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Mortality Following Isolation of Various Respiratory Viruses in Nursing Home Residents

Published online by Cambridge University Press:  02 January 2015

Paul J. Drinka ,
Stefan Gravenstein ,
Elizabeth Langer ,
Peggy Krause  and
Peter Shult
Paul J. Drinka*
Affiliation:
Wisconsin Veterans' Home, King, Wisconsin University of Wisconsin, Madison, Wisconsin Medical College of Wisconsin, Milwaukee, Wisconsin
Stefan Gravenstein
Affiliation:
Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School, Norfolk, Virginia
Elizabeth Langer
Affiliation:
Wisconsin Veterans' Home, King, Wisconsin
Peggy Krause
Affiliation:
Wisconsin Veterans' Home, King, Wisconsin
Peter Shult
Affiliation:
Communicable Diseases Division, State Laboratory of Hygiene, Madison, Wisconsin
*
Medical Director, Wisconsin Veterans' Home, King, WI 54946-0620
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Abstract

Objective:

To compare mortality following isolation of influenza A to mortality following isolation of other respiratory viruses in a nursing home.

Setting:

The Wisconsin Veterans Home, a 688-bed skilled nursing facility for veterans and their spouses.

Participants:

All residents with respiratory viral isolates obtained between 1988 and 1999.

Design:

Thirty-day mortality was determined following each culture-proven illness.

Results:

Thirty-day mortality following isolation of viral respiratory pathogens was 4.7% (15/322) for influenza A 5.4% (7/129) for influenza B; 6.1% (3/49) for parainfluenza type 1; 0% (0/26) for parainfluenza types 2,3, and 4; 0% (0/26) for respiratory syncytial virus (RSV); and 1.6% (1/61) for rhinovirus.

Conclusions:

Mortality following isolation of certain other respiratory viruses may be comparable to that following influenza A (although influenza A mortality might be higher without vaccination and antiviral agents). The use of uniform secretion precautions for all viral respiratory illness deserves consideration in nursing homes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 12 , December 1999 , pp. 812 - 815
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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References

1. Centers for Disease Control and Prevention. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Prevention and control of influenza. MMWR 1997;46:1–20.Google Scholar
2. Parainfluenza infections in the elderly 197-82. Br Med J (Clin Res Ed) 1983;287:1619.Google Scholar
3. Centers for Disease Control. Parainfluenza outbreaks in extended care facilities—United States. MMWR 1978;27:475–476.Google Scholar
4. Respiratory syncytial virus infection in the elderly 1976-82. Br Med J (Clin Res Ed) 1983;287:1618–1619.Google Scholar
5. Sondilo, FJ, Huie, SF, Strassburg, MA, Butsumyo, A, Sbandera, WX, Fannin, SL. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect 1984;9:252–256.Google Scholar
6. Fiore, AE, Iverson, C, Messmer, T, Erdman, D, Lett, SM, Talkington, DF, et al. Outbreak of pneumonia in a long-term care facility: antecedent human parainfluenza virus 1 infection may predispose to bacterial pneumonia. J Am Geriatr Soc 1998;46:1112–1117.Google Scholar
7. Fleming, DM, Cross, KW. Respiratory syncytial virus or influenza? Lancet 1993;342:1507–1510.CrossRefGoogle ScholarPubMed
8. Betts, RF. Influenza virus. In: Mandell, GL, Bennett, JE, Dolin, R eds. Principles and Practices of Infectious Diseases. 4th ed. New York, NY: Churchill Livingstone Inc; 1995:1546–1567.Google Scholar
9. The impact of routine admission chest x-ray films on patient care. N Engl J Med 1985;313:262–264.Google Scholar
10. Arden, NH, Patriarca, PA, Fasano, MB, Lui, KJ, Harmon, MW, Kendal, AP, et al. The roles of vaccination and amantadine prophylaxis in controlling an outbreak of influenza A (H3N2) in a nursing home. Arch Intern Med 1988;148:865–868.CrossRefGoogle ScholarPubMed
11. Degelau, J, Somani, SK, Cooper, SL, Guay, DR, Crossley, KB. Amantadine-resistant influenza A in a nursing facility. Arch Intern Med 1992;152:390–392.Google Scholar
12. Goodman, RA, Orenstein, WA, Munro, TF, Smith, SC, Sikes, RK. Impact of influenza A in a nursing home. JAMA 1982;247:1451–1453.Google Scholar
13. D'Alessio, DJ, Cox, PM Jr, Dick, EC. Failure of inactivated influenza vaccine to protect an aged population. JAMA 1969;210:485–489.Google Scholar
14. Budnick, LD, Stricof, RL, Ellis, F. An outbreak of influenza A in a nursing home, 1982. NY State J Med 1984;84:235–238.Google Scholar
15. Houck, P, Hemphill, M, LaCroix, S, Hirsh, D, Cox, N. Amantadine-resistant influenza A in nursing homes. Identification of a resistant virus prior to drug use. Arch Intern Med 1995;155:533–537.Google Scholar
16. Mast, EE, Harmon, MW, Grevenstein, S, Wu, SP, Arden, NH, Circo, R, et al. Emergence and possible transmission of amantadine-resistant viruses during nursing home outbreaks of influenza A (H3N2). Am J Epidemiol 1991;134:988–997.CrossRefGoogle ScholarPubMed
17. Ruben, FL, Johnston, F, Streift, EJ. Influenza in a partially immunized aged population: effectiveness of killed Hong Kong vaccine against infection with the England strain. JAMA 1974;230:863–866.Google Scholar
18. Barker, WH, Borisute, H, Cox, C. A study of the impact of influenza on the functional status of frail older people. Arch Intern Med 1998;158: 645–650.CrossRefGoogle ScholarPubMed
19. Mathur, U, Bentley, DW, Hall, CB. Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill. Ann Intern Med 1980;93:49–52.Google Scholar
20. Hall, WN, Goodman, RA, Noble, GR, Kendal, AP, Steece, RS. An outbreak of influenza B in an elderly population. J Infect Dis 1981;144:297–302.Google Scholar
21. Hart, RJ. An outbreak of respiratory syncytial virus infection in an old people's home. J Infect 1984;8:259–261.Google Scholar
22. Falsey, AR, Treanor, JJ, Betts, RF, Walsh, EE. Viral respiratory infections in the institutionalized elderly: clinical and epidemiologic findings. J Am Geriatr Soc 1992;40:115–119.Google Scholar
23. Nicholson, KG, Baker, DJ, Farquhar, A, Hurd, D, Kent, J, Smith, SH. Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly. Epidemiol Infect 1990:105:609–618.Google Scholar
24. Wald, TG, Miller, BA, Shult, P, Drinka, P, Langer, L, Grevenstein, S. Can respiratory syncytial virus and influenza A be distinguished clinically in institutionalized older persons? J Am Geriatr Soc 1995;43:170–174.CrossRefGoogle ScholarPubMed
25. Garner, JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:53–80.CrossRefGoogle ScholarPubMed
26. Leclair, JM, Freeman, J, Sullivan, BF, Crowley, CM, Goldmann, DA. Prevention of nosocomial respiratory syncytia] virus infections through compliance with glove and gown isolation precautions. N Engl J Med 1987;317:329–334.CrossRefGoogle Scholar
27. Moser, MR, Bender, TR, Margolis, HS, Noble, GR, Kendal, AP, Ritter, DG. An outbreak of influenza aboard a commercial airliner. Am J Epidemiol 1979;110:1–6.CrossRefGoogle ScholarPubMed
28. Dick, EC, Jennings, LC, Mink, KA, Wartgow, CD, Inhorn, SL. Aerosol transmission of rhinovirus colds. J Infed Dis 1987;156:442–448.CrossRefGoogle ScholarPubMed