The use of oseltamivir during an influenza B outbreak in a chronic care hospital.
The use of oseltamivir during an influenza B outbreak in a chronic care hospital.
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DOI：
10.1111/j.1750-2659.2008.00063.x
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发表时间：
2009-01
影响因子：
4.4
通讯作者：
MacIntyre CR
中科院分区：
文献类型：
--
作者：
Seale H;Weston KM;Dwyer DE;Zhu M;Allchin L;Booy R;MacIntyre CR
背景 疗养院和长期护理机构的居民比社区居民面临更高的流感爆发和流感严重并发症的风险。 2005 年 7 月下旬，澳大利亚悉尼一家拥有 90 个床位的慢性护理老年精神科医院报告其居民中出现流感样疾病 (ILI) 病例。 方法 进行了调查以确认疫情及其原因。对居民的流感疫苗接种水平以及用于预防和治疗的抗病毒药物的效果进行了评估。奥司他韦仅以治疗和预防的形式提供给居民。 结果 89 名居民中共有 22 人符合 2005 年 7 月 27 日或之后发病的 ILI 临床病例定义。这意味着发病率为 25%。奥司他韦于疫情爆发第 9 天开始使用。六名居民中的乙型流感被确定为此次疫情的病原体。此次疫情没有死亡或急性住院治疗记录，在使用奥司他韦后也没有进一步报告病例。疫苗有效率达75%，分离出的乙型流感毒株与当年的疫苗匹配良好。 结论 关于在乙型流感暴发中使用奥司他韦的数据很少。早期抗病毒干预似乎遏制了慢性病护理机构中乙型流感的爆发。我们发现，在这些体弱的、住院的人群中，疫苗的有效性很高，这凸显了流感疫苗接种对于慢性护理机构居民的重要性。
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.