The use of oseltamivir during an influenza B outbreak in a chronic care hospital

Abstract

Background Residents of nursing homes and long‐term care facilities are at a higher risk of outbreaks of influenza and of serious complications of influenza than those in the community. In late July 2005, a 90‐bed chronic care psycho‐geriatric hospital in Sydney, Australia, reported cases of influenza‐like illness (ILI) occurring amongst its residents. Methods An investigation to confirm the outbreak, and its cause, was undertaken. Influenza vaccination levels amongst residents, and the effects of antiviral drugs used for prevention and treatment, were assessed. Oseltamivir was only given to the residents, in the form of both treatment and prophylaxis. Results A total of 22 out of 89 residents met the clinical case definition of ILI with onset on or after 27 July 2005. This represents an attack rate of 25%. Oseltamivir was commenced on day 9 of the outbreak. Influenza B was identified in six residents as the causative agent of the outbreak. No deaths or acute hospitalization were recorded for this outbreak and there were no further reported cases after the introduction of oseltamivir. Vaccine effectiveness was 75% and the strain of influenza B isolated was well matched to that year’s vaccine. Conclusions There are few data on the use of oseltamivir in influenza B outbreaks. Early antiviral intervention appeared to curtail this outbreak of influenza B in a chronic care facility. We found high vaccine effectiveness in this frail, institutionalized population, highlighting the importance of influenza vaccination for residents of chronic care facilities.

Role of viral bioaerosols in nosocomial infections and measures for prevention and control

“…Salgado, Farr, Hall, and Hayden (2002) reviewed 12 influenza outbreaks in hospitals, and reported the patient infection rates ranged from 3% to 50% in wards affected by the outbreaks compared to 0.7-20% throughout the hospital. Outbreaks of influenza B virus have also been reported in hospitalized older adults (Seale et al, 2009;Van Voris, Belshe, & Shaffer, 1982). Other respiratory viruses including adenovirus, rhino/enterovirus, metapneumovirus and RSV could also cause nosocomial infections in pediatric and adult patients (Chow & Mermel, 2017;La Rosa, Fratini, Della Libera, Iaconelli, & Muscillo, 2013;Sakata et al, 1998;Silva Cde et al, 2012;Yang et al, 2014).…”

Elderly vaccination—The glass is half full

“…Residential aged care has its own special challenges, with outbreaks of gastroenteritis, influenza and other respiratory infections being common and often explosive [13][14][15]. Outbreaks can be particularly devastating in residential aged care, with high rates of morbidity and mortality, as well as sickness and absenteeism of staff and forced closure of aged care facilities during outbreaks.…”

Prevention of a Nosocomial Infection Caused by Influenza Virus A Using Prophylactic Administration of Oseltamivir: An Observational Study with Review of the Literature

“…1 it is impossible to prevent all nosocomial influenza virus infections. More specifically, the effectiveness of chemoprophylaxis in the hospital setting [4][5][6][7][8][9][10][11][12][13][14][15][16] has not been well established. Chemoprophylaxis for those who have had close contact with index cases may supplement pre-requisite vaccination to control influenza virus infection.…”