58 Loeb M, McGeer A, McArthur M, Peeling R W, Petric M, Simor A E. Surveillance for outbreaks of respiratory tract infections in nursing homes.  CMAJ. 2000;  162 1133-1137
    PubMedGoogle Scholar
  • 59 Hughes C, Maharg P, Rosario P et al.. Possible nosocomial transmission of psittacosis.  Infect Control Hosp Epidemiol. 1997;  18 165-168
    PubMedGoogle Scholar
  • 60 Heddema E R, van Hanner E J, Duim B et al.. An outbreak of psittacosis due to Chlamydophila psittaci genotype A in a veterinary teaching hospital.  J Med Microbiol. 2006;  55(Pt11) 1571-1575
    PubMedGoogle Scholar
  • 61 Marrie T J, Raoult D. Update on Q fever, including Q fever endocarditis. Current Clinical Topics in Infectious Diseases. Edited by Jack S. Remington, Morton N. Swartz Malden, MA; Blackwell Publishing 2002 22: 97-124
  • 62 Harman J B. Q fever in Great Britain; clinical account of eight cases.  Lancet. 1949;  2 1028-1030
    PubMedGoogle Scholar
  • 63 Gerth H-J, Leidig U, Reimenschneider T H. Q-fieber-epidemie in einem Institut fur Humanpathologie.  Dtsch Med Wochenschr. 1982;  107 1391-1395
    Article in Thieme ConnectPubMedGoogle Scholar
  • 64 Deutch D L, Peterson E T. Q fever: transmission from one human being to others.  JAMA. 1950;  143 348-350
    PubMedGoogle Scholar
  • 65 Raoult D, Stein A. Q fever during pregnancy: a risk factor for women, fetuses and obstetricians [letter].  N Engl J Med. 1994;  330 371
    CrossrefPubMedGoogle Scholar
  • 66 Osorio S, Sarria C, Gonzalez-Ruano P, Casal C, Garcia A. Nosocomial transmission of Q fever.  J Hosp Infect. 2003;  54 162-163
    CrossrefPubMedGoogle Scholar
  • 67 Schachter J, Sung M, Meyer K F. Potential danger of Q fever in a university environment.  J Infect Dis. 1971;  123 301-304
    PubMedGoogle Scholar
  • 68 Meiklejohn G, Reimer L G, Graves P S, Helmick C. Cryptic epidemic of Q fever in a medical school.  J Infect Dis. 1981;  144 107-114
    PubMedGoogle Scholar
  • 69 Hall C J, Richmond S J, Caul E O, Pearce N H, Silver I A. Laboratory outbreak of Q fever acquired from sheep.  Lancet. 1982;  1 1004-1006
    PubMedGoogle Scholar
  • 70 Curet L B, Paust J C. Transmission of Q fever from experimental sheep to laboratory personnel.  Am J Obstet Gynecol. 1972;  114 566-568
    PubMedGoogle Scholar
  • 71 National Association of State Public Health Veterinarians, Inc. (NASPHV); Centers for Disease Control and Prevention (CDC); Council of State and Territorial Epidemiologists; American Veterinary Medical Association . Compendium of measures to prevent disease associated with animals in public settings, 2007.  MMWR Recomm Rep. 2007;  56(RR-5) 1-14
    PubMedGoogle Scholar
  • 72 Bernard K W, Parham G L, Winkler W G, Helmick C G. Q fever control measures: recommendations for research facilities using sheep.  Infect Control. 1982;  3 461-465
    PubMedGoogle Scholar
  • 73 Perry S, Dennie C J, Coblentz C L, Cleland S. Minimizing the risk of Q fever in the hospital setting.  Can J Infect Control. 1994;  9 5-8
    PubMedGoogle Scholar
  • 74 Duchin J S, Koster F T, Peters C J et al.. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease.  N Engl J Med. 1994;  330 949-955
    CrossrefPubMedGoogle Scholar
  • 75 Peters C J, Khan A S. Hantavirus pulmonary syndrome: the new American hemorrhagic fever.  Clin Infect Dis. 2002;  34 1224-1231
    CrossrefPubMedGoogle Scholar
  • 76 Mills J N, Corneil A, Young J C, Garrison L E, Khan A S, Ksiazek T G. Hantavirus pulmonary syndrome—United States updated recommendations for risk reduction.  MMWR Recomm Rep. 2002;  51(RR-9) 1-12
    PubMedGoogle Scholar
  • 77 Lazaro M E, Cantoni G E, Calanni L M et al.. Clusters of hantavirus infection, Southern Argentina.  Emerg Infect Dis. 2007;  13 104-110
    PubMedGoogle Scholar
  • 78 Ferres M, Vial P, Marco C et al.. Prospective evaluation of household contacts of persons with hantavirus cardiopulmonary syndrome in Chile.  J Infect Dis. 2007;  195 1563-1571
    CrossrefPubMedGoogle Scholar
  • 79 Couch R B, Englund J A, Whimbey E. Respiratory viral infections in immunocompetent and immunocompromised persons.  Am J Med. 1997;  102(3A) 2-9
    PubMedGoogle Scholar
  • 80 Templeton K E, Scheltinga S A, van den Eeden W C, Graffelman A W, van den Broek P J, Claas E C. Improved diagnosis of the etiology of community-acquired pneumonia with real-time polymerase chain reaction.  Clin Infect Dis. 2005;  41 345-351
    CrossrefPubMedGoogle Scholar
  • 81 Allander T, Andreasson K, Gupta S et al.. Identification of a third human polyomavirus.  J Virol. 2007;  81 4130-4136
    CrossrefPubMedGoogle Scholar
  • 82 Gaynor A M, Nissen M D, Whiley D M et al.. Identification of a novel polyomavirus from patients with acute respiratory tract infections.  PLoS Pathog. 2007;  3 e64
    CrossrefPubMedGoogle Scholar
  • 83 Raad I, Abbas J, Whimbey E. Infection control of nosocomial respiratory viral disease in the immunocompromised host.  Am J Med. 1997;  102(3A) 48-52
    PubMedGoogle Scholar
  • 84 Nichols W G, Peck Campbell A J, Boeckh M. Respiratory viruses other than influenza virus: impact and therapeutic advances.  Clin Microbiol Rev. 2008;  21 274-290
    CrossrefPubMedGoogle Scholar
  • 85 Rosen L. A hemagglutination-inhibitor technique for typing adenoviruses.  Am J Hyg. 1960;  71 120-128
    PubMedGoogle Scholar
  • 86 Buescher E L. Respiratory disease and the adenoviruses.  Med Clin North Am. 1967;  51 769-779
    PubMedGoogle Scholar
  • 87 Gray G C, Goswami P R, Malasig M D et al.. Adult adenovirus infections: loss of orphaned vaccines precipitates military disease epidemics.  Clin Infect Dis. 2000;  31 663-670
    CrossrefPubMedGoogle Scholar
  • 88 Centers for Disease Control and Prevention (CDC) . Two fatal cases of adenovirus-related illness in previously healthy young adults—Illinois, 2000.  MMWR Morb Mortal Wkly Rep. 2001;  50 553-555
    PubMedGoogle Scholar
  • 89 Yamadera S, Yamashita K, Akatsuka M, Kato N, Inouye S. Trend of adenovirus type 7 infection, an emerging disease in Japan: a report of the national epidemiological surveillance of infectious agents in Japan.  Jpn J Med Sci Biol. 1998;  51 43-51
    PubMedGoogle Scholar
  • 90 Klinger J R, Sanchez M P, Curtin L A, Durkin M, Matyas B. Multiple cases of life threatening adenovirus pneumonia in a mental health care center.  Am J Respir Crit Care Med. 1998;  157 645-649
    CrossrefPubMedGoogle Scholar
  • 91 Centers for Disease Control and Prevention (CDC) . Acute respiratory disease associated with adenovirus serotype 14—four states, 2006–2007.  MMWR Morb Mortal Wkly Rep. 2007;  56 1181-1184
    PubMedGoogle Scholar
  • 92 Palomino M A, Larranaga C, Avendano L F. Hospital-acquired adenovirus 7th infantile respiratory infection in Chile.  Pediatr Infect Dis J. 2000;  19 527-531
    PubMedGoogle Scholar
  • 93 Hatherill M, Levin M, Lawrenson J, Hsiao N Y, Reynolds L, Argent A. Evolution of an adenovirus outbreak in a multidisciplinary children's hospital.  J Paediatr Child Health. 2004;  40 449-454
    PubMedGoogle Scholar
  • 94 Levandowski R A, Rubenis M. Nosocomial conjunctivitis caused by adenovirus type 4.  J Infect Dis. 1981;  143 28-31
    PubMedGoogle Scholar
  • 95 James L, Vernon M O, Jones R C et al.. Outbreak of human adenovirus type 3 infection in a pediatric long-term care facility—Illinois, 2005.  Clin Infect Dis. 2007;  45 416-420
    CrossrefPubMedGoogle Scholar
  • 96 Singh-Naz N, Brown M, Ganeshananthan M. Nosocomial adenovirus infection: molecular epidemiology of an outbreak.  Pediatr Infect Dis J. 1993;  12 922-925
    CrossrefPubMedGoogle Scholar
  • 97 Larranaga C, Martinez J, Palomino A, Pena M, Carrion F, Avendano L F. Molecular characterization of hospital-acquired adenovirus infantile respiratory infection in Chile using species-specific PCR assays.  J Clin Virol. 2007;  39 175-181
    CrossrefPubMedGoogle Scholar
  • 98 Abad F X, Pinto R M, Bosch A. Survival of enteric viruses on environmental fomites.  Appl Environ Microbiol. 1994;  60 3704-3710
    PubMedGoogle Scholar
  • 99 Nwachuku N, Gerba C P, Oswald A, Mashadi F D. Comparative inactivation of adenovirus serotypes by UV light disinfection.  Appl Environ Microbiol. 2005;  71 5633-5636
    CrossrefPubMedGoogle Scholar
  • 100 Takeuchi R, Nomura M, Kojima M, Uchio E, Kobayashi N, Matumoto M. A nosocomial outbreak of epidemic keratoconjunctivitis due to adenovirus type 37.  Microbiol Immunol. 1990;  34 749-754
    PubMedGoogle Scholar
  • 101 Aitken C, Jeffries D J. Nosocomial spread of viral disease.  Clin Microbiol Rev. 2001;  14 528-546
    CrossrefPubMedGoogle Scholar
  • 102 American Academy of Pediatrics .Adenovirus infections. In: Pickering LK, Baker CJ, Long SS, McMillan JA Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL; American Academy of Pediatrics 2006: 202-204
    Google Scholar
  • 103 Allander T, Tammi M T, Eriksson M et al.. Cloning of a human parvovirus by molecular screening of respiratory tract samples.  Proc Natl Acad Sci U S A. 2005;  102 12891-12896
    CrossrefPubMedGoogle Scholar
  • 104 Kesebir D, Vazquez M, Weibel C et al.. Human bocavirus infection in young children in the United States: molecular epidemiology profile and clinical characteristics of a newly emerging respiratory virus.  J Infect Dis. 2006;  194 1276-1282
    CrossrefPubMedGoogle Scholar
  • 105 Kleines M, Scheithauer S, Rackowitz A, Ritter K, Hausler M. High prevalence of human bocavirus detected in young children with severe acute lower respiratory tract disease by use of a standard PCR protocol and a novel real-time PCR protocol.  J Clin Microbiol. 2007;  45 1032-1034
    CrossrefPubMedGoogle Scholar
  • 106 Bastien N, Brandt K, Dust K, Ward D, Li Y. Human bocavirus infection, Canada.  Emerg Infect Dis. 2006;  12 848-850
    PubMedGoogle Scholar
  • 107 Kantola K, Hedman L, Allander T et al.. Serodiagnosis of human bocavirus infection.  Clin Infect Dis. 2008;  46 540-546
    CrossrefPubMedGoogle Scholar
  • 108 Allander T. Human bocavirus.  J Clin Virol. 2008;  41 29-33
    CrossrefPubMedGoogle Scholar
  • 109 Schildgen O, Muller A, Allander T et al.. Human bocavirus: passenger of pathogen in acute respiratory tract infections?.  Clin Microbiol Rev. 2008;  21 291-304
    CrossrefPubMedGoogle Scholar
  • 110 Papadopoulos N G, Hunter J, Sanderson G, Johnston S L. Rhinovirus identification by Bgl I digestion of picornavirus amplicons.  J Virol Methods. 1999;  80 179-185
    CrossrefPubMedGoogle Scholar
  • 111 Ghosh S, Champlin R, Couch R et al.. Rhinovirus infections in myelosuppressed adult bone and marrow transplant recipients.  Clin Infect Dis. 1999;  29 528-532
    CrossrefPubMedGoogle Scholar
  • 112 Wald T G, Shult P, Krause P, Miller B A, Drinka P, Gravenstein S. A rhinovirus outbreak among residents of a long-term care facility.  Ann Intern Med. 1995;  123 588-593
    CrossrefPubMedGoogle Scholar
  • 113 Hendley J O, Gwaltney Jr J M. Mechanisms of transmission of rhinovirus infections.  Epidemiol Rev. 1988;  10 243-258
    PubMedGoogle Scholar
  • 114 Kaiser L, Hayden F G. Rhinovirus pneumonia: a clinical entity?.  Clin Infect Dis. 1999;  29 533-535
    PubMedGoogle Scholar
  • 115 Wenzel R P, Hendley J O, Davies J A, Gwaltney Jr J M. Coronavirus infections in military recruits: three year study with coronavirus strains OC43 and 229E.  Am Rev Respir Dis. 1974;  109 621-624
    PubMedGoogle Scholar
  • 116 McIntosh K, Chao R K, Krause H E, Wasil R, Mocega H E, Mufson M A. Coronavirus infection in acute lower respiratory tract disease of infants.  J Infect Dis. 1974;  130 502-507
    PubMedGoogle Scholar
  • 117 Ksiazek T G, Erdman D, Goldsmith C S and the SARS Working Group et al.. A novel coronavirus associated with severe acute respiratory syndrome.  N Engl J Med. 2003;  348 1953-1966
    CrossrefPubMedGoogle Scholar
  • 118 van der Hoek L, Pyrc K, Jebbink M F et al.. Identification of a new human coronavirus.  Nat Med. 2004;  10 368-373
    CrossrefPubMedGoogle Scholar
  • 119 Fouchier R A, Hartwig N G, Bestebroer T M et al.. A previously undescribed coronavirus associated with respiratory disease in humans.  Proc Natl Acad Sci U S A. 2004;  101 6212-6216
    CrossrefPubMedGoogle Scholar
  • 120 Esper F, Weibel C, Ferguson D, Landry M L, Kahn J. Evidence of a novel human coronavirus that is associated with respiratory tract disease in infants and young children.  J Infect Dis. 2005;  191 492-498
    CrossrefPubMedGoogle Scholar
  • 121 Kahn J S. The widening scope of coronaviruses.  Curr Opin Pediatr. 2006;  18 42-47
    PubMedGoogle Scholar
  • 122 Woo P C, Lau S K, Huang Y, Tsoi H W, Chan K H, Yuen K Y. Phylogenetic and recombination analysis of coronavirus HKU1, a novel coronavirus from patients with pneumonia.  Arch Virol. 2005;  150 2299-2311
    CrossrefPubMedGoogle Scholar
  • 123 Woo P C, Lau S K, Tsoi H W et al.. Clinical and molecular epidemiological features of coronavirus HKU1-associated community-acquired pneumonia.  J Infect Dis. 2005;  192 1898-1907
    CrossrefPubMedGoogle Scholar
  • 124 Kuypers J, Martin E T, Heugel J, Wright N, Morrow R, Englund J A. Clinical disease in children associated with newly described coronavirus subtypes.  Pediatrics. 2007;  119 e70-e76
    CrossrefPubMedGoogle Scholar
  • 125 Clarke S KR. Parainfluenza virus infections.  Postgrad Med J. 1973;  49 792-797
    CrossrefPubMedGoogle Scholar
  • 126 Clarke S KR. Parainfluenza virus infections.  Postgrad Med J. 1973;  49 792-797
    CrossrefPubMedGoogle Scholar
  • 127 Wendt C H, Weisdorf D J, Jordan M C, Balfour Jr H H, Hertz M I. Parainfluenza virus respiratory infection after bone marrow transplantation.  N Engl J Med. 1992;  326 921-926
    CrossrefPubMedGoogle Scholar
  • 128 Lewis V A, Champlin R, Englund J et al.. Respiratory disease due to parainfluenza virus in adult bone marrow transplant recipients.  Clin Infect Dis. 1996;  23 1033-1037
    CrossrefPubMedGoogle Scholar
  • 129 Whimbey E, Vartivarian S E, Champlin R E, Elting L S, Luna M, Bodey G P. Parainfluenza virus infection in adult bone marrow transplant recipients.  Eur J Clin Microbiol Infect Dis. 1993;  12 699-701
    CrossrefPubMedGoogle Scholar
  • 130 Lau S KP, To W, Tse P WT et al.. Human parainfluenza virus 4 outbreak and the role of diagnostic tests.  J Clin Microbiol. 2005;  43 4515-4521
    CrossrefPubMedGoogle Scholar
  • 131 Cortez K J, Erdman D D, Peret T C et al.. Outbreak of human parainfluenza virus 3 infection in a hematopoietic stem cell transplant population.  J Infect Dis. 2001;  184 1093-1097
    CrossrefPubMedGoogle Scholar
  • 132 Fiore A E, Iverson C, Messmer T et al.. Outbreak of pneumonia in a long-term care facility: antecedent parainfluenza virus type 1 infection may predispose to bacterial pneumonia.  J Am Geriatr Soc. 1998;  46 1112-1117
    CrossrefPubMedGoogle Scholar
  • 133 Zambon M, Bull T, Sadler C J, Goldman J M, Ward K N. Molecular epidemiology of two consecutive outbreaks of parainfluenza 3 in a bone marrow transplant unit.  J Clin Microbiol. 1998;  36 2289-2293
    PubMedGoogle Scholar
  • 134 Jalal H, Bibby D F, Bennett J et al.. Molecular investigation of an outbreak of parainfluenza virus type 3 and respiratory syncytial virus infections in a hematology unit.  J Clin Microbiol. 2007;  45 1690-1696
    CrossrefPubMedGoogle Scholar
  • 135 Nichols W G, Erdman D D, Han A, Zukerman C, Corey L, Boeckh M. Prolonged outbreak of human parainfluenza virus 3 infection in a stem cell transplant outpatient department: insights from molecular epidemiologic analysis.  Biol Blood Marrow Transplant. 2004;  10 58-64
    PubMedGoogle Scholar
  • 136 Brady M T, Evans J, Cuartas J. Survival and disinfection of parainfluenza viruses on environmental surfaces.  Am J Infect Control. 1990;  18 18-23
    CrossrefPubMedGoogle Scholar
  • 137 Van den Hoogen B G, de Jong J C, Groen J et al.. A newly discovered human pneumovirus isolated from young children with respiratory tract disease.  Nat Med. 2001;  7 719-724
    PubMedGoogle Scholar
  • 138 Crowe Jr J E. Human metapneumovirus as a major cause of human respiratory tract disease.  Pediatr Infect Dis J. 2004;  23 S215-S221
    PubMedGoogle Scholar
  • 139 Falsey A R, Erdman D, Anderson L J et al.. Human metapneumovirus infections in young and elderly adults.  J Infect Dis. 2003;  187 785-790
    CrossrefPubMedGoogle Scholar
  • 140 Hamelin M E, Cote S, Laforge J et al.. Human metapneumovirus infection in adults with community acquired pneumonia and exacerbation of chronic obstructive pulmonary disease.  Clin Infect Dis. 2005;  41 498-502
    CrossrefPubMedGoogle Scholar
  • 141 O'Gorman C, McHenry E, Coyle P V. Human metapneumovirus in adults: a short case series.  Eur J Clin Microbiol Infect Dis. 2006;  25 190-192
    CrossrefPubMedGoogle Scholar
  • 142 Stockton J, Stephenson I, Fleming D, Zambon M. Human metapneumovirus as a cause of community acquired respiratory illness.  Emerg Infect Dis. 2002;  8 897-901
    CrossrefPubMedGoogle Scholar
  • 143 Boivin G, Abed Y, Pelletier G et al.. Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory tract infections in all age groups.  J Infect Dis. 2002;  186 1330-1334
    CrossrefPubMedGoogle Scholar
  • 144 Boivin G, De Serres G, Hamelin M et al.. An outbreak of severe respiratory tract infection due to human metapneumovirus in a long-term care facility.  Clin Infect Dis. 2007;  44 1152-1158
    CrossrefPubMedGoogle Scholar
  • 145 Johnstone J, Majumdar S R, Fox J D, Marrie T J. Presentation of human metapneumovirus in adults: results from a prospective study.  Clin Infect Dis. 2008;  46 571-574
    CrossrefPubMedGoogle Scholar
  • 146 Chano F, Rousseau C, Laferrier C, Couillard M, Charest H. Epidemiological survey of human metapneumovirus in a large pediatric tertiary care center.  J Clin Microbiol. 2005;  43 5520-5525
    CrossrefPubMedGoogle Scholar
  • 147 Cheng V CC, Wu A KL, Cheung C HY et al.. Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol handrub in prevention of nosocomial outbreaks.  J Hosp Infect. 2007;  67 336-343
    CrossrefPubMedGoogle Scholar
  • 148 Evashuk K M, Forgie S E, Gilmour S, Huynh H, Lee B E, Robinson J L. Respiratory failure associated with human metapneumovirus infection in an infant posthepatic transplant.  Am J Transplant. 2008;  8 1567-1569
    CrossrefPubMedGoogle Scholar
  • 149 Adams J. Primary virus pneumonitis with cytoplasmic inclusion bodies: a study of an epidemic involving thirty-two infants with nine deaths.  JAMA. 1941;  116 925-933
    PubMedGoogle Scholar
  • 150 Morris J A, Blount Jr R E, Savage R E. Recovery of cytopathogenic agent from chimpanzees with coryza.  Proc Soc Exp Biol Med. 1956;  92 544-549
    PubMedGoogle Scholar
  • 151 Chanock R, Roizman B, Myers R. Recovery from infants with respiratory illness of a virus related to chimpanzee coryza agent (CCA). I. Isolation, properties and characterization.  Am J Hyg. 1957;  66 281-290
    PubMedGoogle Scholar
  • 152 Adams J M, Imagawa D T, Zike K. Epidemic bronchiolitis and pneumonia related to respiratory syncytial virus.  JAMA. 1961;  176 1037-1039
    PubMedGoogle Scholar
  • 153 Black C P. Systematic review of the biology and medical management of respiratory syncytial virus infection.  Respir Care. 2003;  48 209-233
    PubMedGoogle Scholar
  • 154 Hall C B. Nosocomial respiratory syncytial virus infections.  N Engl J Med. 1975;  293 1343-1346
    PubMedGoogle Scholar
  • 155 Hall C B. The nosocomial spread of respiratory syncytial virus infections.  Annu Rev Med. 1983;  34 311-319
    CrossrefPubMedGoogle Scholar
  • 156 Langley J M, LeBlanc J C, Wang E E et al.. Nosocomial respiratory syncytial virus infection in Canadian pediatric hospitals: a pediatric investigators collaborative network on infections in Canada study.  Pediatrics. 1997;  100 943-946
    CrossrefPubMedGoogle Scholar
  • 157 Hall C B, Kopelman A, Douglas R J. Neonatal respiratory syncytial virus infections.  N Engl J Med. 1979;  300 393-396
    CrossrefPubMedGoogle Scholar
  • 158 Forster J, Schumacher R. The clinical picture presented by premature neonates infected with the respiratory syncytial virus.  Eur J Pediatr. 1995;  154 901-905
    CrossrefPubMedGoogle Scholar
  • 159 Falsey A R, McCann R M, Hall W J et al.. Acute respiratory tract infection in daycare centers for older persons.  J Am Geriatr Soc. 1995;  43 30-36
    CrossrefPubMedGoogle Scholar
  • 160 Osterweil D, Norman D. An outbreak of an influenza-like illness in a nursing home.  J Am Geriatr Soc. 1990;  38 659-662
    PubMedGoogle Scholar
  • 161 Sorvillo F J, Huie S F, Strassburg M A, Butsumyo A, Shandera W X, Fannin S L. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly.  J Infect. 1984;  9 252-256
    CrossrefPubMedGoogle Scholar
  • 162 Falsey A R, Cunningham C K, Barker W H et al.. Respiratory syncytial virus and influenza A infections in the hospitalized elderly.  J Infect Dis. 1995;  172 389-394
    CrossrefPubMedGoogle Scholar
  • 163 Falsey A R, Treanor J J, Betts R F, Walsh E E. Viral respiratory infections in the institutionalized elderly: clinical and epidemiologic findings.  J Am Geriatr Soc. 1992;  40 115-119
    CrossrefPubMedGoogle Scholar
  • 164 Hall W J, Hall C B, Speers D M. Respiratory syncytial virus infections in adults: clinical, virologic, and serial pulmonary function studies.  Ann Intern Med. 1978;  88 203-205
    PubMedGoogle Scholar
  • 165 Hall C B, Geiman J M, Biggar R, Kotok D I, Hogan P M, Douglas Jr R G. Respiratory syncytial virus infections within families.  N Engl J Med. 1976;  294 414-419
    PubMedGoogle Scholar
  • 166 Falsey A R, Hennessey R N, Formica M A et al.. Respiratory syncytial virus infection in elderly and high risk adults.  N Engl J Med. 2005;  352 1749-1759
    CrossrefPubMedGoogle Scholar
  • 167 Hall C B, Douglas Jr R G. Modes of transmission of respiratory syncytial virus.  J Pediatr. 1981;  99 100-103
    CrossrefPubMedGoogle Scholar
  • 168 Hall C B, Douglas Jr R G, Schnabel K C, Geiman J M. Infectivity of respiratory syncytial virus by various routes of inoculation.  Infect Immun. 1981;  33 779-783
    PubMedGoogle Scholar
  • 169 Hall C B. Nosocomial respiratory syncytial virus infections: the “Cold War” has not ended.  Clin Infect Dis. 2000;  31 590-596
    CrossrefPubMedGoogle Scholar
  • 170 Hall C B, Geiman J M, Douglas Jr R G, Meagher M P. Control of nosocomial respiratory syncytial viral infections.  Pediatrics. 1978;  62 728-732
    PubMedGoogle Scholar
  • 171 Hall C B, Walsh E E, Long C E, Schnabel K C. Immunity to and frequency of reinfection with respiratory syncytial virus.  J Infect Dis. 1991;  163 693-698
    CrossrefPubMedGoogle Scholar
  • 172 Henderson F W, Collier A M, Clyde Jr W A, Denny F W. Respiratory-syncytial-virus infections, reinfections and immunity: a prospective, longitudinal study in young children.  N Engl J Med. 1979;  300 530-534
    CrossrefPubMedGoogle Scholar
  • 173 Hall C B, Douglas Jr R G, Geiman J M. Respiratory syncytial virus infections in infants: quantitation and duration of shedding.  J Pediatr. 1976;  89 11-15
    CrossrefPubMedGoogle Scholar
  • 174 Hall C B, Powell K R, MacDonald N E et al.. Respiratory syncytial viral infection in children with compromised immune function.  N Engl J Med. 1986;  315 77-80
    CrossrefPubMedGoogle Scholar
  • 175 Hall C B, Douglas Jr R G, Geiman J M. Possible transmission by fomites of respiratory syncytial virus.  J Infect Dis. 1980;  141 98-102
    Google Scholar
  • 176 Karanfil L V, Conlon M, Lykens K et al.. Reducing the rate of nosocomially transmitted respiratory syncytial virus.  Am J Infect Control. 1999;  27 91-96
    CrossrefPubMedGoogle Scholar
  • 177 Snydman D R, Greer C, Meissner H C, McIntosh K. Prevention of nosocomial transmission of respiratory syncytial virus in a newborn nursery.  Infect Control Hosp Epidemiol. 1988;  9 105-108
    PubMedGoogle Scholar
  • 178 Krasinski K, LaCouture R, Holzman R S, Waithe E, Bonk S, Hanna B. Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission.  J Pediatr. 1990;  116 894-898
    CrossrefPubMedGoogle Scholar
  • 179 Rotter M L. Hand washing and hand disinfection. In: Mayhall CG Hospital Epidemiology and Infection Control. 2nd ed. Philadelphia; Lippincott, Williams & Wilkins 1999: 1339-1355
    Google Scholar
  • 180 Pittet D, Mouraga P, Pernegar T V et al.. Compliance with hand hygiene in a teaching hospital.  Ann Intern Med. 1999;  130 126-129
    PubMedGoogle Scholar
  • 181 Hugonnet S, Perneger T V, Pittet D. Alcohol-based handrub improves compliance with hand hygiene in intensive care units.  Arch Intern Med. 2002;  162 1037-1043
    CrossrefPubMedGoogle Scholar
  • 182 Harbarth S, Pittet D, Grady L et al.. Interventional study to evaluate the impact of an alcohol-based hand gel in improving hand hygiene compliance.  Pediatr Infect Dis J. 2002;  21 489-495
    PubMedGoogle Scholar
  • 183 Hall C B, Douglas Jr R G, Geiman J M. Possible transmission by fomites of respiratory syncytial virus.  J Infect Dis. 1980;  141 98-102
    Google Scholar
  • 184 Davis P J, Spady D, Forgie S E. A survey of Alberta physicians' use of and attitudes toward face masks and face shields in the operating room setting.  Am J Infect Control. 2007;  35 455-459
    CrossrefPubMedGoogle Scholar
  • 185 Alcasid G, Garcia-Houchins S, Peev M, Marcinak J, Weber S G. Failure to Institute appropriate isolation precautions for suspected respiratory syncytial virus (RSV) infection: frequency and identification of risk factors.  Am J Infect Control. 1994;  32 E1
    PubMedGoogle Scholar
  • 186 Sehulster L, Chinn R Y. Centers for Disease Control and Prevention, HICPAC . Guidelines for environmental infection control in healthcare facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).  MMWR Recomm Rep. 2003;  52(RR-10) 1-42
    PubMedGoogle Scholar
  • 187 Couch R B, Kasel J A, Glezen W P et al.. Influenza: its control in persons and populations.  J Infect Dis. 1986;  153 431-440
    CrossrefPubMedGoogle Scholar
  • 188 Connolly A M, Salmon R L, Williams D H. What are the complications of influenza and can they be prevented? Experience from the 1989 epidemic of H 3 N2 influenza A in general practice.  BMJ. 1993;  306 1452-1454
    PubMedGoogle Scholar
  • 189 Schoch-Spana M. Implications of pandemic influenza for bioterrorism response.  Clin Infect Dis. 2000;  31 1409-1413
    CrossrefPubMedGoogle Scholar
  • 190 Lui K-J, Kendal A P. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985.  Am J Public Health. 1987;  77 712-716
    CrossrefPubMedGoogle Scholar
  • 191 Monto A S, Kioumehr F. Tecumseh study of respiratory illness, IX: Occurrence of influenza in the community, 1966–1971.  Am J Epidemiol. 1975;  102 553-563
    PubMedGoogle Scholar
  • 192 Cox N J, Fukuda K. Influenza.  Infect Dis Clin North Am. 1998;  12 27-38
    CrossrefPubMedGoogle Scholar
  • 193 Cate T R. Viral pneumonia due to influenza and parainfluenza viruses and adenoviruses. In: Marrie TJ Community-Acquired Pneumonia. New York; Kluwer Academic/Plenum 2001: 593-616
    Google Scholar
  • 194 Bridges C B, Fukuda K, Cox N J, Singleton J A. Advisory Committee on Immunization Practices . Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP).  MMWR Recomm Rep. 2001;  50(RR-4) 1-44
    PubMedGoogle Scholar
  • 195 Kaiser L, Hayden F G. Hospitalizing influenza in adults.  Curr Clin Top Infect Dis. 1999;  19 112-134
    PubMedGoogle Scholar
  • 196 Public Heath Agency of Canada .Pandemic Influenza Plan. http://www.phac-aspc.gc.ca/cpip-pclcpi/index.html
    Google Scholar
  • 197 Webster R G, Peiris M, Chen H, Guan Y. H5N1 outbreaks and enzootic influenza.  Emerg Infect Dis. 2006;  12 3-8
    PubMedGoogle Scholar
  • 198 World Health Organization .Cumulative number of confirmed cases of Avian Influenza A/(H5N1) reported to WHO. Available at: http://www.who.int/csr/disease/avian_influenza/country/cases_table__2007__07_02_03/en/index.html
    Google Scholar
  • 199 Simor A E. Influenza outbreaks in long-term care facilities: how can we do better?.  Infect Control Hosp Epidemiol. 2002;  23 564-567
    CrossrefPubMedGoogle Scholar
  • 200 Pachucki C T, Walsh Pappas S A, Fuller G F, Krause S L, Lentino J R, Schaaf D M. Influenza A among hospital personnel and patients.  Arch Intern Med. 1989;  149 77-80
    CrossrefPubMedGoogle Scholar
  • 201 Horcajada J P, Pumarola T, Martinez J et al.. A nosocomial outbreak of influenza during a period without influenza epidemic activity.  Eur Respir J. 2003;  21 303-307
    CrossrefPubMedGoogle Scholar
  • 202 World Health Organization Writing Group . Non-pharmaceutical interventions for pandemic influenza, national and community measures.  Emerg Infect Dis. 2006;  12 88-94
    PubMedGoogle Scholar
  • 203 Sokol D K. Virulent epidemics and scope of healthcare workers' duty of care.  Emerg Infect Dis. 2006;  12 1238-1241
    PubMedGoogle Scholar
  • 204 Starr I. Influenza in 1918: recollections of the epidemic in Philadelphia.  Ann Intern Med. 2006;  145 138-140
    PubMedGoogle Scholar
  • 205 Low D. microbiologist-in-chief, Mount Sinai Hospital, Toronto, Canada .Personal communication. 
    Google Scholar
  • 206 Holmberg S D, Layton C M, Ghneim G S, Wagenert D K. State plans for containment of pandemic influenza.  Emerg Infect Dis. 2006;  12 1414-1417
    PubMedGoogle Scholar
  • 207 Mounier-Jack S, Coker R J. How prepared is Europe for pandemic influenza? Analysis of national plans.  Lancet. 2006;  367 1405-1411
    CrossrefPubMedGoogle Scholar
  • 208 Brankston G, Gitterman L, Hirji Z, Lemieux C, Gardam M. Transmission of influenza in human beings.  Lancet Infect Dis. 2007;  7 257-265
    CrossrefPubMedGoogle Scholar
  • 209 Buxton-Bridges C, Kuehnert M J, Hall C B. Transmission of influenza. implications for control in health care settings.  Clin Infect Dis. 2003;  37 1094-1101
    CrossrefPubMedGoogle Scholar
  • 210 Riley R L. Airborne infection.  Am J Med. 1974;  57 466-475
    CrossrefPubMedGoogle Scholar
  • 211 Goldrock LR, Liverman CT Preparing for an influenza pandemic: personal protective equipment for healthcare workers. 2007 Available at: http://www.nap.edu/catalog/11980.html
    Google Scholar
  • 212 Hui D SC, Sung J JY. Severe acute respiratory syndrome.  Chest. 2003;  124 12-15
    CrossrefPubMedGoogle Scholar
  • 213 Feng Y, Gao G F. Towards our understanding of SARS-CoV an emerging and devastating but quickly conquered virus.  Comp Immunol Microbiol Infect Dis. 2007;  30 309-327
    PubMedGoogle Scholar
  • 214 Kuiken T, Fouchier R AM, Schutten M et al.. Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.  Lancet. 2003;  362 263-270
    CrossrefPubMedGoogle Scholar
  • 215 Wang L-F, Shi Z, Zhang S, Field H, Daszak P, Eaton B T. Review of bats and SARS.  Emerg Infect Dis. 2006;  12 1834-1840
    PubMedGoogle Scholar
  • 216 Gu J, Korteweg C. Pathology and pathogenesis of severe acute respiratory syndrome.  Am J Pathol. 2007;  170 1136-1147
    CrossrefPubMedGoogle Scholar
  • 217 Peiris J S, Yuen K Y, Osterhaus A D, Stohr K. The severe acute respiratory syndrome.  N Engl J Med. 2003;  349 2431-2441
    CrossrefPubMedGoogle Scholar
  • 218 Yu I T, Li Y, Wong T W et al.. Evidence of airborne transmission of severe acute respiratory syndrome virus.  N Engl J Med. 2004;  350 1731-1739
    CrossrefPubMedGoogle Scholar
  • 219 Wenzel R P, Bearman G, Edmond M B. Lessons from severe acute respiratory distress syndrome (SARS): implications for infection control.  Arch Med Res. 2005;  36 610-616
    CrossrefPubMedGoogle Scholar
  • 220 Olsen S J, Chang H-L, Cheung T-Y et al.. Transmission of severe acute respiratory syndrome on aircraft.  N Engl J Med. 2003;  349 2416-2422
    CrossrefPubMedGoogle Scholar
  • 221 Yu I T, Xie Z H, Tsoi K K et al.. Why did outbreaks of severe acute respiratory syndrome occur in some hospital wards but not in others?.  Clin Infect Dis. 2007;  44 1017-1025
    CrossrefPubMedGoogle Scholar
  • 222 Christian M D, Loutly M, McDonald L C et al.. Possible SARS coronavirus transmission during cardiopulmonary resuscitation.  Emerg Infect Dis. 2004;  10 287-293
    PubMedGoogle Scholar
  • 223 Chen M I, Chow A L, Earnest A, Leong H N, Leo Y S. Clinical and epidemiological predictors of transmission is severe acute respiratory syndrome (SARS).  BMC Infect Dis. 2006;  6 151
    CrossrefPubMedGoogle Scholar
  • 224 Cai Q-C, Lu J, Xu Q-F et al.. Influence of meteorological factors and air pollution on the outbreak of acute respiratory syndrome.  Public Health. 2007;  121 258-265
    CrossrefPubMedGoogle Scholar
  • 225 Goh D L, Lee B W, Chia K S et al.. Secondary household transmission of SARS, Singapore.  Emerg Infect Dis. 2004;  10 232-234
    PubMedGoogle Scholar
  • 226 Rea E, LaFleche J L, Stalker S et al.. Duration and distance of exposure are important predictors of transmission among community contacts of Ontario SARS cases.  Epidemiol Infect. 2007;  135 914-921
    CrossrefPubMedGoogle Scholar
  • 227 Rainer T H, Lee N, Ip M et al.. Features discriminating SARS from other severe viral respiratory tract infections.  Eur J Clin Microbiol Infect Dis. 2007;  26 121-129
    CrossrefPubMedGoogle Scholar
  • 228 Muller M, Tomlinson G, Marrie T J et al.. Can routine laboratory tests discriminate between severe acute respiratory syndrome and other causes of community-acquired pneumonia?.  Clin Infect Dis. 2005;  40 1079-1086
    CrossrefPubMedGoogle Scholar
  • 229 Ovens H, Thompson J, Lyver M, Murray M J, Innes G. Implications of the SARS outbreak for Canadian emergency departments.  CJEM. 2003;  5 343-347
    PubMedGoogle Scholar
  • 230 Campbell A. The SARS Commission Report. Available at: http://www.sarscommission.ca/report/index.html Accessed May 21, 2008
    Google Scholar
  • 231 Lee A M, Wong J GWS, McAlonan G M et al.. Stress and psychological distress among SARS survivors one year after the outbreak.  Can J Psychiatry. 2007;  52 233-240
    CrossrefPubMedGoogle Scholar
  • 232 Tansey C M, Louie M, Loeb M et al.. One year outcomes and health care utilization in survivors of severe acute respiratory syndrome.  Arch Intern Med. 2007;  167 1312-1320
    CrossrefPubMedGoogle Scholar
  • 233 Hwang S W, Cheung A M, Moineddin R, Bell C M. Population mortality during the outbreak of severe acute respiratory syndrome in Toronto.  BMC Public Health. 2007;  7 93
    CrossrefPubMedGoogle Scholar

Sarah ForgieM.D. 

Department of Pediatrics, University of Alberta, 8224A Aberhart Centre

Edmonton, AB, Canada T6G 2J3

Email: sarahforgie@cha.ab.ca