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Lessons from a Nursing Home Outbreak of Influenza A

Published online by Cambridge University Press:  02 January 2015

David M. Morens*
Affiliation:
Department of Tropical Medicine, School of Medicine, and the Section of Epidemiology, School of Public Health, University of Hawaii, Honolulu, Hawaii
Valerie M. Rash
Affiliation:
Department of Nursing, Leahi Hospital, Honolulu, Hawaii
*
Biomed 0103, 1960 East-West Road, Honolulu, HZ 96822

Abstract

Objective:

To characterize risk factors for outbreak-associated influenza illness and death in a nursing home.

Design:

Outbreak investigation with predetermined and concurrently determined risk information.

Setting:

A nursing home service in a multiward chronic care hospital, Honolulu, Oahu, 1989 to 1990.

Patients:

Elderly nursing home patients receiving long-term care.

Interventions:

Influenza vaccination, amantadine administration, and infection control measures.

Results:

Neither routine infection control measures nor vaccination prevented illness, complications, or death in a nursing home outbreak of influenza A. The 55% case-fatality rate resulted from severe pneumonia. Influenza transmission may have been mediated by staff via either contaminated hands or fomites.

Conclusions:

Data from this and other outbreaks suggest that recommendations for preventing nosocomial influenza in the nation’s 1.5 million nursing home residents should be reconsidered.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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