The situation of infection in the elderly in Spain: a multidisciplinary opinion document

Herpes zoster infection (HZ) is an important public health problem due to its high incidence and frequent complications, especially post-herpetic neuropathy . The incidence of HZ increases with age and is more frequent in immunocompromised patients. It is estimated that at least 60,000 people develop HZ each year in Spain. The usual forms of HZ are so clinically characteristic that they do not usually require microbiological confirmation, which is reserved for cases without cutaneous manifestations or with atypical presentation. There are currently two vaccines approved by the regulatory agencies and marketed in Spain to prevent the onset of HZ and its complications. The first (Zostavax®) was marketed by the company MSD and licensed in Europe in 2006 and is a live attenuated virus vaccine that is administered in a single dose, while the second (Shingrix®) is a recombinant vaccine, marketed in 2017 and requires two doses. While the former cannot be administered to immunocompromised persons, the latter can be prescribed to any group of adults. The criteria for the indication and financing of these vaccines have not been uniform in the various autonomous communities of Spain. These and other aspects of HZ have been discussed by a group of experts from the Illustrious Official College of Physicians of Madrid (ICOMEM) whose criteria and opinions are included in this paper.

“…After the COVID-19 pandemic, it seems necessary to create a global system that can support both routine immunization and epidemic immunization in adults [ 59 , 60 ].…”

Section: Can the Zoster Vaccine Be Combined With Other Vaccines?mentioning

confidence: 99%

Status of Herpes Zoster and Herpes Zoster Vaccines in 2023: A position paper

García¹,

Guillén²,

Rodríguez‐Artalejo³

et al. 2023

“…These measures must be coordinated from the Primary Care setting and are an inseparable part of the connected fabric of our health system. Aspects such as the vaccination program and schedule for the elderly do not merit emphasis in this section and readers are referred to other sources [47,104].…”

Section: What Can Be Applied From All This To the Elderly Living At H...mentioning

confidence: 99%

“…In the elderly, vaccination takes on greater importance because their immune system is aged and their capacity to respond to infectious processes is diminished, thus increasing the risk of developing serious complications following infections. This statement is especially relevant in people living in LTCF for the elderly, where the presence of comorbidity, functional dependence and cognitive impairment puts them at greater risk of falling ill and, if they do fall ill, more clinical complications and a higher risk of death [ 47 ].…”

Section: What Vaccines Should Be Offered To Persons Living In a Nursi...mentioning

confidence: 99%

“…The efficacy of pneumococcal vaccination is linked to its antigenic composition [polysaccharide (PPV) and polyvalent conjugate (PCV)] and to the impact and application of PCV7, PCV10 and PCV13 in individuals over 65 years of age [ 104 , 105 ]. PPV23 efficacy data [ 106 ] are conclusive for protection from invasive disease, against all-cause pneumonia in low-income countries, and in chronically ill adults.…”

Section: What Measures To Reduce Respiratory Infection Have Been Show...mentioning

confidence: 99%

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Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain

Bouza

Navarro²,

Alonso³

et al. 2023

Self Cite

A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a “nosocomiun”, i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.

“…For further information, we refer interested parties to a recently published document entitled The situation of vaccines for the prevention of infections in adults: An opinion paper on the situation in Spain [ 11 ].…”

Section: Recommendations For Actionmentioning

confidence: 99%

Recommendations for the prevention of healthcare-associated infections in nursing homes

Bouza¹,

Asensio²,

Navarro³

et al. 2023

Nursing homes (NH) conceptually should look as much like a home as possible. However NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate. There is evidence of transmission of microorganisms between residents and between residents and caregivers. We have not found any recommendations specifically aimed at the prevention of nosocomial infections in NH by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.