Prevention and control of influenza A outbreaks in long-term care facilities.
Prevention and control of influenza A outbreaks in long-term care facilities.
复制标题
预防和控制长期护理机构中甲型流感疫情。
DOI：
10.1086/646422
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发表时间：
1992
影响因子：
4.5
通讯作者：
Drinka,P
中科院分区：
文献类型：
--
作者：
Gravenstein,S;Miller,BA;Drinka,P
没有任何一种病毒具有流感那样的健康影响。流感在流行病学上仍然很重要，因为它通过抗原变异逃避宿主的免疫压力，具有高度传染性，并可在最易感宿主中引起肺炎和死亡。在易感宿主之间接触最多的地方，病毒传播最有效。对于人类来说，这包括机构设置，如日托中心、学校、医院和长期护理设施。在三种类型的流感中，丙型流感相对没有毒性。乙型流感在儿童中毒性最强；它的抗原性稳定可能使成年人群受益于获得性免疫。甲型流感对所有年龄段的人都有毒性，特别是对年龄偏大或患有免疫功能低下疾病的人；70岁以上老人的发病率是40岁以下成年人的四倍。导致甲型流感反复流行的一个主要因素是病毒的变化（抗原漂移和转移），这使得疫苗的效力降低。流感流行每年造成数十亿美元的损失，并导致数千人死亡。本次讨论的重点是在长期护理机构中预防和治疗甲型流感。
No single virus has the health impact of influenza. Influenza has remained epidemiologically important because it escapes host immune pressure through antigenic variation, is highly contagious, and can cause pneumonia and death in the most susceptible hosts. Viral transmission is most efficient where contact between susceptible hosts is greatest. For humans, this includes institutional settings such as daycare centers, schools, hospitals, and long-term care facilities. Of the three types of influenza, influenza C is relatively nonvirulent. Influenza B is most virulent in children; its antigenic stability presumably allows the adult population to benefit from acquired immunity. Influenza A is virulent in people of all ages, especially in those at the extremes of age or with immunocompromising disease; the attack rate in persons over 70 years of age is four times that of adults under 40 years of age. A major factor accounting for recurrent influenza A epidemics is change in the virus (antigenic drift and shift) that renders the vaccine less efficacious. Influenza epidemics cost billions of dollars and result in thousands of deaths annually. This discussion will focus on the prevention and treatment of influenza A in the long-term care facility.