Fatigue and tiredness are common sequelae after TBE at long-term follow-up: A self-reported case-control study in Western Gotaland, Sweden

No: 1464 Presentation at ESCV 2015: Poster 1 Fatigue and tiredness are common sequelae after TBE at long-term follow-up: A self-reported case-control study in Western Gotaland, Sweden M. Veje1,∗, T. Bergstrom1, M. Petzold2, T. Linden3, P. Nolskog4, M. Studahl1 1 Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden 2 Centre for applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Sweden 3 Department of Neurology, Sahlgrenska Academy, University of Gothenburg, Sweden 4 Department for Communicable Disease Control in Western Gotaland, Sweden Background: Fatigue and tiredness are common sequelae after TBE at long-term follow-up: a self-reported case–control study in Western Gotaland, Sweden Abs tract Background Tick-borne encephalitis (TBE), caused by the TBE virus (TBEV), is a major neurotropic infectious disease throughout Europe and Asia. The symptoms vary from a very mild disease to a fatal meningoencephalitis. Neurological sequelae are common. Our aim was to study symptoms in patients with TBE (Tick-Borne Encephalitis) infected in Western Gotaland 1997–2012, both in the acute phase and at follow-up after 2–15 years. Methods: Medical records of 96 TBE patients were studied. Phone based interviews regarding symptoms after encephalitis were heldwith 92 patients and 58 control persons,matched by age, sex and residence area (zip code), using the Encephalitis Support Group Questionnaire 2000. Patients and controls also answered a written survey regarding functional outcome of sleep (FOSQ). Results: 35% of the patients were classified as having a mild disease in the acute phase, 56% a moderate and 7.3% had a severe disease. At follow-up after 2–15 years (median time 5.5 years) there was a significant difference between patients and controls regarding the dimensions memory, executive functions and motor symptoms. The symptoms significantly more common in the patient group than in the control group were tiredness/fatigue, poor concentration/attention, decreased initiative/motivation, balance disturbances, coordination problems, difficulties with short and long term memory, learning difficulties and problems with fine motor skills (e.g. holding a pen). There was a significant difference between patients and controls in the written survey FOSQ dimension social outcome. Conclusion: Patients with TBE suffer from sequelae for many years after thedisease. An improved characterizationof the complications of TBE can enable an individualized rehabilitation in order to reduce the risk of permanent sequelae. A large proportion of the TBE patients suffers from tiredness or fatigue long after the disease. These sequelae and their pathogenesis should be explored in future studies. http://dx.doi.org/10.1016/j.jcv.2015.07.061 Abstract No: 1465 Presentation at ESCV 2015: Poster 1 Comparison of four RSV point-of-care tests for the implementation of nosocomial infection control practices in an acute paediatrics setting M. Medina1,∗, C. Wighton2, S. Bandi2, T. Taylor2, J. Tang3 1 Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK 2 Children’s Assessment Unit, University Hospitals of Leicester NHS Trust, Leicester, UK 3 Clinical Microbiology Department, University Hospitals of Leicester NHS Trust, Leicester, UK Background: RSV is the leading and most expensive cause of nosocomial infections (NI) in paediatric wards and NICUs, particularly in children under 6 months of age. In the absence of infection control methods, the hospital transmission rate is generally 50%. Studies suggest that approximately 60% of paediatric staff acquire nosocomial RSV, and at least 27% pass it on to patients and other staff.Deathmayresult inNICURSVNI, due to theseverityof theclinical course of disease.Hospital infection controlmeasures generally comprise of a combination of several containment strategies, none of which have been determined to be more effective than others. Recent studies suggest however, that implementing a regimen of rapid testing, handwashing andpatient cohortingmayhave a slight advantage. RSV point-of-care tests (POCT) provide results within 15minutes; however, their sensitivities and specificities are inferior to that of RT-PCR, the recognised gold standard in diagnostics. Furthermore, compliance inPOC testingdependson its ease-of-use. POCTselection should therefore, bebasedon its closest comparability toRT-PCRand its ease-of-use.Our aim is to implement a regimen of rapid testing and cohorting at the Leicester Royal Infirmary (LRI) acute paediatrics ward, by selecting a POCT that is highly sensitive and specific, and that is easiest to use. Methods: Nasopharyngeal aspirates were collected from children aged 0-2 years, presenting with URTI or LRTI at the Children’s Assessment Unit (CAU) of the LRI during November 2014–December 2014. NPAs were tested at CAU using any one of four RSV POCT kits, provided courtesy of the distributors, which included Alere Binax Card, BDVeritor, Quidel QuickVue, andQuidel Sofia. Split samples were sent to the LRI Clinical Microbiology Department as part of routine respiratory diagnostics. An in-house real-time multiplex RT-PCR method was used as the gold standard in determining POCT sensitivity, specificity, PPV and NPV. Results: Seventy-seven NPAs were tested with one of four POCTs. Respective sensitivities, specificities, PPVs and NPVs for each POCT were: Alere Binax: 69.23%, 100%, 100%, 50%; BD Veritor: 81.25%, 100%, 100%, 57.14%; Quidel QuickVue: 66.67%, 87.50%, 92.31%, and 53.85%. Sensitivity and PPV for Quidel Sofiawere 100%, based on four samples tested, all of which gave concordant positive results to RT-PCR. Conclusion: Highly sensitive, specific and easy-to-use POCTs may augment RSV NI control measures in acute paediatrics. In this cohort, the BD Veritor was preferred for both good sensitivity and ease-of-use. http://dx.doi.org/10.1016/j.jcv.2015.07.062