Hostname: page-component-77c89778f8-rkxrd Total loading time: 0 Render date: 2024-07-17T01:09:29.308Z Has data issue: false hasContentIssue false

Influenza in aged care facilities

Published online by Cambridge University Press:  19 November 2010

Richard I Lindley*
Affiliation:
The University of Sydney, NSW, Australia
*
Address for correspondence: Richard I Lindley, Moran Foundation for Older Australians Professor of Geriatric Medicine, Sydney Medical School – Westmead and The George Institute for Global Health, The University of Sydney, Westmead Hospital (C24), NSW 2006, Australia. Email: richard.lindley@sydney.edu.au

Summary

Seasonal influenza remains a common cause of morbidity and mortality for older residents in aged care facilities. Whilst prevention is best managed by high vaccination rates for the general population, residents and aged care facility staff, new research suggests that a more active approach to surveillance and anti-viral treatment now plays an important role. The practicalities of managing an influenza outbreak are complex and best planned in advance with written protocols available. Good infection control remains a vital part of prevention and outbreak control.

Type
Intermediate care and rehabilitation
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Tillett, HE, Smith, JW, Gooch, CD. Excess deaths attributable to influenza in England and Wales: age at death and certified cause. Int J Epidemiol 1983; 12: 344–52.CrossRefGoogle ScholarPubMed
2Brotherton, J, Wang, H, Schaffer, A, Quinn, H, Menzies, R, Hull, B, Lawrence, G, Wood, J, Wood, N, Rosewell, A, Newall, A, MacIntyre, R, Macartney, K, Gidding, H, McIntyre, P, Booy, R. Vaccine preventable diseases and vaccination coverage in Australia, 2003 to 2005. Communicable Dis Intell 2007; 31 (suppl): S1152.Google ScholarPubMed
3Molinari, NA, Ortega-Sanchez, IR, Messonnier, ML, Thompson, WW, Wortley, PM, Weintraub, E, Bridges, CB. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine 2007; 25: 5086–96.CrossRefGoogle ScholarPubMed
4Pitman, RJ, Melegaro, A, Gelb, D, Siddiqui, MR, Gay, NJ, Edmunds, WJ. Assessing the burden of influenza and other respiratory infections in England and Wales. J Infection 2007; 54: 530–38.CrossRefGoogle ScholarPubMed
5Muller-Pebody, B, Crowcroft, NS, Zambon, MC, Edmunds, WJ. Modelling hospital admissions for lower respiratory tract infections in the elderly in England. Epidemiol Infect 2006; 134: 1150–57.CrossRefGoogle ScholarPubMed
6Sprenger, MJ, Mulder, PG, Beyer, WE, Van Strik, R, Masurel, N. Impact of influenza on mortality in relation to age and underlying disease, 1967–1989. Int J Epidemiol 1993; 22: 334–40.CrossRefGoogle ScholarPubMed
7Carroll, NV, Delafuente, JC, McClure, KL, Weakley, DF, Khan, ZM, Cox, FM. Economic burden of influenza-like illness in long-term-care facilities. Am J Health Syst Pharm 2001; 58: 1133–38.CrossRefGoogle ScholarPubMed
8Communicable Diseases Network Australia. A Practical Guide to Assist in the Prevention and Management of Influenza Outbreaks in Residential Care Facilities in Australia. May 2009. Canberra: Commonwealth of Australia. Online ISBN 1-74186-900-5.Google Scholar
9Rosewell, A, Chiu, C, Lindley, R, Dwyer, DE, Moffatt, CR, Shineberg, C, Clarke, E, Booy, R, MacIntyre, CR. Surveillance for outbreaks of influenza-like illness in the institutionalised elderly. Epidemiol Infect 2010; 138: 1126–34.CrossRefGoogle Scholar
10Playford, EG, Dwyer, DE. Laboratory diagnosis of influenza virus infection. Pathology 2002; 34: 115–25.CrossRefGoogle ScholarPubMed
11Jefferson, T, Del Mar, C, Dooley, L, Ferroni, E, Al-Ansary, LA, Bawazeer, GA, van Driel, ML, Foxlee, R, Rivetti, A. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. BMJ 2009; 339: b3675.CrossRefGoogle ScholarPubMed
12Jefferson, T, Di Pietrantonj, C, Al-Ansary, LA, Ferroni, E, Thorning, S, Thomas, RE. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2010; 2: CD004876.Google Scholar
13Ridda, I, Lindley, R, MacIntyre, RC. The challenges of clinical trials in the exclusion zone: the case of the frail elderly. Austral J Ageing 2008; 27: 6166.CrossRefGoogle ScholarPubMed
14Kelly, H, Newall, AT. Mortality benefits of influenza vaccination in elderly people. Lancet Infect Dis 2008; 8: 462–63; author reply 3–5.CrossRefGoogle ScholarPubMed
15Dean, AS, Moffatt, CR, Rosewell, A, Dwyer, DE, Lindley, RI, Booy, R, MacIntyre, CR. Incompletely matched influenza vaccine still provides protection in frail elderly. Vaccine 2010; 28: 864–67.CrossRefGoogle ScholarPubMed
16Goodwin, K, Viboud, C, Simonsen, L. Antibody response to influenza vaccination in the elderly: a quantitative review. Vaccine 2006; 24: 1159–69.CrossRefGoogle ScholarPubMed
17Thomas, RE, Jefferson, T, Lasserson, TJ. Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database Syst Rev 2010; 2: CD005187.Google Scholar
18Armstrong, BG, Mangtani, P, Fletcher, A, Kovats, S, McMichael, A, Pattenden, S, Wilkinson, P. Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people. BMJ 2004; 329: 660.CrossRefGoogle ScholarPubMed
19Sprenger, MJ, Van Naelten, MA, Mulder, PG, Masurel, N. Influenza mortality and excess deaths in the elderly, 1967–82. Epidemiol Infect 1989; 103: 633–41.CrossRefGoogle ScholarPubMed
20Thijs, C, Beyer, WEP, Govaert, PME, Sprenger, MJW, Dinant, G-J, Knottnerus, A. Mortality benefits of influenza vaccination in elderly people. Lancet Infect Dis 2008; 8: 460–61; author reply 3–5.CrossRefGoogle ScholarPubMed
21Simonsen, L, Taylor, RJ, Viboud, C, Miller, MA, Jackson, LA. Mortality benefits of influenza vaccination in elderly people: an ongoing controversy. Lancet Infect Dis 2007; 7: 658–66.CrossRefGoogle ScholarPubMed
22Alves, Galvao MG, Rocha-Crispino-Santos, MA, Alves da Cunha, AJL. Amantadine and rimantadine for influenza A in children and the elderly. Cochrane Database Syst Rev 2008; 1: CD002745.Google Scholar
23Amantadine oseltamivir and zanamivir for the treatment of influenza (NICE technology appraisal guidance 168); 2009. London: NICE.Google Scholar
24Jefferson, T, Jones, M, Doshi, P, Del Mar, C. Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis. BMJ 2009; 339: b5106.CrossRefGoogle ScholarPubMed
25Schilling, M, Povinelli, L, Krause, P, Gravenstein, M, Ambrozaitis, A, Jones, HH, Drinka, P, Shult, P, Powers, D, Gravenstein, S. Efficacy of zanamivir for chemoprophylaxis of nursing home influenza outbreaks. Vaccine 1998; 16: 1771–74.CrossRefGoogle ScholarPubMed
26Lindley, R, Booy, R, Heron, L, Macintyre, CCA, Dwyer, D, Yin, Y. Control of influenza in aged care facilities: a cluster randomised controlled trial. Age Ageing 2010; p. i25.Google Scholar
27Sintchenko, V, Gilbert, GL, Coiera, E, Dwyer, D. Treat or test first? Decision analysis of empirical antiviral treatment of influenza virus infection versus treatment based on rapid test results. J Clin Virol 2002; 25: 1521.CrossRefGoogle ScholarPubMed
28Stephenson, I, Clark, TW, Pareek, M. Antiviral treatment and prevention of seasonal influenza: a comparative review of recommendations in the European Union. J Clin Virol 2008; 42: 244–48.CrossRefGoogle ScholarPubMed
29Van Der Vries, E, Jonges, M, Herfst, S, Maaskant, J, Van Der Linden, A, Guldemeester, J, Aron, GI, Bestebroer, TM, Koopmans, M, Meijer, A, Fouchier, RA, Osterhaus, AD, Boucher, CA, Schutten, M. Evaluation of a rapid molecular algorithm for detection of pandemic influenza A (H1N1) 2009 virus and screening for a key oseltamivir resistance (H275Y) substitution in neuraminidase. J Clin Virol 2010; 47: 3437.CrossRefGoogle ScholarPubMed