Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-10T05:45:53.171Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

Published online by Cambridge University Press:  15 May 2009

K. G. Nicholson ,
D. J. Baker ,
A. Farquhar ,
D. Hurd ,
J. Kent  and
S. H. Smith
K. G. Nicholson
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
D. J. Baker
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
A. Farquhar
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
D. Hurd
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
J. Kent
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
S. H. Smith
Affiliation:
Infectious Diseases Unit, Groby Road Hospital, Leicester LE3 9QE.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine.

Influenza immunization rates by home ranged from 15·4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0·7 upper respiratory episodes per bed per annum with a mortality of 3·4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately £7.50 per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.

Type
Research Article
Information
Epidemiology & Infection , Volume 105 , Issue 3 , December 1990 , pp. 609 - 618
Copyright
Copyright © Cambridge University Press 1990

References

REFERENCES

1.Eickhoff, TC, Sherman, IL, Serfling, RE. Observations on excess mortality associated with epidemic influenza. JAMA 1961; 176: 776–82.CrossRefGoogle ScholarPubMed
2.Housworth, J, Langmuir, AD. Excess mortality from epidemic influenza, 1957–1966. Am J Epidem 1974; 100: 40–8.CrossRefGoogle ScholarPubMed
3.Barker, WH, Mullooly, JP. Pneumonia and influenza deaths during epidemics. Implications for prevention. Arch Intern Med 1982; 142: 85–9.CrossRefGoogle ScholarPubMed
4.Glezen, WP. Serious morbidity and mortality associated with influenza epidemics. Epidemiol Rev 1982; 4: 25–44.CrossRefGoogle ScholarPubMed
5. Immunisation against infectious disease. Joint Committee on Vaccination and Immunisation. Department of Health. 1990. London: Her Majesty's Stationery Office.Google Scholar
6.Nicholson, KG, Wiselka, MJ, May, A. Influenza vaccination of the elderly: perceptions and policies of general practitioners and outcome of the 1985–86 immunization programme in Trent, UK. Vaccine 1987; 5: 302–6.CrossRefGoogle ScholarPubMed
7.Kurinczuk, JJ, Nicholson, KG. Uptake of influenza vaccination by patients with serious cardiac disease. Br Med J 1989; 299: 367.CrossRefGoogle ScholarPubMed
8.Pachuki, CT, Lentino, JR, Jackson, GG. Attitudes and behaviour of health care personnel regarding the use and effiacy of influenza vaccine. J Infect Dis 1985; 151: 1170–1.CrossRefGoogle Scholar
9.Kraaijeveld, CA, Reed, SE, Macnaughton, MR. Enzyme-linked immunosorbent assay for detection of antibody in volunteers experimentally infected with coronavirus 229E group viruses. J Clin Microbiol 1980; 12: 493–7.CrossRefGoogle Scholar
10. Prospects for immunising against influenza viruses A and B. In: New vaccine development; establishing priorities. Vol 1. Diseases of importance in the United States. Division of Health Promotion and Disease Prevention. Institute of Medicine. National Academy Press. Washington 1985, 342–64.Google Scholar
11.Garvie, DG, Gray, J. Outbreak or respiratory syncytial virus infection in the elderly. Br Med J 1980; 281: 1253–4.CrossRefGoogle ScholarPubMed
12.Communicable Disease Surveillance Centre. Respiratory syncytial virus infection in the elderly, 1976–1982. Br Med J 1983; 287: 1618–9.CrossRefGoogle Scholar
13.Hart, RJC. An outbreak of respiratory syncytial virus infection in an old people's home. J Infect 1984; 8: 259–61.CrossRefGoogle Scholar
14.Respiratory syncytial disease – Missouri. MMWR 1977; 26: 351.Google Scholar
15.Mathur, U, Bentley, DW, Hall, CB. Concurrent respiratory syncytial virus and influenza A infections in the institutionalised elderly and chronically ill. Ann Intern Med 1980; 93: 49–52.CrossRefGoogle ScholarPubMed
16.Morales, F, Calder, MA, Inglis, JM, Murdoch, PS, Williamson, J. A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus. J Infect 1983; 7: 236–47.CrossRefGoogle ScholarPubMed
17.Sorvillo, FJ, Huie, SF, Strassburg, MA, Butsumyo, A, Shandera, WX, Fannin, SL. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect 1984; 9: 252–6.CrossRefGoogle Scholar
18.Macnaughton, MR. Occurrence and frequency of coronavirus infections in humans as determined by enzyme-linked immunosorbent assay. Infect Immunity 1982; 38: 419–23.CrossRefGoogle ScholarPubMed
19.Salk, JE, Rapalski, AJ. Evaluation of influenza vaccine in an explosive epidemic of mixed aetiology. US Armed Forces Medical Journal. 1958; 9: 469–78.Google Scholar
20.Kitamoto, O. Therapeutic effectiveness of amantadine hydrochloride in influenza A2. Double blind studies. Jap J Tuberc Chest Dis 1968; 15: 17–26.Google ScholarPubMed
21. Adult immunization. Recommendations of the immunization practices advisory committee. MMWR Supplement No. 1S, 1984; 33: 23s–26s.Google Scholar
22.Howells, CHL, Vesselinova-Jenkins, CK, Evans, AD, James, J. Influenza vaccination and mortality from bronchopneumonia in the elderly. Lancet 1985; i: 381–3.Google Scholar
23.Serie, C, Barme, M, Hannoun, C, Thibon, M, Beck, H, Aquino, JP. Effects of vaccination on an influenza epidemic in a geriatric hospital. Dev Biol Stand 1977; 39: 317–21.Google Scholar
24.Gross, PA, Quinnan, GV, Rodstein, M. Association of influenza immunisation with reduction in mortality in an elderly population. A prospective study. In Program and Abstracts of the 24th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington DC: American Society for Microbiology, Abstract No. 288.Google Scholar
25.Patriarca, PA, Weber, JA, Parker, Ra et al. , Efficacy of influenza vaccine in nursing homes. Reduction in illness and complications during an influenza A (H3N2) epidemic. JAMA 1985; 253: 1136–9.CrossRefGoogle ScholarPubMed
26.Nicholson, KG. Antiviral agents in clinical practice. Respiratory infections, genital herpes, and herpetic keratitis. Lancet 1984; ii: 617–21.CrossRefGoogle Scholar