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Sequential outbreak of influenza A and B in a nursing home: efficacy of vaccine and amantadine.

AbstractOBJECTIVE:
To describe the sequential occurrence of influenza A and B in a nursing home, and to determine the efficacy of influenza vaccine and/or amantadine treatment with respect to incidence and sequelae.
SETTING:
The Jewish Home and Hospital for Aged, a skilled-care nursing facility.
PARTICIPANTS:
Of 499 frail older nursing home residents, 139 contracted influenza during the study period (mean age 87.5 years; SD = 6.7). The residents were followed from February through April 1988.
INTERVENTION: MEASUREMENTS:
Episodes of influenza and their sequelae, i.e., pneumonia, hospitalization, and death.
RESULTS:
The vaccine had no effect on the incidence of influenza-like illness, length of illness, or the associated death rate. It reduced the rate of pneumonia secondary to influenza A and B (relative risk = .57; 95% CI: .37 to .89; P = .023). Amantadine did not affect the attack rate of influenza nor the rate of pneumonia secondary to influenza. It was associated with decreased mortality (relative risk = 0; P = .001), and shorter length of influenza A illness (PWilcoxon = .082). Although the combination of amantadine and vaccine did not affect length of influenza (A or B) illness, it was associated with a significantly lower rate of sequelae (relative risk = .58; 95% CI: .36 to .95; P = .024).
CONCLUSION:
In this epidemic, the combination of amantadine and vaccine was most effective in reducing the rate of influenza-associated sequelae. The possibility of a "biphasic" epidemic prompts consideration of vaccinating nonimmunized nursing home residents, even though it may be late in the influenza season.
AuthorsL S Libow, R R Neufeld, E Olson, B Breuer, P Starer
JournalJournal of the American Geriatrics Society (J Am Geriatr Soc) Vol. 44 Issue 10 Pg. 1153-7 (Oct 1996) ISSN: 0002-8614 [Print] UNITED STATES
PMID8855992 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Influenza Vaccines
  • Amantadine
Topics
  • Aged
  • Aged, 80 and over
  • Amantadine (therapeutic use)
  • Disease Outbreaks
  • Frail Elderly
  • Homes for the Aged
  • Hospitalization
  • Humans
  • Incidence
  • Influenza A virus
  • Influenza B virus
  • Influenza Vaccines
  • Influenza, Human (complications, epidemiology, therapy)
  • New York City (epidemiology)
  • Nursing Homes
  • Pneumonia (epidemiology, etiology, mortality)
  • Retrospective Studies

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