INFLUENZA-A VIRUS-INFECTIONS AMONG HOSPITALIZED ADULT BONE-MARROW TRANSPLANT RECIPIENTS

Although influenza virus continues to cause annual epidemics of respir atory diseases, surprisingly little is known about the frequency and c linical course of influenza among adult patients with cancer. During t he 1991-92 influenza epidemic in Houston, Texas, we followed all adult BMT recipients hospitalized at M.D. Anderson Cancer Center. None of t hese 68 patients had received prophylaxis for influenza. Influenza vir us type A was isolated from 8 (29%) of 28 BMT recipients with an acute respiratory illness. Five of these infections were acquired in the ho spital. All 8 patients presented with an upper respiratory tract illne ss. In 6 patients, the infection was complicated by pneumonia. The fre quency of influenza was similar among autologous (5 of 18) and allogen eic (3 of 10) BMT recipients. The risk of developing pneumonia was not related to the type of transplant or to the engraftment status. All p atients received broad-spectrum antibiotics. The 2 patients who did no t develop pneumonia also received amantadine. The mortality with pneum onia was 17%. During community outbreaks, influenza is a frequent caus e of acute respiratory illness among hospitalized adult BMT recipients and is frequently complicated by pneumonia. Studies are needed to def ine the optimal means of preventing and treating influenza in BMT reci pients.