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UBC Theses and Dissertations

Respiratory infection in the hospital setting : modeling transmission patterns and intervention strategies using multitype contact networks Gauld, Jillian


Respiratory infections in the hospital setting are a burden to patients, healthcare workers and the surrounding community. The patterns of disease spread in hospital settings are difficult to capture, due to the heterogeneous rates of contact among healthcare workers (HCWs). Patterns of healthcare worker contact were analyzed for a large Canadian hospital. A novel tool was developed to capture the heterogeneous patterns in contact in hospital settings, and data from the Canadian hospital was used to inform a realistic contact network. The spread of respiratory infections with reproductive numbers approximating SARS, influenza, and measles were simulated on the network, and control strategies including vaccination, transmission reduction, and social distancing were tested. The efficacies of measures were compared between subsets of the population, which were divided by occupation and contact rate. The results of this study found that nurses are in the most contact with other healthcare workers, but the least mobile. Additionally, “other” healthcare workers such as respiratory therapists are at a high likelihood for superspreading events in the hospital setting. This study also identified locations that would reach a large subset of the hospital, which could be used for hand-washing stations or other interventions. Simulations suggest targeting the most highly connected HCW occupations for vaccination, transmission reduction measures, and social distancing may lead to more effective disease containment in outbreak scenarios, and a reduction in resources needed. The results of this study can be used to inform policy decisions, and direct future research towards targeted control strategies in hospital settings.

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Attribution-NonCommercial-NoDerivs 2.5 Canada