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Characteristics of respiratory outbreaks in care homes over four influenza seasons, 2011-2015

tetano

Editor, Senior Moderator
J Hosp Infect. 2017 Sep 2. pii: S0195-6701(17)30464-4. doi: 10.1016/j.jhin.2017.08.020. [Epub ahead of print]
[h=1]Characteristics of respiratory outbreaks in care homes over four influenza seasons, 2011-2015.[/h] Gallagher N[SUP]1[/SUP], Johnston J[SUP]2[/SUP], Crookshanks H[SUP]2[/SUP], Nugent C[SUP]2[/SUP], Irvine N[SUP]2[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza and other respiratory infections can spread rapidly and cause severe morbidity and mortality in care home settings.
[h=4]AIM:[/h] This study describes the characteristics of respiratory outbreaks in care homes in Northern Ireland over a four year period, and aims to identify factors that predict which respiratory outbreaks are more likely to be positively identified as influenza.
[h=4]METHODS:[/h] Epidemiological, virological and clinical characteristics of outbreaks during the study period were described. Variables collected at notification were compared to identify predictors for an outbreak testing positive for influenza. T-tests and chi squared tests were used to compare means and proportions respectively; significance level was set at 95%.
[h=4]FINDINGS:[/h] During the four seasons, 95 respiratory outbreaks were reported in care homes, 70 of which were confirmed as influenza. Over 1000 cases were reported, with 135 associated hospitalisations and 22 deaths. Vaccination uptake in residents was consistently high (mean 86%), however in staff was poorly reported and when reported, consistently low (mean 14%). Time to notification and number of cases at notification were both higher than expected given national recommendations for reporting outbreaks. No clinically significant predictors of a positive influenza outbreak were identified.
[h=4]CONCLUSIONS:[/h] Respiratory outbreaks in care homes were associated with significant morbidity and mortality, despite high vaccination uptake. The absence of indicators at notification of an outbreak to accurately predict influenza infection highlights the need for prompt reporting and laboratory testing. Raising staff awareness, training in the management of respiratory outbreaks in accordance with national guidance, and improvement of staff vaccination uptake is recommended.
Copyright ? 2017. Published by Elsevier Ltd.


[h=4]KEYWORDS:[/h] influenza; outbreaks; respiratory infections; vaccines and immunisation

PMID: 28873336 DOI: 10.1016/j.jhin.2017.08.020
 
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