Elsevier

Public Health

Volume 128, Issue 10, October 2014, Pages 944-947
Public Health

Short Communication
Outbreak of acute respiratory infection in a care home for the vulnerable elderly: investigation, management and challenges

https://doi.org/10.1016/j.puhe.2014.07.009Get rights and content

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Background

On the afternoon of Friday 2nd April 2012, the West Midlands East Health Protection Team (HPT), based in Birmingham UK, was contacted by a NHS Primary Care Trust (PCT) infection control nurse. Seven deaths due to respiratory illness had occurred since the 13th of March in a 70 bed care home for elderly and end of life patients. The home was contacted and they reported that 18 residents and two members of staff had suffered chest infections since 27th February.

Methods

Case data were collected by two trained health professionals from the clinical and nursing notes held by the care home and GPs, supplemented from discussion with care home managers and GPs treating the cases. Information collected included demographic characteristics, clinical presentation and current state, unit of normal residence in the care home, prior vaccination history and subsequent microbiological samples collected. This information was entered onto a spreadsheet in MS Excel and

Findings

The setting for the outbreak was a privately owned care home providing elderly residents with nursing care and end of life care in an urban region. Seventy residents were housed and 100 staff members were employed at the home. The care home comprised of a two floor building housing four units with 15 or 20 beds each. One unit housed the majority of end of life care residents. Most rooms were single occupancy with en-suite bathrooms. Residents were under the care of different primary care

Management

An Outbreak Control Team (OCT) was established consisting of the Health Protection Unit (HPU) consultant in communicable disease control, communicable disease nurse and public health registrar; HPA consultants in microbiology and virology; HPA Regional Epidemiologist and field epidemiology training fellow; PCT infection control nurse; care home managers; and local general practitioner. The care home was visited and an infection control nurse provided advice on enhanced measures to reduce the

Discussion

Outbreaks of respiratory infection in care homes are likely to spread easily2 and infections such as influenza can cause serious illness with a significant risk of death in elderly or vulnerable patients.3 For these reasons influenza and pneumococcal vaccination is recommended for residents, influenza vaccination is recommended for staff and antiviral prophylaxis is available for treatment and prophylaxis in influenza outbreaks.4 Influenza vaccination of staff is recommended in the UK because

Author statements

The authors declare that they have no conflict of interest.

Ethical approval was not required as this was a descriptive data analysis and carried out as part of the routine management of an acute outbreak.

AM held an Academic Clinical Fellowship post which was funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The sponsor had no role in study design, data collection,

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