Skip to main content
Epidemiology and Infection logoLink to Epidemiology and Infection
. 1990 Dec;105(3):609–618. doi: 10.1017/s0950268800048251

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly.

K G Nicholson 1, D J Baker 1, A Farquhar 1, D Hurd 1, J Kent 1, S H Smith 1
PMCID: PMC2271825  PMID: 2249724

Abstract

Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine. Influenza immunization rates by home ranged from 15.4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0.7 upper respiratory episodes per bed per annum with a mortality of 3.4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately 7.50 pounds per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.

Full text

PDF
613

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barker W. H., Mullooly J. P. Pneumonia and influenza deaths during epidemics: implications for prevention. Arch Intern Med. 1982 Jan;142(1):85–89. [PubMed] [Google Scholar]
  2. EICKHOFF T. C., SHERMAN I. L., SERFLING R. E. Observations on excess mortality associated with epidemic influenza. JAMA. 1961 Jun 3;176:776–782. doi: 10.1001/jama.1961.03040220024005. [DOI] [PubMed] [Google Scholar]
  3. Garvie D. G., Gray J. Outbreak of respiratory syncytial virus infection in the elderly. Br Med J. 1980 Nov 8;281(6250):1253–1254. doi: 10.1136/bmj.281.6250.1253-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Glezen W. P. Serious morbidity and mortality associated with influenza epidemics. Epidemiol Rev. 1982;4:25–44. doi: 10.1093/oxfordjournals.epirev.a036250. [DOI] [PubMed] [Google Scholar]
  5. Hart R. J. An outbreak of respiratory syncytial virus infection in an old people's home. J Infect. 1984 May;8(3):259–261. doi: 10.1016/s0163-4453(84)94075-1. [DOI] [PubMed] [Google Scholar]
  6. Housworth J., Langmuir A. D. Excess mortality from epidemic influenza, 1957-1966. Am J Epidemiol. 1974 Jul;100(1):40–48. doi: 10.1093/oxfordjournals.aje.a112007. [DOI] [PubMed] [Google Scholar]
  7. Kitamoto O. Therapeutic effectiveness of amantadine hydrochloride in influenza A2--double blind studies. Jpn J Tuberc Chest Dis. 1968 Dec;15(1):17–26. [PubMed] [Google Scholar]
  8. Kraaijeveld C. A., Reed S. E., Macnaughton M. R. Enzyme-linked immunosorbent assay for detection of antibody in volunteers experimentally infected with human coronavirus strain 229 E. J Clin Microbiol. 1980 Oct;12(4):493–497. doi: 10.1128/jcm.12.4.493-497.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kurinczuk J. J., Nicholson K. G. Uptake of influenza vaccination by patients with serious cardiac disease. BMJ. 1989 Aug 5;299(6695):367–367. doi: 10.1136/bmj.299.6695.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Macnaughton M. R. Occurrence and frequency of coronavirus infections in humans as determined by enzyme-linked immunosorbent assay. Infect Immun. 1982 Nov;38(2):419–423. doi: 10.1128/iai.38.2.419-423.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mathur U., Bentley D. W., Hall C. B. Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill. Ann Intern Med. 1980 Jul;93(1):49–52. doi: 10.7326/0003-4819-93-1-49. [DOI] [PubMed] [Google Scholar]
  12. Morales F., Calder M. A., Inglis J. M., Murdoch P. S., Williamson J. A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus. J Infect. 1983 Nov;7(3):236–247. doi: 10.1016/s0163-4453(83)97142-6. [DOI] [PubMed] [Google Scholar]
  13. Nicholson K. G. Antiviral therapy. Respiratory infections, genital herpes, and herpetic keratitis. Lancet. 1984 Sep 15;2(8403):617–621. doi: 10.1016/S0140-6736(84)90604-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Nicholson K. G., Wiselka M. J., May A. Influenza vaccination of the elderly: perceptions and policies of general practitioners and outcome of the 1985-86 immunization programme in Trent, UK. Vaccine. 1987 Dec;5(4):302–306. doi: 10.1016/0264-410x(87)90156-3. [DOI] [PubMed] [Google Scholar]
  15. Pachucki C. T., Lentino J. R., Jackson G. G. Attitudes and behavior of health care personnel regarding the use and efficacy of influenza vaccine. J Infect Dis. 1985 Jun;151(6):1170–1171. doi: 10.1093/infdis/151.6.1170. [DOI] [PubMed] [Google Scholar]
  16. Patriarca P. A., Weber J. A., Parker R. A., Hall W. N., Kendal A. P., Bregman D. J., Schonberger L. B. Efficacy of influenza vaccine in nursing homes. Reduction in illness and complications during an influenza A (H3N2) epidemic. JAMA. 1985 Feb 22;253(8):1136–1139. [PubMed] [Google Scholar]
  17. SALK J. E., RAPALSKI A. J. Evaluation of influenza vaccine in an explosive epidemic of mixed etiology. U S Armed Forces Med J. 1958 Apr;9(4):469–478. [PubMed] [Google Scholar]
  18. Sorvillo F. J., Huie S. F., Strassburg M. A., Butsumyo A., Shandera W. X., Fannin S. L. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect. 1984 Nov;9(3):252–256. doi: 10.1016/s0163-4453(84)90530-9. [DOI] [PubMed] [Google Scholar]
  19. Sérié C., Barme M., Hannoun C., Thibon M., Beck H., Aquino J. P. Effects of vaccination on an influenza epidemic in a geriatric hospital. Dev Biol Stand. 1977 Jun 1;39:317–321. [PubMed] [Google Scholar]
  20. Taylor D. N., Echeverria P., Blaser M. J., Pitarangsi C., Blacklow N., Cross J., Weniger B. G. Polymicrobial aetiology of travellers' diarrhoea. Lancet. 1985 Feb 16;1(8425):381–383. doi: 10.1016/s0140-6736(85)91397-2. [DOI] [PubMed] [Google Scholar]

Articles from Epidemiology and Infection are provided here courtesy of Cambridge University Press

RESOURCES