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Concurrent Summer Influenza and Pertussis Outbreaks in a Nursing Home in Sydney, Australia

Published online by Cambridge University Press:  02 January 2015

Mark J. Ferson ,
Keira Morgan ,
Peter W. Robertson ,
Alan W. Hampson ,
Ian Carter  and
William D. Rawlinson
Mark J. Ferson*
Affiliation:
South Eastern Sydney Public Health Unit, Randwick, New South Wales, Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Keira Morgan
Affiliation:
South Eastern Sydney Public Health Unit, Randwick, New South Wales, Australia
Peter W. Robertson
Affiliation:
Serology Laboratory, SEALS Microbiology, Randwick, New South Wales, Australia
Alan W. Hampson
Affiliation:
WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Victoria, Australia
Ian Carter
Affiliation:
Virology Division, SEALS Microbiology, Randwick, New South Wales, Australia
William D. Rawlinson
Affiliation:
Virology Division, SEALS Microbiology, Randwick, New South Wales, Australia School of Medical Sciences and the School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
*
Public Health Unit, Locked Bag 88, Randwick, NSW 2031, Australia
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Abstract

Objective:

To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home.

Design:

An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later.

Setting:

A nursing home located in Sydney, Australia, during February to July 1999.

Patients:

The cohort of residents present in the nursing home at the time of the outbreak.

Interventions:

Public health interventions included recommendations regarding hygiene, cohorting of residents and staff, closure to further admissions, and prompt reporting of illness; and virologic and serologic studies of residents.

Results:

Of the 69 residents (mean age, 85.1 years), 35 fulfilled the case definition of acute respiratory illness. Influenza A infection was confirmed in 19 residents, and phylogenetic analysis of the resulting isolate, designated H3N2 A/Sydney/203/99, showed that it differed from strains isolated in eastern Australia during the same period. Serologic evidence of Bordetella infection was also found in 10 residents; however, stratified epidemiologic analysis pointed to influenza A as the cause of illness.

Conclusions:

The investigation revealed an unusual summer outbreak of influenza A concurrent with subclinical pertussis infection. Surveillance of acute respiratory illness in nursing homes throughout the year, rather than solely during epidemic periods, in combination with appropriate public health laboratory support, would allow initiation of a timely public health response to outbreaks of acute respiratory illness in this setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 962 - 966
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1. Kohn, MA, Farley, TA, Sundin, D, Tapia, R, McFarland, LM, Arden, NH. Three summertime outbreaks of influenza type A. J Infect Dis 1995;172:246–249.CrossRefGoogle ScholarPubMed
2. Robertson, PW, Goldberg, H, Jarvie, BH, Smith, DD, Whybin, LR. Bordetella pertussis infection: a cause of persistent cough in adults. Med JAust 1987;146:522–525.Google ScholarPubMed
3. Poynten, IM, Hanlon, M, Irwig, L, Gilbert, GL. Serological diagnosis of pertussis: evaluation of IgA against whole cell and specific Bordetella pertussis antigens as markers of recent infection. Epidemiol Infect 2001;128:161–167.CrossRefGoogle Scholar
4. Madore, HP, Reichman, RC, Dolin, R. Serum antibody response in naturally occurring influenza A virus infection determined by enzyme-linked immunosorbent assay, hemagglutination inhibition, and complement fixation. J Clin Microbiol 1983;18:1345–1350.CrossRefGoogle Scholar
5. Matthey, S, Nicholson, D, Ruhs, S, et al. Rapid detection of respiratory viruses by shell vial culture and direct staining by using pooled and individual monoclonal antibodies. J Clin Microbiol 1992:30:540–544.CrossRefGoogle ScholarPubMed
6. Reina, J, Fernandez, B, Blanco, I, Munar, M. Comparison of Madin-Darby canine kidney cells MDCK with green monkey continuous cell line (Vero) and human lung embryonated cells (MRC-5) in the isolation of influenza A virus from nasopharyngeal aspirates by shell viral culture. J Clin Microbiol 1997;35:1900–1901.CrossRefGoogle Scholar
7. Halliday, L, Roberts, L, Hampson, A, for the National Influenza Surveillance Scheme. Annual report of the National Influenza Surveillance Scheme, 1998. Commun Dis Intell 1999;23:185–192.Google ScholarPubMed
8. Centers for Disease Control and Prevention. Outbreak of influenza A infection among travelers: Alaska and the Yukon Territory, May-June 1999. MMWR 1999;48:545-546, 555.Google Scholar
9. Anonymous. Influenza on a cruise ship in the Mediterranean. CDR Wkly 1999;9:209, 212.Google Scholar
10. Ferson, MJ, Paraskevopoulos, P, Hatzi, S, Yankos, P, Fennell, M, Condylios, A. Presumptive summer influenza A: an outbreak on a trans-Tasman cruise. Commun Dis Intell 2000;24:45–47.Google Scholar
11. Thomson, J, Lin, M, Hampson, A. Annual report of the National Influenza Surveillance Scheme, 1999. Commun Dis Intell 2000;24:145–152.Google ScholarPubMed
12. Jakeman, KJ, Sweet, C. Summer outbreaks of influenza. J Infect Dis 1996;174:674–675. Letter.CrossRefGoogle ScholarPubMed
13. Morens, DM, Rash, VM. Lessons from a nursing home outbreak of influenza A. Infect Control Hosp Epidemiol 1995;16:275–280.CrossRefGoogle ScholarPubMed
14. Drinka, PJ, Gravenstein, S, Krause, P, Schilling, M, Miller, BA, Shult, P. Outbreaks of influenza A and B in a highly immunized nursing home population. J Fam Pract 1997;45:509–514.Google Scholar
15. Potter, J, Stott, DJ, Roberts, MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:1–6.CrossRefGoogle ScholarPubMed
16. Arden, NH. Control of influenza in the long-term-care facility: a review of established approaches and newer options. Infect Control Hosp Epidemiol 2000;21:59–64.CrossRefGoogle ScholarPubMed
17. Bradley, SF, the Long-Term-Care Committee of the Society for Healthcare Epidemiology of America. Prevention of influenza in long-term-care facilities. Infect Control Hosp Epidemiol 1999;20:629–637.CrossRefGoogle ScholarPubMed
18. Weber, DJ, Rutala, WA. Pertussis: an underappreciated risk for nosocomial outbreaks. Infect Control Hosp Epidemiol 1998;19:825–827.CrossRefGoogle ScholarPubMed
19. Addiss, DG, Davis, JR, Meade, BD, et al. A pertussis outbreak in a Wisconsin nursing home. J Infect Dis 1991;164:704–710.CrossRefGoogle Scholar
20. Deville, JG, Cherry, JD, Christenson, PD, et al. Frequency of unrecognized Bordetella pertussis infection in adults. Clin Infect Dis 1995;21:639–642.CrossRefGoogle ScholarPubMed